hand tremor

[alasaar]

I have a patient with C/O hand tremor. This is only when the pt does 90 degrees of flexion with shoulder distraction forward. At rest all other movements there was no tremor nor any pain or upper and lower limb weakness. She also has the opposite lower limb tremor on full knee extension with planter flexion. There is no H/O injury or illnesses. Could you help me please?

[pkkenchan]

if talking about hand tremor, I would think of proximal muscle weakness , or other neurological disease.
does the case suffer from any stroke or other neurological disorder at the same time ?
if not, and the muscle are clear from weakness, then I will try check for the muscle length of the affected part, as the knee extension and plantarflexion really stretches the anterior mm located at the tibia.

I hope it can help.

[alasaar]

Thank you for the replay
I did examine the shoulder stability and muscle strength and the pt was having weak shoulder muscle so I have given the pt strengthening exs and I will review her in 2 weeks
No she didn’t have any H/O stroke or head injury
Lets see the out come and I will write to you again
Thanks

[linbin]

if a muscle is lengthened over time,as in the case of poor posture it wont be able to generate force effectively t the outer range.because the normal cross bridging action wont take place.so the weakness manifests as tremor .so the weak muscles should be strengthened in the normal length position and also try active stretching of the antagonist which is usually seen to be tight
cheers

[alasaar]

Thank you for the replay pt not yet seen post the last session till then I will wait and see then I will inform you
Thank you all