Session Information
Date: Tuesday, June 6, 2017
Session Title: Tremor
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: The objective of this study was to determine if there is impairment of balance in orthostatic tremor patients which is against the current thinking that balance is normal in this patient population due to infrequent falls.
Background: Orthostatic Tremor (OT) is a rare movement disorder characterized by a sensation of unsteadiness and high frequency tremors present only upon standing. The pathophysiology of OT is not well understood and there are many proposed theories. There is a strong relationship between a sensation of instability and the presence of OT. The etiological direction of this association is unclear at this point. Despite the sensation of unsteadiness, OT patients rarely fall. Due to the lack of falls, balance in OT has previously been presumed to be normal. We present a prospective study comparing balance assessment in patients with OT versus normal controls.
Methods: We prospectively enrolled OT patients and spousal controls. Participants underwent evaluations of balance by blinded physical therapists (PT). PT assessment included Berg Balance Scale (BBS), Functional Gait Assessment (FGA), Dynamic Gait Index (DGI), Unipedal Stance Test (UST), Functional Reach Test (FRT), pull test (PuT), gait speed (GS) and five times sit to stand (FTSS). All of these functional scales have been validated and are widely used by PT.
Results: There were statistically significant differences between OT patients and controls on BBS, FGA, DGI, UST, FRT and PT.
Conclusions: Common balance scales are abnormal in OT. Current scales seem unable to differentiate between fear of falling and true imbalance. Further studies are needed to elucidate the factors that might play a role in these results including cerebellar dysfunction and fear of falling.
References: 1. Heilman, K. M. (1984, Aug). Orthostatic tremor. Arch Neurol, 8, 880-1.
2. Deuschl, G., & Brian, P. B. (1998). Consensus statement of the Movement Disorder Society
on Tremor. Ad Hoc Scientific Committee. Mov Disord, 13(Suppl 3), 2-23.
To cite this abstract in AMA style:
D. Bhatti, R. Thompson, x. yiwen, A. Hellman, J. Mckune, L. Schmaderer, K. Suing, C. Penke, R. Iske, B.J. Roeder, K.-C. Siu, J. Bertoni, D. Torres-Russotto. Ascertainment of Impaired Balance in Orthostatic Tremor Patients [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/ascertainment-of-impaired-balance-in-orthostatic-tremor-patients/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/ascertainment-of-impaired-balance-in-orthostatic-tremor-patients/