1. Introduction
Essential tremor (ET) is one of the most common tremor diseases [
1]. The muscles of the patient with ET operate in the frequency range of 4–12 Hz [
2]. ET is characterized by postural and kinetic tremors, mostly affecting the hands [
3]. Postural tremor (PT) is presented during a voluntary movement to maintain a body part at a position against gravity, whereas kinetic tremor occurs during a voluntary movement towards a target. Propranolol and primidone are the most effective pharmacological treatments for ET; however, a large number of patients do not respond to either of these treatments [
2], leaving severe side effects on the patient’s quality of life [
3].
Recent studies have been conducted to provide a non-invasive, wearable mechanical device to attenuate the tremor [
4,
5]. Stone et al. [
6] modeled the forearm as a 305 mm × 25 mm × 25 mm aluminum beam attached to the hand. The test bench is fabricated as one segment pinned at the elbow joint and is attached rigidly to the hand at a position reflecting the wrist joint. The system is excited by an electro-dynamic shaker using ET signals in the horizontal direction to reflect the flexion-extension motion. A 120 g proportional–integral–derivative (PID) controller was able to provide a 20–60% reduction in the linear displacement amplitude of the segment at the position of the wrist, within the 6–13 Hz bandwidth. Teixeira et al. [
7] modeled the forearm as a 1088 g rectangular beam made up of wood and excited using a shaker by a signal of Parkinson’s disease (PD) in the vertical direction. A TMD with variable weight was adapted to reach the tuning frequency by controlling the level of water entering or leaving the piezoelectric micro-pumps. A 200–400 g TMD operating between 4.5–6 Hz is placed near the free end of the beam. It causes a 57% reduction in the amplitude of acceleration at the resonance frequency of 5.32 Hz. Buki et al. [
8] manufactured a forearm as an inertial rod attached rigidly to the hand and excited by a direct-current (DC) motor at the wrist joint to apply a pronation-supination motion. The system is operating at the resonance frequency in a range of 4.40–5.78 Hz, measured for patients with PD using an inertial measurement unit (IMU). A 280 g passive bracelet is tuned to the resonance frequency to reduce the simulated tremor. The passive device reduced to 86% of the angular displacement amplitude at 4.75 Hz, measured using the IMU at the wrist. Rudraraju and Nguyen [
9] fabricated an experimental setup with a 1690 g mannequin hand excited by a sinusoidal signal of 50 mm amplitude and a frequency of 4.5 Hz, representing the measured tremor behavior of a patient with PD. Two TMDs designs as a 109 mm × 72 mm × 9 mm metallic rectangular box each, of 530 g total mass, are placed symmetrically on the top and the bottom of the hand, at the wrist joint, to reduce the motion in the horizontal direction. These TMDs were tested on a real patient by tracing the pre-drawn line on a whiteboard. This resulted in a 70–80% reduction in the tremor amplitude, which validates the numerical study. Phan Van and Ngo [
10] designed a prototype of a wearable small and comfortable gyroscope-based mechanism device with low power consumption, weighing 268 g and of 105 mm × 84 mm × 50 mm physical size. It is prepared to reduce uniaxial hand tremors in the range of 1.41 ± 2.58˚ and with a frequency between 4–6 Hz of PD. Its effectiveness is validated by a simulation using Matlab; it results in a 92.6% reduction in the amplitude. However, the high-quality testing equipment used was not enough to produce exact tremor data of PD. Masoumi et al. [
11] used two seesaw-like actuators with magnetic discs of 120 g mass to reduce a tremor simulated by a wearable tremor simulator device composed of 32 g eccentric mass and a DC motor. The effectiveness of the device was estimated by visualizing the water level in a beaker held by the participant. The tremor assistance device was able to mitigate the fluctuation in the water level.
In this paper, an experimental arm is fabricated in the form of a rectangular beam to reflect the flexion-extension motion of the hand in the horizontal direction. The system is excited by a mechanical shaker, using Electromyography (EMG) signals, measured for the extensor carpi radialis (ECR) muscle involved in the generation of tremors [
12,
13]. TMDs designed in the form of thin cantilever beams with concentrated masses are used to test the ability of passive absorbers to reduce the amplitude of the system due to the excitation signal measured for a real patient. The mass of the TMDs respects the efficient mass range of 5–25% of the total mass of the system of interest [
14]. Similar to most research work related to orthoses, the efficiency of the tremor controller is analyzed depending on the reduction in the power spectral density (PSD) of the measured signals [
4].
The TMD is designed to reduce the amplitude of the system at 6.64 Hz, which represents the critical peak frequency of the measured tremor signal of the patient. The operating frequency of a TMD, having a 5.7% mass ratio, changes within a bandwidth of 5.52–7.57 Hz as the position of its proof mass changes. The corresponding mean value of modal damping ratio, for the used stainless steel beam material of the TMD, is estimated to be 0.33% using the half-power bandwidth method and 0.21% using the continuous wavelets method. The optimal modal damping ratio calculated numerically for a similar TMD is 0.99%. The best positions for the proof mass of the one TMD system, determined through experimental measurements, were those corresponding to an operational frequency between 6.44–6.66 Hz representing a 2 mm wide displacement range. Three similar TMDs, with a mass ratio of 15.7%, are attached to the experimental arm to provide a 69% reduction in the amplitude of the velocity signal measured using a vibrometer. Measurements using an IMU show that the reduction in the acceleration, displacement, angular velocity, and angular displacement signals, is 29%, 79%, 67%, and 82%, respectively.
The rest of the paper is organized as follows.
Section 2 describes the experimental setup used to simulate the measured tremor of the patient and the fabricated TMD used as a passive controller and gives information about the sensors used to provide the processed signals.
Section 3 provides the results of the measurements for the behavior of the TMD and its effect in reducing the amplitude of the system.
Section 4 includes a discussion of the results in addition to a comparison with the literature.
Section 5 provides the conclusions and perspectives.
4. Discussion
The addition of two and three TMDs did not show a remarkable improvement in the system response compared with the response obtained with one TMD in
Figure 7, in contrast to what is expected by [
23]. This can be explained by the low modal damping ratios (in comparison with that obtained in the numerical study) provided by the manufactured TMDs (of stainless beams), which are not high enough to lessen the amplitude of critical peaks. Despite this, the TMDs improved the response of the system and cause a minimum reduction of 88%; however, a considerable value of 5.7% minimum mass ratio was used for the testing. To find a compromise between the patient’s comfort due to the addition of masses to the hand and the reduction in the amplitude of the tremor caused by these TMDs, a study with a lower mass ratio can be performed while achieving a satisfying reduction.
The optimal damping ratios determined numerically are not reached in this study due to a low damping ratio provided by the strain rate of the stainless steel beam material, air damping provided by the beam and the screw, and frictional damping provided by the clamped end and the surface of contact with the attached screw, without the addition of an external damper. Due to this, the optimization of TMDs parameters obtained from the numerical study was not very useful for reflecting the best position of the TMD in the experimental study. Since the manufactured TMDs have low modal damping ratios, tuning these absorbers may be a good choice to obtain a better reduction for the system with three TMDs (
Figure 7). The operating frequency of the three TMDs is chosen to be close to the critical frequency (6.64 Hz), and within the best frequency range (6.44–6.66 Hz) of the one TMD deduced from
Figure 6. The three TMDs placed at positions ‘0’, ‘1’, and ‘2’ (
Figure 4a) are adjusted to 6.61 Hz, 6.61 Hz, and 6.52 Hz, respectively, and referred to as Set#2.
The responses of the experimental arm (without IMU) due to the addition of the three TMDs of Set#1 (
Figure 7) and Set#2 are shown in
Figure 10 and compared with that obtained for one TMD corresponding to the numerical study (
Figure 7). The three TMDs of Set#2 improved the response at the critical frequency in comparison with the other responses. It causes also a slight amplification in comparison with Set#1 at the frequency of 9.57 Hz, which is a frequency higher than the frequency of the critical peak, thus the 9.57 Hz will not lead to a critical effect on the signal of the system. However, a slightly higher level of damping is still interesting to further reduce the amplitudes at all peaks within the range of PT.
Encouraging results are obtained in this study, which motivates the development in the design of the passive type of tremor controllers, to be competitive to the work found in the literature. The 120 g controller used by Stone et al. [
6] represents a PID controller which provides a 20–60% reduction in the displacement amplitude, although a higher level of reduction could be expected by an active type of controller. A TMD of 200–400 g (representing 18.3–36.7% mass ratio) was used by Teixeira et al. [
7] and adjusted by the water level entering or leaving the piezoelectric micro-pump. It provided a 57% reduction in the amplitude of acceleration. The system was loaded with a high mass ratio that did not cause a high reduction. An efficient 280 g TMD used by Buki et al. [
8] causes an 83% reduction in the pronation-supination amplitude of a system modeled as an inertial rod excited at resonance. An interesting design of the bracelet was provided in the study of Buki et al. [
8] which can be comfortable and easily wearable by the patient. The 530 g passive TMDs (representing 31.4% mass ratio) manufactured by Rudraraju and Nguyen [
9] cause a good reduction of 70–80% in the tremor amplitude. However, this TMD is considered heavy, and the effect of this mass on the amplitude of the system could be tested to quantify the reduction caused by the TMD. An innovative prototype of a gyroscope-based controller weighing 268 g used by Phan Van and Ngo [
10], caused a 92.6% reduction in the simulated uniaxial tremor amplitude with low power consumption. Masoumi et al. [
11] prove that a magnetic spring system could be added to the wearable gadget devices used to reduce the tremor of the hand. The effectiveness of the 120 g device used was not quantified.
The perfect design of the tremor controller is a competitive work that is still under study by several researchers. In our study, a good level of reduction is reached by a simple passive three TMD system representing a 15.7% mass ratio. It causes a 79% reduction in the displacement signal and a 67% reduction in the angular displacement signal of an experimental arm excited by a measured signal of the muscles generating the tremor.
5. Conclusions
An experimental arm is modeled to reflect the hand of a patient. It is excited by the ECR signal of a patient with PT. The mechanical shaker was able to precisely simulate the data of the PT signal. The TMD is modeled as a cantilever beam with a screw that can be fixed at different positions along the beam. Measurements are carried out to determine the new operation frequency of the TMD resulting from each screw position. The modal damping ratio for each position is determined using the half-power bandwidth method and the continuous wavelets method. The half-power bandwidth method could not provide a good estimation for the modal damping ratio of the designed TMD.
The effect of the designed TMDs on the response of the experimental arm is obtained. The passive TMD shows its effectiveness in reducing the vibration of the system excited by the PT signal of a real patient. Three TMDs with a total mass of 41.23 g, representing a mass ratio of 15.7%, reduced the angular displacement amplitude of the flexion-extension motion by 82%, measured using the IMU. The beam’s material used in the design of the TMD needs to be modified to provide a relatively higher level of damping. A 3D printer will be used to manufacture a TMD of precise dimension and less expensive material. Therefore, the stainless steel beam will be replaced by Acrylonitrile Butadiene Styrene (ABS) material.
The beam composing the TMD in this study has a circular cross-section to allow multi-directional operation of the TMD to be tested in further experiments. An experimental arm is prepared in the form of a tube to position the TMD(s) in orientations different from the excitation direction and thus test the ability of the TMD system for multidirectional excitations, which will occur in experimental tests to be applied for the patient. To anticipate the effect of the skin, an elastomer, representing the hand segment, will be placed between the tube and the TMD fixation to take into account the effect of the patient’s epidermis, dermis, and subcutaneous tissues. A passive lightweight bracelet will also be designed to keep the TMDs attached in different directions around the tube to attenuate the essential tremor.