Application of modified Rhythmical Skeletal Muscle Tension (RSMT)

<p>  [Introduction] Heart rate variability biofeedback (HRV-BF) has been clinically applied to both physical and psychological disorders. An HRV-BF study using rhythmical 0.1 Hz (6 times per minute) skeletal muscle tension (RSMT) instead of respiratiory approach has been reported in the past which seems to bring about the same resonance effect of the cardiovascular system. We devised a modified-RSMT-method, using a repetitive wrist dorsiflexion (grasping) with finger group flexion for 5 seconds, and wrist joint palmar, extension (releasing) with finger group extension for 5 seconds. Application of this method resulted in improvement of a patient with essential tremor. Consent for reporting of this study has been obtained from the patient, and there are no conflicts of interest to be disclosed.</p><p>  [Subject and method] The subject was a teenage woman who presented with essential tremor continuing for 8 months after a traffic accident. She was introduced to our Rehabilitation Department, at the time of scrutiny hospitalization in the Neurology Department. After we explained the aforementioned method, she sat in a chair, with her upper limbs placed on a desk. We taught the patient to repetitively “grasp” and “release”, by calling out at 5-second intervals, and had her practice for 5 minutes. The effect was judged by her actual writing (graphology) and video recording, and treatment continued for 4 days.</p><p>  [Results and discussion] The patient immediately felt a decrease in the amplitude of the essential tremor from the first intervention, and she also felt “calm”. On the 4th day (the day of her discharge), her head and lower limb’s symptoms had disappeared, and her graphological collapse was significantly improved. After her discharge, she practiced at home for 11 weeks. When she returned to the hospital on Day 78, she told us that although she felt a strong tremor at times, she felt the tremor decrease after her self-practice. We saw her tremor improve just by her sitting and relieving her tension. The modified-RSMT-method can be easily practiced, and may be applicable to a wide range of diseases.</p>