Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor

Introduction: Primary Orthostatic Tremor (POT) is a rare hyperkinetic movement disorder characterized by unsteadiness while standing, often exacerbated by anxiety and fatigue. It significantly impairs quality of life, and current treatment options are limited, with invasive procedures carrying notab...

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Main Authors: Viktoria Azoidou, Alexandra Zirra, Thomas Boyle, David Gallagher, Alastair John Noyce, Cristina Simonet
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Clinical Parkinsonism & Related Disorders
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590112525000830
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author Viktoria Azoidou
Alexandra Zirra
Thomas Boyle
David Gallagher
Alastair John Noyce
Cristina Simonet
author_facet Viktoria Azoidou
Alexandra Zirra
Thomas Boyle
David Gallagher
Alastair John Noyce
Cristina Simonet
author_sort Viktoria Azoidou
collection DOAJ
description Introduction: Primary Orthostatic Tremor (POT) is a rare hyperkinetic movement disorder characterized by unsteadiness while standing, often exacerbated by anxiety and fatigue. It significantly impairs quality of life, and current treatment options are limited, with invasive procedures carrying notable risks. Methods: This unblinded interventional study assessed the usability, safety, and tolerability of the CUE1, a non-invasive vibrotactile stimulation device worn on the sternum. Secondary exploratory outcomes included objective measures of balance and mobility: maximal stance time, tandem walk, heel raise hold, tandem stance, and Timed Up and Go (TUG) with and without dual tasking (DT). Assessments were performed at baseline, immediately after a 20-minute acclimatization session, and after 9 weeks of daily use (8 h/day). Patient-reported outcomes on fatigue, anxiety, and perceived change were also collected. Results: Ten participants with POT (70 % female, aged 58–88 years) completed the study. Compliance and tolerability were excellent (100 %), with only mild, transient skin irritation reported in two cases. Immediate post-intervention improvements were observed in TUG [-1.22 s (95 % CI: −2.03, −0.26), p = 0.020], tandem stance [+1.41 s (0.00, 6.13), p = 0.025], tandem walk [+0.50 steps (0.00, 2.50), p = 0.042], and heel raise hold [+1.62 s (1.00, 3.32), p = 0.020]. After 9 weeks, improvements were observed in TUG [-2.13 s (−4.00, −0.26), p = 0.028], TUG-DT [-7.51 s (−14.88, −0.14), p = 0.047], tandem stance [+9.06 s (1.04, 17.08), p = 0.028], fatigue [-7.00 (−13.63, −0.37), p = 0.035], and patient-reported impression of change [+1.10 (0.14, 2.06), p = 0.027]. Conclusion: CUE1 vibrotactile stimulation is safe, well-tolerated, and shows promise in improving balance, mobility, and fatigue in POT. Larger, controlled trials are warranted.
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spelling doaj-art-a5c078ba4c58437e9ea0b2fe593320022025-08-20T03:44:27ZengElsevierClinical Parkinsonism & Related Disorders2590-11252025-01-011310037910.1016/j.prdoa.2025.100379Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremorViktoria Azoidou0Alexandra Zirra1Thomas Boyle2David Gallagher3Alastair John Noyce4Cristina Simonet5Centre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom; Corresponding authors at: Centre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.Centre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United KingdomOlder Person’s Services & GIM Special Interest in Parkinson’s Disease, Royal London Hospital, United KingdomDepartment of Neurology, Royal London Hospital, Barts Health, London, United KingdomCentre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom; Department of Neurology, Royal London Hospital, Barts Health, London, United KingdomCentre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom; Neurology Department, Homerton Healthcare NHS Foundation Trust, United Kingdom; Corresponding authors at: Centre for Preventive Neurology, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.Introduction: Primary Orthostatic Tremor (POT) is a rare hyperkinetic movement disorder characterized by unsteadiness while standing, often exacerbated by anxiety and fatigue. It significantly impairs quality of life, and current treatment options are limited, with invasive procedures carrying notable risks. Methods: This unblinded interventional study assessed the usability, safety, and tolerability of the CUE1, a non-invasive vibrotactile stimulation device worn on the sternum. Secondary exploratory outcomes included objective measures of balance and mobility: maximal stance time, tandem walk, heel raise hold, tandem stance, and Timed Up and Go (TUG) with and without dual tasking (DT). Assessments were performed at baseline, immediately after a 20-minute acclimatization session, and after 9 weeks of daily use (8 h/day). Patient-reported outcomes on fatigue, anxiety, and perceived change were also collected. Results: Ten participants with POT (70 % female, aged 58–88 years) completed the study. Compliance and tolerability were excellent (100 %), with only mild, transient skin irritation reported in two cases. Immediate post-intervention improvements were observed in TUG [-1.22 s (95 % CI: −2.03, −0.26), p = 0.020], tandem stance [+1.41 s (0.00, 6.13), p = 0.025], tandem walk [+0.50 steps (0.00, 2.50), p = 0.042], and heel raise hold [+1.62 s (1.00, 3.32), p = 0.020]. After 9 weeks, improvements were observed in TUG [-2.13 s (−4.00, −0.26), p = 0.028], TUG-DT [-7.51 s (−14.88, −0.14), p = 0.047], tandem stance [+9.06 s (1.04, 17.08), p = 0.028], fatigue [-7.00 (−13.63, −0.37), p = 0.035], and patient-reported impression of change [+1.10 (0.14, 2.06), p = 0.027]. Conclusion: CUE1 vibrotactile stimulation is safe, well-tolerated, and shows promise in improving balance, mobility, and fatigue in POT. Larger, controlled trials are warranted.http://www.sciencedirect.com/science/article/pii/S2590112525000830Vibrotactile stimulationOrthostatic tremorAnxiety, fatigueBalance control
spellingShingle Viktoria Azoidou
Alexandra Zirra
Thomas Boyle
David Gallagher
Alastair John Noyce
Cristina Simonet
Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
Clinical Parkinsonism & Related Disorders
Vibrotactile stimulation
Orthostatic tremor
Anxiety, fatigue
Balance control
title Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
title_full Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
title_fullStr Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
title_full_unstemmed Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
title_short Usability, safety and tolerability of CUE1 vibrotactile device as promising therapeutic approach in orthostatic tremor
title_sort usability safety and tolerability of cue1 vibrotactile device as promising therapeutic approach in orthostatic tremor
topic Vibrotactile stimulation
Orthostatic tremor
Anxiety, fatigue
Balance control
url http://www.sciencedirect.com/science/article/pii/S2590112525000830
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