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RESEARCH ARTICLE | SEPTEMBER 08 2023

Investigation and development of hand tremor controlling


device 
Shelan Khudhur Saleh  ; Saleem Lateef Mohammed; Ali Al-Askery; Huda Farooq Jameel

AIP Conf. Proc. 2804, 040009 (2023)


https://doi.org/10.1063/5.0155773

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10 September 2023 13:07:52


Investigation and Development of Hand Tremor Controlling
Device
Shelan Khudhur Saleh1,a), Saleem Lateef mohammed1,b), Ali Al-Askery1,c) and
Huda Farooq Jameel1,d)
1
Electrical Engineering Technical College, Middle Technical University, Baghdad, Iraq
a)
Corresponding author: shelankhudhursaleh@gmail.com
b)
Saleem_lateef_mohammed@mtu.edu.iq
c)
a.alaskery@mtu.edu.iq
d)
huda_baban@mtu.edu.iq

Abstract. Current therapies for hand disease tremors are medication and surgery, which have demonstrated different
degrees of efficacy with the risk of serious side effects. Wearable tremor suppression devices have proven that the usage
of mechanical and electronic devices has produced positive outcomes. There are a variety of tremor suppression devices

10 September 2023 13:07:52


available. In this study, patients with hand tremor disorders were evaluated and validated for a wearable tremor arm
prototype. A motor, hand brace, microprocessor, and LCD are the main features for this system. Two preliminary tests
were carried out to evaluate the proposed device's effectiveness in suppressing tremor motion and following voluntary
movements. The results of the study show that the patients are able to control their hand tremors using a microcontroller
and a four-speed motor. Participants are chosen with age range from 38 to 60 years old and included both men and
women. Both evaluations yielded satisfactory findings for the proposed device's validation. However, the suggested
methods require more human trials to improve its performance.

Keywords. Hand Tremor, Hand Brace, Microcontroller, Motor, Wearable Tremor Arm.

INTRODUCTION

Simple activities like drinking from a glass or tying shoelaces are typically the most difficult for people with
hand tremor illnesses. Essential tremor, or ET for abbreviation, can affect anybody at any age, although it is more
frequent in people over the age of 40 years old and above (Ferenčík, Jaščur, Bundzel, & Zolotová, 2018). In
addition, Parkinson's disease (PD) was a complicated neurodegenerative condition characterized by bradykinesia,
postural instability, muscle stiffness, and resting tremor, among other motor symptoms. Although tremors were the
most well-known symptom, they were not the most common. About 75% of people with Parkinson's disease
interfere with their everyday activities and lowers their quality of life significantly(Oliveira et al., 2019).
Furthermore, the current status and future direction of action mechanisms, safety, clinical applications and
effectiveness profiles for various types of health instruments that have been used for the purpose of tremor
reduction. Similar data have been examined for potential future advancements in the medical devices to control
tremor for both clinical and biomechanical ways(Mo & Priefer, 2021). An overview of the telehealth and automatic
systems created to deal with pathological boundary, so that professionals may enhance the quality of life (QoL) with
advantages for patients who live with Parkinson's disease (LeMoyne, Mastroianni, Whiting, & Tomycz, 2020). Also,
an overview of the techniques that have been identified much further to lessen the impact of tremors. Tremor
reduction and device implementation are evaluated based on their metric system and mechanisms, which could be
additionally refined by overcoming restrictions and reducing tremor impacts(Somisetti, Jain, Chugh, & Charaya,
2020).

The Fourth Scientific Conference for Electrical Engineering Techniques Research (EETR2022)
AIP Conf. Proc. 2804, 040009-1–040009-11; https://doi.org/10.1063/5.0155773
Published by AIP Publishing. 978-0-7354-4637-3/$30.00

040009-1
To objectively analyze tremors, an inertial measurement unit (IMU) and sensors have been utilized as part of
motion capture approach. A prototype of a wearable tremor-suppression glove (WTSG) has been created, which
included a sensor glove, actuating unit, and a power transmission system cable set. This might be utilized to
mechanically inhibit Parkinsonism tremor in the index finger metacarpophalangeal (MCP) joint, thumb MCP joint,
and wrist in the flexion-extension direction without compromising voluntary movement. Offline data processing and
analysis were carried out utilizing the MATLAB program. The experimental validation was carried out using a
tremor simulator using 7 recorded data sets from Parkinson's disease patients. However, further work was required
to improve the suggested device's performance prior to human testing.(Zhou, Jenkins, Naish, & Trejos, 2018). In
addition, a new method was presented for wearable and wireless accelerometers. However, the system needs
development due to the availability of wearable and local wireless systems, wearable as well as wireless systems
(LeMoyne, Mastroianni, Whiting, & Tomycz, 2019). A soft jamming layer for hand tremor reduction was added to
the glove, coupled with a control system and sensors, to form a closed-loop feedback system. A validation of the
soft glove was provided, as well as an assessment of the influence of the installation of a jamming actuator layer.
The performance of the soft gaze was evaluated by measuring the suppression of a simulated tremor for the dorsal
and perineal nerve forms. However, the glove's performance in the actual environment, as well as its impact on
human factors during practical usage, should be taken into account(Awantha, Wanasinghe, Kavindya, Kulasekera, &
Chathuranga, 2020). Wearable technology was designed to prevent hand tremors in Parkinson's disease patients as a
mechanical therapy. The biodynamic design of the human hand was completed by viewing the hand as the main
mass-spring-damper system. Dual passive vibration absorbers were created to match tremor frequencies. The
device's performance evaluation was carried out with a temporary reaction from hand tremors. However, the active
vibration control (AVC) method can be included to prevent further residual tremors in the hands(Faizan &
Muzammil, 2020).
There are established surgical and pharmaceutical therapeutic approaches; therefore, a semi-active actuator
wearing elbow exoskeleton for tremor suppression (WEETS) was developed as an alternative support technology.
WEETS technology uses a novel magnetorheological fluid-based design and a controlled rotating semi-active

10 September 2023 13:07:52


actuator (RSAA) to minimize elbow joint tremor.(Zahedi, Wang, Martinez-Hernandez, & Zhang, 2021). A
suppression method for elbow tremor was tested using a robotic orthosis called the Tremor Suppression Orthosis
(TSO). The study places a particular emphasis on voluntary motion performance. Wearable technology is a viable
treatment for tremor elimination with minimum disruption to intentional motion(Yi, Zahedi, Wang, Tan, & Zhang,
2019). To identify the features of finger shaking and wrist shaking that can be utilized to create tremor-suppressing
tools for the hand was proposed(Zhou, Jenkins, Naish, & Trejos, 2016). The magnitudes of tremors were expressed
as velocity, acceleration, and angular displacement. Furthermore, manufacturing of a 3D-printed tremor reduction
wearable device were presented. This research presents an integrated strategy in which context-aware sensors were
used to describe voluntary and tremor movement as well as identify everyday activities. Using related information,
the system could identify the user's purpose, optimize their control, and reduce power usage by suppressing only
when required(Huen, Liu, & Lo, 2016). Furthermore, created a tool based on a wrist-attached interface for a
workspace similar to the user's arm. A device of this type was capable of exerting regulated stress on the user's wrist
and inducing a hand tremor with a frequency and amplitude comparable to those observed in handicapped people.
The gadget was controlled by a unique path algorithm that uses tremor signals obtained from patients utilizing a
motion capture monitoring system as input(Papini, Fontana, & Bergamasco, 2015).
Although, a new soft exoskeleton for tremor suppression (SETS) based on assistive technologies. The SETS
system has a magnetorheological fluid-based tunable flexible semi-active actuator. To evaluate the system's
performance, simulation studies and experimental testing were carried out(Zahedi, Zhang, Yi, & Zhang, 2021).
Moreover, a novel wrist tremor suppression exoskeleton (WTSE) system for wrist joint tremor suppression was
developed. The entire system is portable and uses extremely little energy. A small embedded acquisition platform is
used to acquire real-time tremor data. To match the tremor, the damping force could be dynamically adjusted in real-
time, and WTSE could greatly reduce wrist tremors(Zhou, Naish, Jenkins, & Trejos, 2017). Similarly, a wearable
passive device that uses magnetic actuators to reduce hand and arm vibrations have been developed as a technique to
minimize tremors that emerge during the early stages of the disease(Masoumi, Kmanzi, Wang, & Mohammadi,
2021).
The initial model was proposed, which was created using CAD software (Solid Works). MATLAB software is
used to model and run the system. In the envisioned system, two connections were linked to two servo motors
placed in orthogonal orientations. When PID and computed torque techniques are used to actively operate the
system, hand tremors on the tip of the instrument are decreased. These controllers regulate the rotation of the motors
that move the hand tremor links in various directions.(Abbasi, Afsharfard, Arasteh, & Safaie, 2018). Furthermore,

040009-2
propose a design for a wearable haptic measurement glove (HMG) and demonstrate how it may be used to collect
force and inertial data on handshakes. In order to develop intelligent shared control algorithms for nature in each
area tested, the results revealed variances in handshakes. The HMGs were able to record all of the desired data
(firmness, vigor, duration, completeness of grip, and the number of pulses) as well as define five stages of
handshakes with accuracy and consistency(Capelle, Benson, Anderson, Weinberg, & Gorlewicz, 2020). For persons
who suffer spontaneous tremors in their daily lives, a wearable technology for controlling axial vibration has been
developed. To generate interactive torques in the working environment, an investigation to the dynamic model of the
gyroscopic system has been performed. The feedback linearization approach has been applied to quantify the control
input for balancing the kinetic energy and the system state. The proposed method has been verified by means of
mechanical analysis and prototype designing. MATLAB simulations have been used to validate the effectiveness of
the mathematical dynamics of this method(Phan Van & Ngo, 2021).
This work describes the Vib-bracelet, a passive absorber device for attenuating pronation and supination tremors.
It is tailored to the frequency of the tremor and is based on the principles of dynamic vibration absorption.
Prototypes were created and tested on a human forearm mechanical model. Simulations and studies show that the
device is effective at attenuating vibrations in the 4–6 Hz frequency range, which is the frequency range of reported
tremors, with an amplitude attenuation of 85 %(Buki, Katz, Zacksenhouse, & Schlesinger, 2018).
In addition, a wearable tremor suppression (WTS) glove has been proposed to reduce tremor effect while
enabling free movement in the wrist, index and thumb joints. The WTSG is outfitted with three motors and five
IMUs that concurrently and independently measure and direct the motion of the three joints. To transfer force from
the motors to the user's joints, a transmission system with distributed cables was developed. By connecting the
WTSG to the user's forearm, this design decreases the WTSG's size and weight while increasing compliance. To
evaluate the suppression function, the sensor was connected to the position above the third metacarpal of the hand to
capture the motion data from the gyroscope and accelerometer. In addition, electric motors were employed as
actuators in the exoskeleton to suppress tremor motions (Zhou et al., 2021).
This research has classified several related studies based on model type, software as well as hardware, evaluation

10 September 2023 13:07:52


method, and disadvantages for controlling a tremor hand (Table 1). Address challenges and develops solutions to
improve conditions, as well as assisting the disabled so that they are not separated from society. This would enhance
their psychological health and allow them to accomplish their everyday tasks more naturally. As a result, the current
study describes a system comprised of a microcontroller, motor, LCD, and hand brace for the treatment of hand
tremor. The research contribution can be illustrated as follows:
• A review of earlier studies that used tremor treatment systems.
• Categorization of tremor treatment systems based on model type, software and hardware, evaluation
method, and previous work limitations.
• An overview of a suggested tremor treatment system, including relevant components and an operation
algorithm.

TABLE 1. Previous works compared in terms of controlling tremor treatment systems.


Research Model software Evaluation Disadvantage
type and Method
hardware
1- Seven patients are subjected
" Development of a Wearable Tremor LabVIEW
Wrist and to a tremor simulator
Suppression Glove " (Zhou et al., & TD
hand 2- Evaluating the system on the
2018) Gyroscope
users have to be done.
" A Novel Soft Glove for Hand
Tremor Suppression: Evaluation of Stimulator and Evaluation of
Hand
Layer Jamming Actuator Placement " N.A. TD the system on patients should
(Awantha et al., 2020) be conducted.

"Hand tremor suppression device for


patients suffering from Parkinson’s
disease " (Faizan & Muzammil, 2020) Wrist HP Residual tremors in the hands
MATLAB

040009-3
TABLE 1. Continued.
Research Model software Evaluation Disadvantage
type and Method
hardware
"A wearable elbow exoskeleton for
Stereo
tremor suppression equipped with Currently, it has been used in
Hand joint lithography HP
rotational semi-active actuator " healthy people only.
appearance
(Zahedi, Wang, et al., 2021)
"A Novel Exoskeleton System Based
Stereo
on Magnetorheological Fluid for Currently, it has been used in
Wrist lithography HP
Tremor Suppression of Wrist Joints " healthy people only.
appearance
(Yi et al., 2019)
" A Soft Exoskeleton for Tremor Currently, it has been used in
Stereo
Suppression Equipped with Flexible healthy people only.
wrist lithography HP
Semiactive Actuator " (Zahedi,
appearance
Zhang, et al., 2021)
a friction Currently, it has been used in
" Design and validation of a novel
drive healthy people only.
mechatronic transmission system for a
hand mechanism TD
wearable tremor suppression device "
&
(Zhou et al., 2017)
MATLAB
" Design and fabrication of a novel
Currently, it has been used in
passive hand tremor attenuator " Wrist N.A. HP
healthy people only.
(Masoumi et al., 2021)
" Design and Implementation of a

10 September 2023 13:07:52


Haptic Measurement Glove to Create Currently, it has been used in
Hand N.A. N.A.
Realistic Human-Telerobot healthy people only.
Interactions " (Capelle et al., 2020)
No practical results are carried
CAD
" Design of a noninvasive and smart out, it is under simulation. The
software
hand tremor attenuation system with results shows a delay in the
Hand (SolidWork N.A.
active control: a simulation study " response that sprung from
s) &
(Abbasi et al., 2018) using low-pass filter (LPF) in
MATLAB
the controlling unit.
" Developing an Assisting Device to gyroscopic
do not use patient data in the
Reduce the Vibration on the Hands of hand system & N.A.
real world.
Elders " (Phan Van & Ngo, 2021) MATLAB
" Vib-bracelet: a passive absorber for
gyroscopic tested on a human forearm
attenuating forearm tremor " (Buki et arm N.A.
system mechanical model
al., 2018)
" Design and Preliminary
SOLIDWO Most of the WTSD researches
Performance Assessment of a hand
RKS & are simulation-based type.
Wearable Tremor Suppression Glove and finger TP
gyroscopic However, several studies have
" (Zhou et al., 2021) tremors
system considered using real patients
"Essential
" Controlling a motorized orthosis to 1- The results have shown that
Tremor
follow elbow volitional movement: tremor suppression can be of a
(ET)" or
tests with individuals with Elbow LabVIEW good use for real patients. 2-
"Parkinson’
pathological tremor "(Herrnstadt, More research is required to
s disease
McKeown, & Menon, 2019) support this technique.
(PD)"
Investigation is required to
Proposed method Arm Flowcode HP further enhance this technology
and the development trials.
TP: Tremor Patient, TD: Tremor Dataset, HS: Healthy Subject, N.A.: Not Available.

040009-4
SYSTEM DESIGN

The proposed tremor treatment system enhances the quality of life for people with Parkinson's condition and
gives them the power required for their daily life. This section shows the methodology steps to the control strategy
of the proposed tremor treatment system which is consisted of servo motor, hand brace, LCD, and a microcontroller
as shown in Fig. 1. Figure 2 illustrate the actual components of the system and Fig 3 clarify three snap shot of the
hand tremor. The system is made up of a centrifugal clutch motor that works according to centrifugal force, a hand
brace that holds and covers the hand, and an LCD that displays the appropriate speed to suppress tremors.. The
subjects use the device in every day because this disease is chronic, so when the condition of the hand tremor
begins, the device will work to dampen the condition to the maximum possible degree. In this case, the device is
considered somewhat good as a prototype and upgradable.

FIGURE 1. The proposed system.

10 September 2023 13:07:52


FIGURE 2. Components of the system.

040009-5
FIGURE 3. Clarify three snap shot of the hand tremor

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Servo Motor

NUM servo motor offer an excellent volume as well as performance ratio and great dynamics, and are
suited to almost all applications(https://www.num.com/products/motors). Which is worked on the principle of
centripetal force used to reduce the hand tremor. Figure 4 a and b shows the motor.

(a) (b)

FIGURE 4. Snapshot of the motor a) front side b) back side.

Hand brace

Design a hand brace with strong specification to hold hand in the desired way and stabilizing the other
components of the system.

040009-6
LCD

Used to show the speed of motor and select the desired speed for each case of hand tremor because each person
has a special case of illness. Figure 5 indicate the LCD with speed 4.

FIGURE 5. Snapshot of the LCD.

Microcontroller

The system used a PIC 16f767 to program the speed of the motor and connected with the LCD to show the
selected speed according the illness case. Figure 6 shows the microcontroller.

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FIGURE 6. Snapshot of the PIC 16f767.

SYSTEM ALGORITHM

Figure 7 demonstrated the code of the system and how the code works using flow code program
(https://flowcode.software.informer.com/4.0/) when the circuit is ON. The motor is set at four speeds to manage the
severity of the disease. When the program starts and point A is reached, show how to connect the microcontroller
and create a formula to control the motor. In addition, port A represents the motor driver's connection. In addition, in
the called component macro, the equation for controlling the motor's speed was written, and the output was utilized
to receive the response. Figure 8 represent the flow chart of the system. Finally, the delay is employed to regulate
the motor's spinning. Also, Fig. 9 clarifies a snapshot of the speed of the motor. The speed depends on the RPM of
the motor. Furthermore, it can calculate the speed of the motor by knowing the number of RPM by the number of
rotations will be as follows (Jameel, Mohammed, & Gharghan, 2020; Verma, Gokulakrishnan, & Sathishkumar,
2019; Zhang, Zhu, Wang, & Zhu, 2020):
𝑅𝑜𝑢𝑛𝑑𝑠
𝑅𝑃𝑀 = (1)
𝑀𝑖𝑛𝑢𝑡𝑒𝑠
The cycle time can be found by
1
𝑇= (2)
𝑅𝑃𝑀
where T = time.
To convert the time in seconds:

040009-7
60
𝑇= (3)
𝑅𝑃𝑀
The speed motion Equation is as follows (Jameel et al., 2020; Verma et al., 2019):
𝐶𝑓
𝑉= (4)
𝑇
where CF = motor circumference.

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FIGURE 7. Snapshot of the code.

040009-8
Start

Set programs and


hardware

Motor ON and
suppression of the
YES hand tremor as well
If hand shaking
as select the speed
according to the
case
NO

END

FIGURE 8. The flowchart of the proposed system.

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FIGURE 9. Snapshot of the speed of the motor.

EXPERIMENTAL RESULTS
In the proposed device, there are four speeds. The system is designed in such a way that it can accommodate
various wrist motions. Table 2 shows the initial results for the range of motion of different people. The tests are
carried out to ensure that the system uses the patient's arm measurement. The stepper motors are controlled by the
microprocessor, which calculates the required movement of the arm stabilizers.

TABLE 2. Initial results for the range of motion.


subject Age sex Range of speed (RPM) Speed motion
1 45 male 2800 70
2 48 female 7800 90
3 55 male 3800 60
4 38 male 3500 55
5 60 female 8400 75

040009-9
From the experimental tests it is noticed that the relationship between the speed motion and the age of the
person, as age increases, hand tremor increases, and therefore we need to increase the speed of the motor in order to
reduce hand tremor.

CONCLUSION

Medication and brain surgery are two important therapies for hand tremors, both of which have different degrees
of efficacy and hold the risk of serious adverse impact. Using Electromechanical technology in WTS devices have
demonstrated good results. Patients with hand tremor problems were investigated and validated for a wearable
tremor arm prototype in this study. The system is composed of a motor, a hand brace, a microprocessor, and an
LCD. The suggested device's efficiency in suppressing tremor motion and tracking voluntary movements was tested
in preliminary studies. Users control their hand tremors using a microcontroller and a four-speed motor, according to
the study's findings. This research included participants ranging in age from 38 to 60 years old. In both tests, the
validation of the proposed device was found to be satisfactory. Yet, deep investigation is required to further enhance
this technology and the development trials and use a vibration sensors before and after wearing the device to
estimate the enhancement in the subject condtion.

ACKNOWLEDGMENTS

"The authors would like to express their gratitude to the employees of the Department of Medical
Instrumentation Techniques Engineering, Electrical Engineering Technical College, Middle Technical University
for their assistance during this work".

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