5
Management
Non-Pharmacological/Non-Surgical Treatment Options
Transcutaneous Afferent Patterned Stimulation (TAPS)
• Cala Health's TAPS device is an individualized, re-chargeable, non-invasive
wrist-worn device to reduce tremor in a targeted arm. It provides electrical
stimulation to the median and radial nerves through electrodes placed on
the inside of a wrist band. This stimulation therapy is called transcutaneous
afferent patterned stimulation (TAPS).
• Cala Health's TAPS device was cleared by the Food and Drug Administration
(FDA) in 2018, and is indicated in adults with essential tremor to provide
transient relief of hand tremors following stimulation.
▶ The wrist band device is worn for 40 minutes, after which 64% of patients
reported having persistent relief for an average of 94 minutes, and 54% of patients
experienced ≥50% improvement in tremor power.
▶ When starting therapy, patients should choose an activity (e.g. eating ) and use
TAPS 20–40 minutes prior. This usage should continue on-demand for at least 2
weeks to determine benefits.
▶ A typical charge will last for approximately 5 sessions. It takes approximately 3–4
hours to fully charge the device.
▶ It can be used with or without pharmacological therapies.
• TAPS is contraindicated in patients with implanted electrical devices
such as a pacemaker, defibrillator, or deep brain stimulation device;
patients with a seizure disorder; pregnant women; and in persons with skin
irritations, open wounds, or lesions on the wrist.
Pharmacological Treatment Options
• It has been estimated that 30–60% of persons with ET who tolerate
current pharmacological treatment options have a reduction in tremor.
▶ Those that do respond to medications tend to have a 30–50% reduction in tremor.
• Tremor rarely completely resolves with medication.
• Limb tremor is generally the targeted tremor and tends to have a better
and more consistent response than head or voice tremor.
