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Chapter 5 – Discussion
reduce postural tremor in neurologically normal older adults (J.W.L
Keogh, et al., 2007; J W. L. Keogh, et al., 2010). Utilising this general RT
programme, there was a significant increase in hand and finger dexterity
as assessed in the unilateral tasks of the PPT. The most affected hand
task displayed improvement at both the Post 1 and Post 2 assessments,
while the least affected hand showed significant improvement at the
Post 2 assessment only. These findings complement those of Bilodeau,
et al. (2000); where, after a period of RT, ET patients with a greater
severity of tremor had the greatest improvements in force steadiness.
Similar improvements in PPT performance after a period of RT have
been seen in previous studies (Kornatz, et al., 2005). Kornatz, et al.
(2005), prescribed RT for the non-dominant hand only in older adults.
After the six week RT intervention, PPT dexterity results for the non-
dominant hand had significantly improved to scores on par with those
achieved in the dominant hand task. The resulting gains of strength and
dexterity after training were also found to have a mild but significant
correlation (r = 0.41, p=0.03).
It is conceivable that for long-term ET patients, as used in this study, the
most affected hand would be used relatively infrequently in tasks
requiring hand and finger dexterity. This could mean that the most
affected limb may have a functional role similar to the non-dominant
hand in those without pathological tremor. The earlier changes seen in
PPT performance seen in the current study for the most affected hand
may be in part due to the different functional and physiological
characteristics of the two upper limb limbs. The non-dominant hand is
known to have greater motor unit force variability and reduced force
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