The science behind steadier hands

Essential tremor can make the smallest movements feel uncertain, like holding a cup, signing your name, sharing a meal, or reaching for your phone.

Encora X1 was developed to work within the body’s natural movement pathways to help relieve hand tremors in the treated limb during stimulation.

Here’s the science behind how it works.

Illustration of a stylized human brain with black lines representing neural pathways over a blue-green background.
Illustration of a stylized human brain with black lines representing neural pathways over a blue-green background.

THE SCIENCE AT-A-GLANCE

Essential tremor starts in the brain

Silhouette of a smartwatch with a blank screen.
Silhouette of a smartwatch with a blank screen.

Encora X1 begins at
the wrist

Icon of a hand with four fingers extended, representing a gesture of number four.
Icon of a hand with four fingers extended, representing a gesture of number four.
Pattern of dark teal wavy lines on a black background.
Pattern of dark teal wavy lines on a black background.

Stimulation disrupts tremor signal generation and transmission

Designed for all-day tremor support

The signal starts in the brain
The tremor shows up in the hand

UNDERSTANDING ESSENTIAL TREMOR

A woman holding a mug, wearing Endora X1 for essential tremor with a digitally illustrated overlay of a glowing brain and nervous system connecting to her body.
A woman holding a mug, wearing Endora X1 for essential tremor with a digitally illustrated overlay of a glowing brain and nervous system connecting to her body.

Essential tremor is a neurological condition that affects movement. It’s associated with rhythmic signaling in the brain’s movement networks that becomes harder for the body to smooth out. Those signals travel through the nervous system to the muscles of the arm and hand, where they can appear as shaking during everyday activities.

What this means: Essential tremor is not a hand problem or a willpower problem. It is a neurological condition that affects movement control.

Working within the body’s natural movement pathways

HOW ENCORA X1 WORKS

Encora X1 delivers gentle mechanical neurostimulation to stretch receptors in the wrist that are part of the movement feedback pathway between the brain and hand.

This mechanical input adds a new signal into the body’s natural movement feedback system. That added input helps disrupt the rhythmic signaling associated with tremor, helping the hand become steadier while stimulation is active.

What this means: The result many users notice is simple, steadier hands during use.

Experts Perspectives on Encora X1

  • "For the 7 million Americans suffering from essential tremor, medications are often ineffective or poorly tolerated, leaving invasive brain therapy as the only alternative. Non-invasive technologies like this represent an important area of innovation in the treatment of essential tremor.”

    — Ann Murray, M.D., Principal investigator and Chief of the WVU Rockefeller Neuroscience Institute (RNI) Comprehensive Movement Disorder Center

  • "The data demonstrate meaningful improvement in tremor severity and functional outcomes for patients with limited options.”

    — Ann Murray, M.D., Principal investigator and Chief of the WVU Rockefeller Neuroscience Institute (RNI) Comprehensive Movement Disorder Center

Studied in the clinic
Tested In Real Life

CLINICAL EVIDENCE

Encora X1 is FDA-cleared to aid in the relief of hand tremors in the treated limb during stimulation in adults with essential tremor. Our two initial clinical studies looked at both short-term response during stimulation and continued use at home over time.

15 Min.

Device effects observed in ~15 minutes

Achieved meaningful tremor improvement in ULTRE clinical trail, compared to 48% of the sham group

70-75%

Observed benefit after 90 days (combined/pooled responder rate across both cohorts)

78%

96%

Rated Encora X1 therapy as “comfortable all of the time”

  • Encora X1 is not a cure for essential tremor. Individual results may vary. In clinical trials, all device-related adverse events were non-serious, temporary, and self-resolving. Reported side effects include numbness (3%), buzzing/tingling sensation (3%), discomfort/pain (1.5%), skin irritation/rash (<1%), muscle weakness (<1%), and possible temporary worsening of tremor (<1%).

What researchers observed

ULTRE STUDY: How Active Modes Compared to An Inactive Sham

Ultra Study Comparison Table
Ultra Study Comparison Table

What Researchers Observed: In the ULTRE Study, participants using active therapy demonstrated greater improvement in daily-task performance and clinician-rated outcomes than participants using sham therapy.

More participants improved with active mechanical neurostimulation than with inactive sham stimulation.

What this means: The study measured changes in activities that reflect real hand use, not just abstract lab performance.

Randomized, double-blind, sham-controlled crossover study. Results are descriptive (feasibility design; no pre-specified effectiveness endpoint). Measured during stimulation.

Data on file.

90-Day Home Use: Daily-task Improvement at Day 90

Bar graph showing 90-day home use study results. 78% achieved at least 1-point improvement, and 73% achieved at least 2-point improvement.
Bar graph showing 90-day home use study results. 78% achieved at least 1-point improvement, and 73% achieved at least 2-point improvement.

90-Day Home Use Study: Improvements observed early in treatment were maintained through Day 90 for many participants.

In the home-use study, most participants showed improvement in daily-task ability at Day 90.

Prospective, single-arm, open-label study (no sham arm); raters blinded. Pooled across both cohorts (n=59), share improving on the BF-ADL daily-activities scale at Day 90 vs. Day-0 baseline measured during stimulation.

Data on file.

Measured in everyday activities

WHAT IMPROVEMENT MEANS

Researchers evaluated improvement using the Bain & Findley Activities of Daily Living Scale (BF-ADL). The scale looks at activities people perform every day, including:

Silhouette of a person wearing headphones and holding a music player or smartphone, facing from the side.
Silhouette of a person wearing headphones and holding a music player or smartphone, facing from the side.

Drinking from
a cup

Graphic design with a dark teal circle in the center and white icons of a fork, a spoon, and a knife arranged vertically.
Graphic design with a dark teal circle in the center and white icons of a fork, a spoon, and a knife arranged vertically.

Using utensils

Stylized illustration of a human hand holding a pen
Stylized illustration of a human hand holding a pen

Writing or signing
a name

Silhouette of a person holding a garment.
Silhouette of a person holding a garment.

Completing routine daily tasks

Science FAQs

  • No. Encora X1 uses mechanical neurostimulation and does not deliver electrical current through the body during therapy.

  • Encora X1 uses mechanical neurostimulation instead of electrical stimulation. It’s designed to be worn throughout the day so support is there when you need it.

    Encora X1 has no electrical contraindications. Which means it can be considered for use in people with pacemakers, ICDs, insulin pumps, and other implanted electrical devices.

    Compatibility with implanted electronic devices is supported by bench testing conducted in accordance with IEC 60601-1-2. Five participants with implanted electronic devices were included in the 90-Day Home Use Study. This limited clinical experience may not be representative of all patients or implanted devices. Talk to your doctor before using Encora X1.

  • In clinical studies, some participants experienced device effects within approximately 15 minutes.

  • No. Encora X1 aids in the relief of hand tremors in the treated limb during stimulation.

  • Yes. It can be used alongside medication or on its own when medication is no longer your preferred path.

  • “FDA-cleared” and “FDA-approved” are two different routes a product takes to reach the market. Which one applies depends on the type of device and its risk category, not on how trustworthy or well-studied the product is.

    Most wearable medical devices, including Encora X1, go through a process called 510(k) clearance. To be cleared, a device has to show the FDA that it is substantially equivalent to a device already legally on the market, and it is then subject to the FDA’s ongoing requirements for that device type. Encora X1 is FDA-cleared to aid in the relief of hand tremors during stimulation in adults with essential tremor.

    “FDA-approved” is the term used mainly for prescription drugs and a smaller group of higher-risk devices, which follow a separate, longer approval pathway.

Close-up of an older man wearing a blue denim button-up shirt and a black Encora X1 wearable neurostimulation for essential tremor on his right wrist, standing in a wooden library with shelves filled with books in the background.

See if Encora X1 is right for you

BUILT ON SCIENCE, DESIGNED FOR LIFE

If you’re wondering whether Encora X1 could fit into your day, a Patient Advocate can help you understand next steps, coverage, and what to discuss with your doctor.

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