Assesment of walk and balance performance in essential tremor patients

Essential tremor (ET) has been considered as a benign monosymptomatic disease for decades whereas today it is accepted as a heterogeneous syndrome with both motor and non-motor symptoms such as cognitive deficits, depression and personality traits. The coexistence of vocal cord, head, face, tongue and body tremor is considered as midline tremor which seems to be a distinct subtype of essential tremor different than pure upper extremity tremor. In this study, it was aimed to examine the walking and balance performance of Essential Tremor patients. The walking performance of the cases was evaluated with a 10 step tandem walk and their balance was evaluated with Berg Balance Test and BIODEX Balance System. FTMTÖ, Beck Anxiety Scale and MMSE were also performed. There weren't any significant differences between the two groups' characteristics, including age, sex, BMI and waist circumference. There were three prominent groups among ET patients according to the tremor location; these were bilateral upper extremity tremor group, four extremity tremor group and midline tremor group. The overall stability, anteroposterior stability and fall risk indices of patients with midline tremor were worse than other groups. ET patients were more anxious than the control group, and their anxiety scores were not related to gender and tremor scores. The most effective factor on the risk of falling was BMI. The factor that best predicted the fall in the past 6 months was the midline tremor. The balance parameters of the lower extremity tremor group were not different from the controls, and the lower extremity tremor in ET was not associated with an imbalance. Advanced disease onset age was associated with poor balance performance. It is recommended that clinicians evaluate all ET patients in terms of balance disorder, especially ET patients with midline tremor. In patients with ET, it is recommended to question anxiety as well as social and occupational disability and improve their BMI. Conducting prospective, controlled studies investigating the pathophysiology of impairment of postural and dynamic balance in ET patients and developing exercise programs to improve their balance can contribute greatly to these patients.