Objective: The primary aim of this study was to investigate the effects of exercise with and without self-initiated unclassified therapeutic tremors (SUTT) on dynamic balance performance and general anxiety in individuals with Parkinson’s disease (IwPD).

Background: IwPD experience symptoms aggravated by distress, including postural instability and anxiety. SUTT, utilised in some recently-popular body-based stress-relief therapies, is hypothesised to be an innate mammalian response that allows the nervous system to reorganise. This study explored whether evoking these tremors through relaxation exercises could improve clinical outcomes beyond standard relaxation alone.

Method: Thirty-six individuals with idiopathic PD (Hoehn & Yahr I-III) participated in a double-blinded randomised time-series study. Participants were allocated to 9-week interventions: i) SUTT (n=14; 72.7±7.5 years); ii) exercise and relaxation (EAR) (n=10, 70.3±5.7 years); or iii) a non-exercising waitlist control (n=12; 69.6±8.3 years). Outcomes included the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Mini Balance Evaluation Systems Test (Mini-BESTest) and the General Anxiety Disorder-7 (GAD-7) questionnaire.

Results: Groups did not differ at baseline (p>0.05). Following the 9-week intervention, the SUTT group demonstrated no significant change in overall MiniBESTest score, however there was a statistically significant improvement in the cognitive timed-up and go (CTUG) duration (p=0.028). The SUTT group also showed significant improvements in MDS-UPDRS II (motor experience of ADL) scores, decreasing by 11.2% (p=0.022), and 28.9% reduction in postural instability-gait difficulty (PIGD) subtype scores (p=0.046). No significant changes were found for MDS-UPDRS III, tremor dominance, or akinetic-rigid sub-scores (p>0.05). The EAR group showed a significant increase in stability of gait domain in the Mini-BESTest (p=0.02) and GAD-7 scores (p=0.044).

Conclusion: Supervised relaxation exercises are a viable therapy for IwPD. While exercises without SUTT benefited dynamic gait and anxiety, the addition of SUTT specifically enhanced motor experiences of ADL and PIGD subtype scores, with significant gains in functional mobility such as dual-tasking gait. These findings suggest SUTT may help with reducing the attentional demands of ADL, though further research in stress-vulnerable populations is warranted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beyond-relaxation-can-self-initiated-therapeutic-tremors-improve-functional-gait-and-adl-in-parkinsons-disease/