ARTICLES: PDF OnlyOrthostatic Tremor Two Persons in a Balance Disorders PracticeWhitney, Susan L. PhD, PT, NCS, ATC1,2,3; Wrisley, Diane M. PhD, PT, NCS1,3,4; Musolino, Mark C. MS5; Furman, Joseph M. MD, PhD1,2Author Information 1Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA ([email protected]) 2Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 3Centers for Rehab Services, University of Pittsburgh Medical Center, Pittsburgh, PA 4Neurological Sciences Institute, Oregon Health and Sciences University, Beaverton, OR 5Department of Bioengineering, School of Engineering, University of Pittsburgh, PA Neurology Report: Volume 27 - Issue 2 - p 46-53 Free Abstract The objective of this paper is to help physical therapists recognize orthostatic tremor. Two cases of orthostatic tremor are reported from a tertiary referral center. The 2 patients presented to the Balance Disorders Clinic with complaints of imbalance and shaking in the legs while standing but not with walking. Postural sway was recorded during the Sensory Organization Test of computerized dynamic posturography and was analyzed for shear and center-of-pressure components. Power in the shear force spectrum and the center of pressure power measures were increased compared to 18 normal controls in both patients. Patient 1 underwent balance rehabilitation and improved some with a reduction in the power in his shear force spectrums during dynamic posturography. He was then treated with gabapentin. Patient 2 was provided gabapentin and later was sent to physical therapy. A reduction in the power of the shear force spectrum also was noted. Using shear force data from computerized dynamic posturography to assist in making the diagnosis of orthostatic tremor has not previously been reported. In addition to medication, physical therapy may be an effective adjunct in persons with orthostatic tremor. © 2003 Lippincott Williams & Wilkins, Inc.