{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T16:53:43Z","timestamp":1788627223258,"version":"build-2803163510"},"reference-count":59,"publisher":"ASME International","issue":"8","content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:p>Although tremor is the most common movement disorder, there are few noninvasive treatment options. Creating effective tremor suppression devices requires a knowledge of where tremor originates mechanically (which muscles) and how it propagates through the limb (to which degrees-of-freedom (DOF)). To simulate tremor propagation, we created a simple model of the upper limb, with tremorogenic activity in the 15 major superficial muscles as inputs and tremulous joint displacement in the seven major DOF as outputs. The model approximated the muscle excitation\u2013contraction dynamics, musculoskeletal geometry, and mechanical impedance of the limb. From our simulations, we determined fundamental principles for tremor propagation: (1) The distribution of tremor depends strongly on musculoskeletal dynamics. (2) The spreading of tremor is due to inertial coupling (primarily) and musculoskeletal geometry (secondarily). (3) Tremorogenic activity in a given muscle causes significant tremor in only a small subset of DOF, though these affected DOF may be distant from the muscle. (4) Assuming uniform distribution of tremorogenic activity among muscles, tremor increases proximal-distally, and the contribution from muscles increases proximal-distally. (5) Although adding inertia (e.g., with weighted utensils) is often used to suppress tremor, it is possible to increase tremor by adding inertia to the wrong DOF. (6) Similarly, adding viscoelasticity to the wrong DOF can increase tremor. Based solely on the musculoskeletal system, these principles indicate that tremor treatments targeting muscles should focus first on the distal muscles, and devices targeting DOF should focus first on the distal DOF.<\/jats:p>","DOI":"10.1115\/1.4043442","type":"journal-article","created":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T00:22:43Z","timestamp":1554855763000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":22,"title":["Simulated Tremor Propagation in the Upper Limb: From Muscle Activity to Joint Displacement"],"prefix":"10.1115","volume":"141","author":[{"given":"Thomas H.","family":"Corie","sequence":"first","affiliation":[{"name":"Mechanical Engineering, 350 EB, Provo, UT 84602"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven K.","family":"Charles","sequence":"additional","affiliation":[{"name":"Mechanical Engineering and Neuroscience, Brigham Young University, 350 EB, Provo, UT 84602 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"issue":"1","key":"2019100320083550900_bib1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Consensus Statement on the Classification of Tremors. From the Task Force on Tremor of the International Parkinson and Movement Disorder Society","volume":"33","year":"2018","journal-title":"Mov. Disord."},{"issue":"6","key":"2019100320083550900_bib2","first-page":"510","article-title":"Tremor Disorders. Diagnosis and Management","volume":"162","year":"1995","journal-title":"West. J. Med."},{"issue":"1","key":"2019100320083550900_bib3","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/1743-0003-10-36","article-title":"A Neuroprosthesis for Tremor Management Through the Control of Muscle Co-Contraction","volume":"10","year":"2013","journal-title":"J. NeuroEng. Rehabil."},{"issue":"S3","key":"2019100320083550900_bib4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1002\/mds.870131303","article-title":"Consensus Statement of the Movement Disorder Society on Tremor","volume":"13","year":"2008","journal-title":"Mov. Disord."},{"issue":"5","key":"2019100320083550900_bib5","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1002\/mds.22838","article-title":"How Common Is the Most Common Adult Movement Disorder? Update on the Worldwide Prevalence of Essential Tremor","volume":"25","year":"2010","journal-title":"Mov. Disord."},{"key":"2019100320083550900_bib6","doi-asserted-by":"publisher","first-page":"259","DOI":"10.7916\/D8TT4P4B","article-title":"How Many People in the USA Have Essential Tremor?, Deriving a Population Estimate Based Epidemiological Data","volume":"4","year":"2014","journal-title":"Tremor Other Hyperkinetic Mov."},{"issue":"7","key":"2019100320083550900_bib7","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1212\/WNL.36.7.1001","article-title":"Disability in Essential Tremor: Effect of Treatment,\u201c (in Eng)","volume":"36","year":"1986","journal-title":"Neurology"},{"issue":"6","key":"2019100320083550900_bib8","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.parkreldis.2005.05.009","article-title":"Quality of Life in Essential Tremor Questionnaire (QUEST): Development and Initial Validation","volume":"11","year":"2005","journal-title":"Parkinsonism Relat. Disord."},{"key":"2019100320083550900_bib9","doi-asserted-by":"publisher","first-page":"331","DOI":"10.7916\/D87080M9","article-title":"Defining the Treatment Gap: What Essential Tremor Patients Want That They Are Not Getting","volume":"5","year":"2015","journal-title":"Tremor Other Hyperkinetic Mov."},{"issue":"12","key":"2019100320083550900_bib10","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1212\/01.WNL.0000163769.28552.CD","article-title":"Practice Parameter: Therapies for Essential Tremor","volume":"64","year":"2005","journal-title":"Neurology"},{"issue":"2","key":"2019100320083550900_bib11","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/S1474-4422(10)70322-7","article-title":"Treatment of Patients With Essential Tremor","volume":"10","year":"2011","journal-title":"Lancet Neurol."},{"issue":"6","key":"2019100320083550900_bib12","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1111\/j.1468-1331.2009.02926.x","article-title":"How Are We Doing With the Treatment of Essential Tremor (ET)?","volume":"17","year":"2010","journal-title":"Eur. J. Neurol."},{"issue":"9","key":"2019100320083550900_bib13","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.parkreldis.2010.07.011","article-title":"Survey of Medication Usage Patterns Among Essential Tremor Patients: Movement Disorder Specialists vs. general Neurologists","volume":"16","year":"2010","journal-title":"Parkinsonism Relat. Disord."},{"issue":"1","key":"2019100320083550900_bib14","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s13311-013-0230-5","article-title":"The Treatment of Tremor","volume":"11","year":"2014","journal-title":"Neurotherapeutics"},{"issue":"11","key":"2019100320083550900_bib15","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1002\/mds.23195","article-title":"Deep Brain Stimulation for Essential Tremor: A Systematic Review","volume":"25","year":"2010","journal-title":"Mov. Disord."},{"key":"2019100320083550900_bib16","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.parkreldis.2017.03.017","article-title":"Thalamic DBS With a Constant-Current Device in Essential Tremor: A Controlled Clinical Trial","volume":"40","year":"2017","journal-title":"Parkinsonism Relat. Disord."},{"key":"2019100320083550900_bib17","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.nicl.2016.11.019","article-title":"Probabilistic Mapping of Deep Brain Stimulation Effects in Essential Tremor","volume":"13","year":"2017","journal-title":"NeuroImage: Clin."},{"issue":"4","key":"2019100320083550900_bib18","doi-asserted-by":"publisher","first-page":"506","DOI":"10.3171\/jns.2006.104.4.506","article-title":"Long-Term Evaluation of Deep Brain Stimulation of the Thalamus","volume":"104","year":"2006","journal-title":"J. Neurosurg."},{"key":"2019100320083550900_bib19","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.jns.2016.06.001","article-title":"Reduction in DBS Frequency Improves Balance Difficulties After Thalamic DBS for Essential Tremor","volume":"367","year":"2016","journal-title":"J. Neurol. Sci."},{"issue":"2\u20133","key":"2019100320083550900_bib20","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1159\/000094035","article-title":"Are Complications Less Common in Deep Brain Stimulation Than in Ablative Procedures for Movement Disorders?","volume":"84","year":"2006","journal-title":"Stereotactic Funct. Neurosurg."},{"issue":"7","key":"2019100320083550900_bib21","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.parkreldis.2013.03.006","article-title":"Loss of Benefit in VIM Thalamic Deep Brain Stimulation (DBS) for Essential Tremor (ET): How Prevalent Is It?","volume":"19","year":"2013","journal-title":"Parkinsonism Relat. Disord."},{"issue":"10","key":"2019100320083550900_bib22","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1136\/jnnp.74.10.1387","article-title":"Multicentre European Study of Thalamic Stimulation in Essential Tremor: A Six Year Follow Up","volume":"74","year":"2003","journal-title":"J. Neurol., Neurosurg., Psychiatry"},{"issue":"5","key":"2019100320083550900_bib23","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1136\/jnnp-2013-304943","article-title":"The Safety and Efficacy of Thalamic Deep Brain Stimulation in Essential Tremor: 10 Years and Beyond","volume":"85","year":"2014","journal-title":"J. Neurol., Neurosurg. Psychiatry"},{"issue":"4","key":"2019100320083550900_bib24","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1002\/mdc3.12185","article-title":"Estimating the Proportion of Essential Tremor and Parkinson's Disease Patients Undergoing Deep Brain Stimulation Surgery: Five\u2010Year Data From Columbia University Medical Center (2009\u20132014)","volume":"2","year":"2015","journal-title":"Mov. Disord. Clin. Pract."},{"issue":"4","key":"2019100320083550900_bib25","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1007\/s10439-016-1765-5","article-title":"Fundamental Principles of Tremor Propagation in the Upper Limb","volume":"45","year":"2017","journal-title":"Ann. Biomed. Eng."},{"issue":"4","key":"2019100320083550900_bib26","doi-asserted-by":"publisher","first-page":"e0153739","DOI":"10.1371\/journal.pone.0153739","article-title":"Functional Ability Improved in Essential Tremor by IncobotulinumtoxinA Injections Using Kinematically Determined Biomechanical Patterns\u2014A New Future","volume":"11","year":"2016","journal-title":"PLoS One"},{"issue":"6","key":"2019100320083550900_bib27","doi-asserted-by":"publisher","first-page":"e0178670","DOI":"10.1371\/journal.pone.0178670","article-title":"Long-Term Tremor Therapy for Parkinson and Essential Tremor With Sensor-Guided Botulinum Toxin Type a Injections","volume":"12","year":"2017","journal-title":"PLoS One"},{"issue":"3","key":"2019100320083550900_bib28","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1109\/TNSRE.2014.2328296","article-title":"Online Tremor Suppression Using Electromyography and Low-Level Electrical Stimulation","volume":"23","year":"2015","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"2019100320083550900_bib29","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.mechatronics.2015.10.008","article-title":"Repetitive Control of Functional Electrical Stimulation for Induced Tremor Suppression","volume":"32","year":"2015","journal-title":"Mechatronics"},{"issue":"10","key":"2019100320083550900_bib30","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s11517-011-0803-6","article-title":"Electrical Stimulation for the Suppression of Pathological Tremor","volume":"49","year":"2011","journal-title":"Medical Biol. Eng. Comput."},{"issue":"2","key":"2019100320083550900_bib31","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/BF02368521","article-title":"Attenuation of Pathological Tremors by Functional Electrical-Stimulation\u20141: Method","volume":"20","year":"1992","journal-title":"Ann. Biomed. Eng."},{"key":"2019100320083550900_bib32","volume-title":"Biomechanics and Motor Control of Human Movement","year":"2009"},{"key":"2019100320083550900_bib33","volume-title":"Human Robotics","year":"2013"},{"issue":"6","key":"2019100320083550900_bib34","doi-asserted-by":"publisher","first-page":"4244","DOI":"10.1152\/jn.00404.2005","article-title":"Optimal Control of Redundant Muscles in Step-Tracking Wrist Movements","volume":"94","year":"2005","journal-title":"J. Neurophysiol."},{"issue":"13","key":"2019100320083550900_bib35","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1080\/10255842.2014.916698","article-title":"Benchmarking of Dynamic Simulation Predictions in Two Software Platforms Using an Upper Limb Musculoskeletal Model","volume":"18","year":"2015","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"issue":"4","key":"2019100320083550900_bib36","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/j.jbiomech.2006.11.011","article-title":"Upper Limb Muscle Volumes in Adult Subjects","volume":"40","year":"2007","journal-title":"J. Biomech."},{"issue":"11","key":"2019100320083550900_bib37","doi-asserted-by":"publisher","first-page":"2442","DOI":"10.1016\/j.jbiomech.2006.11.013","article-title":"Moment-Generating Capacity of Upper Limb Muscles in Healthy Adults","volume":"40","year":"2007","journal-title":"J. Biomech."},{"issue":"6","key":"2019100320083550900_bib38","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1007\/s10439-005-3320-7","article-title":"A Model of the Upper Extremity for Simulating Musculoskeletal Surgery and Analyzing Neuromuscular Control","volume":"33","year":"2005","journal-title":"Ann. Biomed. Eng."},{"issue":"5","key":"2019100320083550900_bib39","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1016\/j.jbiomech.2004.05.042","article-title":"ISB Recommendation on Definitions of Joint Coordinate Systems of Various Joints for the Reporting of Human Joint Motion\u2014Part II: Shoulder, Elbow, Wrist and Hand","volume":"38","year":"2005","journal-title":"J. Biomech."},{"issue":"4","key":"2019100320083550900_bib40","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1152\/jn.01014.2011","article-title":"The Passive Stiffness of the Wrist and Forearm","volume":"108","year":"2012","journal-title":"J. Neurophysiol."},{"issue":"9","key":"2019100320083550900_bib41","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1007\/s10439-014-1054-0","article-title":"Passive Stiffness of Coupled Wrist and Forearm Rotations","volume":"42","year":"2014","journal-title":"Ann. Biomed. Eng."},{"issue":"8","key":"2019100320083550900_bib42","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1109\/TBME.2014.2313532","article-title":"Position-Dependent Characterization of Passive Wrist Stiffness","volume":"61","year":"2014","journal-title":"IEEE Trans. Bio-Med. Eng."},{"issue":"9","key":"2019100320083550900_bib43","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/0021-9290(95)00178-6","article-title":"Adjustments to Zatsiorsky-Seluyanov's Segment Inertia Parameters","volume":"29","year":"1996","journal-title":"J. Biomech."},{"key":"2019100320083550900_bib44","volume-title":"Robotics, Vision and Control: Fundamental Algorithms in MATLAB\u00ae Second, Completely Revised, Extended and Updated Edition","year":"2017"},{"key":"2019100320083550900_bib45","doi-asserted-by":"crossref","unstructured":"Matsumoto, Y.,  Seki, M., Ando, T., Kobayashi, Y.,  Iijima, H., Nagaoka, M., and Fujie, G. M., 2012, \u201cAnalysis of EMG Signals of Patients With Essential Tremor Focusing on the Change of Tremor Frequency,\u201d Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), San Diego, CA, Aug. 28\u2013Sept. 1, pp. 2244\u20132250.10.1109\/EMBC.2012.6346409","DOI":"10.1109\/EMBC.2012.6346409"},{"key":"2019100320083550900_bib46","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.neuroscience.2016.03.028","article-title":"Nonlinear Interactions in the Thalamocortical Loop in Essential Tremor: A Model-Based Frequency Domain Analysis","volume":"324","year":"2016","journal-title":"Neuroscience"},{"issue":"1","key":"2019100320083550900_bib47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2200\/S00129ED1V01Y200807BME020","article-title":"Tremor: From Pathogenesis to Treatment","volume":"3","year":"2008","journal-title":"Synth. Lectures Biomed. Eng."},{"issue":"1","key":"2019100320083550900_bib48","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.parkreldis.2010.10.006","article-title":"Synchronous Pattern Distinguishes Resting Tremor Associated With Essential Tremor From Rest Tremor of Parkinson's Disease","volume":"17","year":"2011","journal-title":"Parkinsonism Relat. Disord."},{"issue":"9","key":"2019100320083550900_bib49","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1016\/S1388-2457(01)00629-0","article-title":"Electromyographic Differentiation of Tremors","volume":"112","year":"2001","journal-title":"Clin. Neurophysiol."},{"key":"2019100320083550900_bib50","volume-title":"System Dynamics","year":"2014","edition":"3rd ed."},{"issue":"1","key":"2019100320083550900_bib51","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40648-017-0082-6","article-title":"Algorithm to Demodulate an Electromyogram Signal Modulated by Essential Tremor","volume":"4","year":"2017","journal-title":"Robomech J."},{"key":"2019100320083550900_bib52","article-title":"Anthropometric Data Explorer","year":"2014"},{"issue":"23","key":"2019100320083550900_bib53","doi-asserted-by":"publisher","first-page":"8925","DOI":"10.1523\/JNEUROSCI.0106-15.2015","article-title":"The Phase Difference Between Neural Drives to Antagonist Muscles in Essential Tremor Is Associated With the Relative Strength of Supraspinal and Afferent Input","volume":"35","year":"2015","journal-title":"J. Neurosci."},{"issue":"1","key":"2019100320083550900_bib54","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/brain\/117.1.39","article-title":"Rapid Wrist Movements in Patients With Essential Tremor. The Critical Role of the Second Agonist Burst","volume":"117","year":"1994","journal-title":"Brain: J. Neurol."},{"issue":"43","key":"2019100320083550900_bib55","doi-asserted-by":"publisher","first-page":"14475","DOI":"10.1523\/JNEUROSCI.0087-14.2014","article-title":"Thalamomuscular Coherence in Essential Tremor: Hen or Egg in the Emergence of Tremor?","volume":"34","year":"2014","journal-title":"J. Neurosci."},{"issue":"8","key":"2019100320083550900_bib56","doi-asserted-by":"publisher","first-page":"2178","DOI":"10.1109\/TBME.2011.2118756","article-title":"A Model of the Surface Electromyogram in Pathological Tremor","volume":"58","year":"2011","journal-title":"IEEE Trans. Biomed. Eng."},{"issue":"4","key":"2019100320083550900_bib57","first-page":"169","article-title":"Controllable Mechanical Tremor Reduction.Assessment of Two Orthoses","volume":"19","year":"2007","journal-title":"Technol. Disability"},{"issue":"3","key":"2019100320083550900_bib58","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1109\/TNSRE.2007.903917","article-title":"Design and Validation of a Rehabilitation Robotic Exoskeleton for Tremor Assessment and Suppression","volume":"15","year":"2007","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"2019100320083550900_bib59","volume-title":"Applied Dynamics","year":"2014"}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4043442\/6390173\/bio_141_08_081001.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/doi\/10.1115\/1.4043442\/6390173\/bio_141_08_081001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T00:08:48Z","timestamp":1570147728000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/doi\/10.1115\/1.4043442\/727397\/Simulated-Tremor-Propagation-in-the-Upper-Limb"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,6]]},"references-count":59,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4043442","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,6]]},"article-number":"081001"}}