Accredited gold winner of the 2020 Edison Award, Cala Trio by Cala Health is one-of-a-kind non-invasive personalized prescription therapy for hand tremors in adults. Thanks to Cala Trio, one of the most prevalent tremor disorders that affect over seven million people in the United States, can now be easily managed and treated with the wrist-worn neuromodulation device. The advanced medical device can be used at home, unsupervised, and under real-world conditions so that it flows with your life. Offering a new approach for managing tremors without any systemic side effects, the bioelectronic alternative, Cala Trio provides excellent outcomes and improves the quality of life for patients suffering from essential tremors or tremors implicated by Parkinson's disease. 

Working

The first wrist-worn non-invasive medical device works more effectively than a mass-prescribed medication by effectively and directly targeting the source of the tremor. The ground-breaking therapy is calibrated to treat the tremor, a common motor symptom of Parkinson’s, that was earlier irreversibly debilitating. The FDA-approved Cala Trio works by sending small electric signals to the brain to stimulate tremor-associated nerve cells in the wrist. The wearable transcutaneous nerve stimulator involves two functioning electrodes well-positioned over the median and radial nerves on the anterior surface of the wrist and a counter electrode placed on the posterior surface of the wrist. The device consists of an accelerometer that measures the frequency of the patient’s tremor, which enables personalized calibration of the stimulation intensity. The two working electrodes transmit electrical signals that excite the median and radial nerves in the upper limbs. Peripheral sensory nerves also project to the ventral intermediate nucleus (VIM) of the thalamus and neural circuits associated with essential tremors. The mode of action of the wrist band is somewhat similar to deep brain stimulation, where electrical stimulation of VIM elicits very fast oscillations of tremors. Gradually, the stimulation with Cala Trio normalizes the neural firing in the pathological tremor network to reduce tremors. 

Levodopa, the primary treatment for managing the motor symptoms is not as effective in treating the tremors as the non-invasive device, and negatively affects performing easy tasks such as eating or writing. On the contrary, wearing the Cala Trio wrist band for two 40-minute sessions per day can create significant changes to reduce the severity of tremors over the course of three months. The best part about the device is that the patient does not need to undergo any surgical procedure, rather he/she need to simply wear a Cala Trio wrist band as a watch for transient relief. 

Essential Tremors can be physically and psychologically draining so the patients need to choose between living with tremors or risk unwanted side-effects from pharmacologic treatment options. But the new approach offered by Cala Trio provides not only efficient treatment but also prevents the patient from compromising his/her health status. According to the clinical trials conducted by Cala Health to determine the efficacy of Cala Trio wrist band, it was found that 57% of patients experienced at least a 50% reduction in the severity of tremor and 61% reported improvement in their ability to perform simple tasks such as eating, drinking, and writing. 

Cala Health is targeting a large and under-penetrated market opportunity, providing a simple, easy-to-wear watch for essential tremor therapy. The company is actually able to see the usage and kinematic data to understand the usage of the device in real-world settings. When the patient rests their Cala Trio on the charging station, recorded data automatically uploads on Cala Health’s cloud platform, which is further utilized for quality checks. 

Cala Trio is designed to provide at least three to five sessions when charged fully. However, the patient needs to take medical advice from their physician to determine the frequency of use that works best for them. With a 40-minute stimulating session, the patient experience tremor reduction for up to an hour. The stimulator and base station have an average life of three years while the band has an expected service life of 90 days. The stimulator comes with a two-year warranty and the band has a 45-day warranty. The bands are specific to left and right wrists and can support the patient on both hands. However, the patient should take prescription from the physician to determine the hand where tremor reduction can help the most.

Applications

Before wearing the wrist band, dampen the entire circumference of your wrist with water or use excess lotion. Moisture helps with the connection between your skin and electrodes and without water one may experience discomfort or warning display while undergoing therapy. Cala Trio is calibrated when the patient has their “Tremor Task” performed thrice. The device calibration helps to characterize tremor and individualize stimulation. The accelerometers measure motion of the device and determine the best pattern to deliver the stimulation.

Limitations

Although the device is convenient to wear, the patient might feel a tingling sensation in fingers, however the device provides the flexibility to reduce intensity during the therapy session in case of discomfort. Carla Trio cannot be used if the patient has a pacemaker, implantable cardiac device, or any other implanted electronic devices. Since Cala Trio is a novel technology, the first-in-class therapy requires a prescription. Some of the possible side-effects of wearing Cala Trio are stinging, sensation of weakness, allergic reaction, skin irritation, burns, lesions at the site of stimulation, muscle stiffness, chest pressure, swelling on arm, wrist, or hand. The band electrodes need to be placed correctly in order to avoid any activity that would cause the placement of the band to change. Cala Trio is not waterproof so the patient cannot swim or take shower while wearing the device. Also, Cala Trio is only available in the USA currently. 

Other Devices for Tremor Suppression

GyroGlove


GyroGlove is a wearable medical device that uses mechanical gyroscopes to resist the patient’s hand movements implicated by Parkinson’s disease. The gyroscope self-stabilizes to ensure shakes are largely negated and make everyday tasks easier like using a computer, writing, cooking possible for someone with involuntary tremors. In the device, the gyroscopes are mounted to a fabric glove on the dorsal surface of the hand function to combat tremors. Each gyroscope involves a rotatable disc, capable of rotating about an axis to resist involuntary motion, allowing angular momentum to be conserved during rotational displacement. Early GryoGlove tests show reduced significant tremors in individuals up to 80% and the device has a huge potential to help professional surgeons, athletes, photographers, etc. The device is currently under developmental stages and more data is needed to determine its accuracy.

Emma watch


Emma watch introduced by Microsoft is a wrist wearable that works to reduce the hand tremor diagnosed with Parkinson’s disease. Emma watch works precisely to alleviate the tremor effects by creating a vibration cue that distracts the brain from creating involuntary motion of the hands. The inside of the watch consists of small vibrating motors that produce vibration in a certain pattern which helps to disrupt the path between brain and hand, triggering the tremor. Wearing the device, the patient would be able to feel the tremors, but not see its effects while performing any activity. The device is currently under clinical trials.

Conclusion

With no cure available to Parkinson’s, medical developers, and researchers are moving to creating technology to fill the void. Cala Trio is no less than a modern-day miracle, improving lives of hundreds of people enabling them to do easy tasks with their hands, which was not possible before. The device is paving way for more developers to create a technology that can be life-changing for people living with symptoms of disorders with no cure yet.

According to TechSci research report on “Global Wearable Patches Market By Technology (Connected v/s Regular), By Application (Monitoring, Drug Delivery, Diagnostics, Others), By End User (Healthcare v/s Fitness & Sports), By Company, By Region, Forecast & Opportunities, 2026”, the global wearable patched market is expected to grow at a steady rate in the coming years. The growth can be attributed to the huge advancements in research and technology, increasing prevalence of diabetes around the world, and introduction of advanced wearable patches. Besides, growing awareness towards customization of health preferences and emerging technologies for real-time analytics with constant monitoring and generation of data is expected to propel the demand for global wearable patches market.

According to another TechSci research report on “Global Wearable Medical Devices Market By Type (Vital Signs Monitoring Devices v/s Therapeutic Devices), By Product Type (Activity Monitors/Trackers, Smartwatches, Patches, Smart Clothing), By Purpose (Heart rate, Blood Pressure, Body Temperature, Blood oxygen saturation, Posture, Physical Activities, Hearing Aids, Others), By Site (Handheld, Headband, Strap/Clip/Bracelet, Shoe Sensors, Others), By Application (General Health & Fitness, Remote Patient Monitoring, Home Healthcare), By Distribution Channel (Store-Based v/s Non-Store-Based), By Business Segment (B2B Vs B2C), By Region, Forecast & Opportunities, 2025”, the global wearable devices market is projected to grow at a formidable rate of around 18% on account of growing geriatric population suffering from various chronic diseases and increasing healthcare costs. Besides, technological advancements and rapid adoption of AI, IoT, cloud computing, among others is expected to fuel the demand for global wearable devices market.