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What is the role of physiotherapist in handling tremor? Tremor is rhythmic oscillation of limbs, trunk, head, or tongue. 3 types: 1 Resting tremor- worst at rest .eg from parkinsonism (±bradykinesia and rigidity; tremor is more resistant to treatment than other symptoms). It is usually a slow tremor (frequency of 3–5Hz), typically ‘pill-rolling’ of the thumb over a finger. 2 Postural tremor —worst if arms are outstretched. Typically rapid (8–12Hz). May be exaggerated physiological tremor (eg anxiety, hyperthyroidism, alcohol, drugs), due to brain damage (eg Wilson’s disease, syphilis) or benign essential tremor (BET). This is often familial (autosomal dominant) tremor of arms and head presenting at any age. Cogwheeling may occur, 66 but there is no bradykinesia. It is suppressed by alcohol, and patients may self-medicate rather than admit problems. Rarely progressive (unless onset is unilateral). Propranolol (40–80mg/8–12h PO) can help, but not in all patients. 3 Intention tremor- worst on movement, seen in cerebellar disease, with pastpointing and dysdiadochokinesis. No effective drug has been found. #physioscare #physiotherapyathome #physiotherapyhomeservices #tremor #parkinson #bestphysiotherapyserviceinpune #physiotherapy