BACKGROUND: Although performance rating scales, spiral drawing, water pouring, and accelerometry are commonly used to assess tremor severity, the extent to which their results correlate with impairment in activities of daily living (ADL) remains unclear. OBJECTIVE: The aim was to identify the most effective predictors of ADL in essential tremor (ET). METHODS: Forty ET patients were examined using The Essential Tremor Rating Assessment Scale (TETRAS), spiral drawing, volume of water spilled, and accelerometric tremor power. Root-mean-square error, R2, and F-test were calculated for models predicting TETRAS ADL subscore. RESULTS: TETRAS Performance Subscale explained the variability in TETRAS ADL with an R2 value of 0.686. Models incorporating spiral rating and accelerometric tremor power (R2 = 0.731) and water spillage volume (R2 = 0.756) were not statistically superior. CONCLUSIONS: TETRAS performance subscore predicted nearly 70% ADL impairment in ET patients. Incorporating the spiral rating, accelerometric tremor power, and water pouring test did not enhance ADL estimation.

Department of Biomedical Informatics Faculty of Biomedical Engineering Czech Technical University Prague Kladno Czech Republic

Department of Circuit Theory Faculty of Electrical Engineering Czech Technical University Prague Prague Czech Republic

Department of Neurology and Center of Clinical Neuroscience Charles University 1st Faculty of Medicine and General University Hospital Prague Prague Czech Republic

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Louis ED, Ottman R, Hauser WA. How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord 1998;13:5–10. PubMed

Fahn S, Tolosa E, Marín C. Clinical rating scale for tremor. In: Jankovic J, Tolosa E, eds. Parkinson's Disease and Movement Disorders. 2nd ed. Baltimore: Williams and Wilkins; 1993:271–280.

Elble R, Comella C, Fahn S, et al. Reliability of a new scale for essential tremor. Mov Disord 2012;27:1567–1569. PubMed PMC

Elble RJ, Pullman SL, Matsumoto JY, Raethjen J, Deuschl G, Tintner R. Tremor amplitude is logarithmically related to 4‐ and 5‐point tremor rating scales. Brain 2006;129:2660–2666. PubMed

Elble R, Bain P, Forjaz MJ, et al. Task force report: scales for screening and evaluating tremor: critique and recommendations. Mov Disord 2013;28:1793–1800. PubMed

Elble RJ, Ondo W. Tremor rating scales and laboratory tools for assessing tremor. J Neurol Sci 2022;435:120202. PubMed

Bain PG, Findley LJ. Assessing Tremor Severity: A Clinical Handbook. London: Smith‐Gordon; 1993.

Louis ED, Gillman A, Boschung S, Hess CW, Yu Q, Pullman SL. High width variability during spiral drawing: further evidence of cerebellar dysfunction in essential tremor. Cerebellum 2012;11:872–879. PubMed

Louis ED, Ford B, Wendt KJ, Lee H, Andrews H. A comparison of different bedside tests for essential tremor. Mov Disord 1999;14:462–467. PubMed

Kraus PH, Hoffmann A. Spiralometry: computerized assessment of tremor amplitude on the basis of spiral drawing. Mov Disord 2010;25:2164–2170. PubMed

Haubenberger D, Kalowitz D, Nahab FB, et al. Validation of digital spiral analysis as outcome parameter for clinical trials in essential tremor. Mov Disord 2011;26:2073–2080. PubMed PMC

Kim CY, Luo L, Yu Q, et al. Repeated spiral drawings in essential tremor: a possible limb‐based measure of motor learning. Cerebellum 2019;18:178–187. PubMed

Elble RJ, Brilliant M, Leffler K, Higgins C. Quantification of essential tremor in writing and drawing. Mov Disord 1996;11:70–78. PubMed

Hess CW, Pullman SL. Tremor: clinical phenomenology and assessment techniques. Tremor Other Hyperkinet Mov (NY) 2012;2:tre‐02‐65‐365‐1. PubMed PMC

R Core Team . R: A language and environment for statistical computing (Version 4.3.1) [Computer software] R Foundation for Statistical Computing; https://www.R-project.org/ 2023.

Elble RJ. The essential tremor rating assessment scale. J Neurol Neuromedicine 2016;1(4):34–38. PubMed

Louis ED, Wendt KJ, Albert SM, Pullman SL, Yu Q, Andrews H. Validity of a performance‐based test of function in essential tremor. Arch Neurol 1999;56:841–846. PubMed

van der Veen S, Klamer MR, Elting JWJ, Koelman J, van der Stouwe AMM, Tijssen MAJ. The diagnostic value of clinical neurophysiology in hyperkinetic movement disorders: a systematic review. Parkinsonism Relat Disord 2021;89:176–185. PubMed

van der Stouwe AM, Elting JW, van der Hoeven JH, et al. How typical are ‘typical’ tremor characteristics? Sensitivity and specificity of five tremor phenomena. Parkinsonism Relat Disord 2016;30:23–28. PubMed

Gauthier‐Lafreniere E, Aljassar M, Rymar VV, Milton J, Sadikot AF. A standardized accelerometry method for characterizing tremor: application and validation in an ageing population with postural and action tremor. Front Neuroinform 2022;16:878279. PubMed PMC

van Brummelen EMJ, Ziagkos D, de Boon WMI, et al. Quantification of tremor using consumer product accelerometry is feasible in patients with essential tremor and Parkinson's disease: a comparative study. J Clin Mov Disord 2020;7:4. PubMed PMC

Ulmanova O, Homann CN, Ulman R, et al. Tremor magnitude: a single index to assess writing and drawing in essential tremor. Parkinsonism Relat Disord 2007;13:250–253. PubMed

Bain PG, Findley LJ, Atchison P, et al. Assessing tremor severity. J Neurol Neurosurg Psychiatry 1993;56:868–873. PubMed PMC