Easy-to-use Parkinson's gloves can automatically reduce tremors

Doctors at King Chulalongkorn Memorial Hospital have developed lightweight and easy-to-use Parkinson's gloves that can automatically reduce tremors, allowing Parkinson's Disease patients to enjoy social life and reducing side effects from medication and risk from brain surgery.

Tremors, slowness, stiffness -; these are the noticeable symptoms of patients with Parkinson's disease (PD), especially the hand tremors while resting which are found in 70 percent of patients. These uncontrollable tremors make patients appear disabled and unable to enjoy their daily routines, calling for a caretaker, which lowers their self-esteem and makes them scared to socialize.

The current method of treating Parkinson's is taking a cocktail of medications, which is mostly unable to reduce all the tremors. Some patients whose tremors are especially strong may need brain surgery, which is an always undesirable option due to its high cost and many side effects. This conundrum has inspired a team of researchers at the Faculty of Medicine, Chulalongkorn University, led by Prof. Dr. Roongroj Bhidayasiri and Asst. Prof. Onanong Phokaewvarangkul, Ph.D. to research and develop the prototype of "tremor-reducing Parkinson's gloves" since 2014. The product received a patent under the name portable tremor measuring and reducing device using electrical muscle stimulation in January 2017. Many research articles have been published in international medical journals to support the efficiency of the device. The team has now succeeded in developing the "5th generation tremor-reducing Parkinson's gloves" which are lightweight, easy to wear, and effective, not to mention cheaper than similar imported device.  

"The tremor-reducing Parkinson's gloves are the first medical device that can help reduce tremors in the hands of PD patients through automatic electric stimulation of the hand muscles. We hope this will help reduce the tremors for the patients without having to increase the dosage of their medication unnecessarily and reduce the risk of brain surgery," discussed Asst. Prof. Dr. Onanong in connection with the significance of the innovation for Parkinson's disease.

Currently, there are over 10 million PD patients around the world and approximately 150,000 patients in Thailand. It is estimated that for every 100 elderly people (aged 60 and over), there is one with Parkinson's disease! (For more information, read Getting to Know Parkinson's Disease).

"As we move further into the aging society, the number of PD patients will only increase. Our estimation predicts an increase of 2-3 times in the future."

Asst. Prof. Dr. Onanong added that the rise of PD patients will affect the socioeconomic status and the treatment methods in the country's public health system. If the PD patients are of working age, their quality of life and performance will be affected, as well as the financial status of their families. On the other hand, elderly patients with Parkinson's disease will face many other health issues from age, including poor balance, difficulty walking, and stiff muscles. Other health-related problems may also follow such as falling, which could lead to injuries or broken bones, causing them to potentially become bedridden. All of these have an impact on the methods of treatment, budget, and wellbeing of both the patients and the family, as well as the country's public health system.

How does the tremor-reducing Parkinson's glove stimulate the hand muscles to lessen shaking?

In 2014, a research team led by Asst. Prof. Dr. Onanong succeeded in developing the prototype model of Parkinson's gloves that can detect the tremors in the hands of the patients and automatically use electric current to stimulate the hand muscles to reduce the tremors.

Asst. Prof. Dr. Onanong explained that the automatic tremor-reducing Parkinson's gloves operate by combining 2 systems as follows:

1. Detecting and measuring Parkinson's tremors using an accelerometer and a gyroscope, which are highly accurate and low in error risk. Parkinson's tremors measure at 4-7 Hz.
2. Suppressing tremors with electrical stimulation of the hand muscles -; when the sensors detect Parkinson's-specific tremors, they will transmit a signal via Bluetooth to the muscle stimulator to release an electric current that will reduce the tremors from a small battery. The muscle stimulator uses the physiotherapy standard resistance, frequency, and electric current, which are safe for use with patients.

Asst. Prof. Dr. Onanong explained that one set of the Parkinson's gloves includes 3 main components: (1) a glove with the muscle stimulator installed, (2) a control panel for detecting tremors and releasing electric current, and (3) a mobile phone with an application to control the device and store the tremors and stimulation. The device's uses will be stored on the phone's memory or a computer with a program to analyze the tremors in detail. All 3 components of the Parkinson's gloves will automatically work together via Bluetooth.

6 highlights of tremor-reducing Parkinson's gloves

From its prototype of a noticeably large glove, today the 5^th generation tremor-reducing Parkinson's gloves have developed into a pleasant-looking, small, lightweight device, which resembles a palm strap to make it look less like a medical device. Asst. Prof. Dr. Onanong has summed up the advantages of the latest Parkinson's gloves as follows:

1. They are safe in detecting and noticeably reducing tremors in the hand.
2. They are lightweight and easy to wear.
3. The production cost is low compared to medication and surgery.
4. The device is an alternative treatment that can reduce the side effects of using multiple medicines or the need to add more treatments to reduce tremors.
5. The device can automatically record the patient's tremors, which can be immediately sent to a doctor online for regular treatment evaluation.
6. The gloves can be used to reduce tremors in the hand from other conditions as well.

The patient needs to always wear the glove to stimulate the hand muscles with electric current. If the device is turned off, the tremors will return. Most PD patients usually have other abnormalities in motion such as slowness or stiffness, forcing them to take Parkinson's disease medicine. However, the tremors are found only when the patient reacts negatively to medication. Therefore, using the tremor-reducing gloves will prevent the patient from having to take more medication to control the tremors and having to risk brain surgery."

Asst. Prof. Onanong Phokaewvarangkul, Ph.D., Chulalongkorn University

Support research, reduce production costs, and increase quality of life for PD patients

Although devices to reduce PD patients' hand tremors are available in other countries, they are mostly very expensive. Also, there are no similar devices backed up by medical research, but Chulalongkorn's Parkinson's gloves are accompanied by clinical research which has been published in international medical journals. The cost of production of the gloves is also lower than the imported ones. Currently, the production cost is around 30,000 – 40,000 baht per set.

"The team would like to show our gratitude for the continuous support in the research from many organizations, which has made the development of the tremor-reducing Parkinson's gloves possible. We have received funding from Chulalongkorn University, the government, and the private sector, as well as other benefactors who donated money to sponsor the development of this device for patients, giving them more access to the treatment with these gloves," said Asst. Prof. Dr. Onanong.

Currently, the tremor-reducing Parkinson's gloves have been given to over 50 Parkinson's disease patients at King Chulalongkorn Memorial Hospital and have proven to be effective (Figure 3).

Plans for next-generation Parkinson's gloves

Chula's Parkinson's gloves were awarded the National Innovation Award in Society and Environment (Private Sector) 2022 from the National Innovation Agency (Public Organization), the Ministry of Higher Education, Science, Research, and Innovation. Even so, the research team remains committed to developing more useful and practical innovations for patients.

"In the future, the team plans to develop the gloves to be smaller and better looking. They won't look like a medical device, but more like an accessory or part of the outfit. Still, they will retain the efficiency in reducing tremors, the stability of electrical current, and the ease of data upload. More development will include detection and reduction of tremors in other parts of the body, such as the legs, as well as tremors stemming from other diseases."

Finding co-investors to produce the gloves for PD patients

Right now the tremor-reducing Parkinson's gloves are limited to only patients at King Chulalongkorn Memorial Hospital. The Excellence Center for Parkinson's Disease & Related Disorders is receiving patients to test the device. If the device works well for the patient, the Center will gladly sponsor the device for the patient's continuous use.

Asst. Prof. Dr. Onanong mentioned that the tremor-reducing Parkinson's gloves innovation is ready to be introduced to patients at large. They are welcoming potential entrepreneurs to help develop the device further before commercial production so that PD patients will best benefit from medical devices.

Contact information for organizations and individuals interested in tremor-reducing Parkinson's gloves

• Parkinson's disease patients both in and out of Thailand who have hand tremors and need to use tremor-reducing Parkinson's gloves
• Hospitals in and out of Thailand, medical clinics, and general physicians, including medical and nursing schools that need the device as educational tools to be used on real patients