Effect of tactile stimulation in disorders of consciousness: a systematic review

BACKGROUND: Disorders of consciousness (DoC) represent a major challenge in neurorehabilitation. Sensory stimulation, particularly tactile stimulation, has been proposed as a therapeutic intervention to enhance arousal and awareness in these patients. OBJECTIVE: This systematic review aimed to evaluate the effectiveness of tactile stimulation interventions in patients with DoC. METHODS: A systematic search of the literature identified 25 studies published between 1989 and 2025 investigating tactile stimulation in these patients. Data were extracted on the types of tactile interventions, methodologies, frequency, duration, and outcomes. RESULTS: Tactile stimulation was most commonly delivered through massage, brushing, or textured contact, targeting areas, such as the hands, arms, and face. Interventions were typically brief, administered daily over short periods, and often embedded within multimodal rehabilitation programmes. Across studies, tactile stimulation was associated with short-term improvements in behavioral indicators of consciousness and physiological responses, including heart rate and electroencephalographic activity. Interventions administered by family members appeared to yield particularly robust effects, highlighting the affective dimension of touch. CONCLUSIONS: Current evidence supports the short-term benefits of tactile stimulation in DoC, while long-term effects remain insufficiently investigated. Future research should prioritize standardized, patient-centered protocols, with systematic follow-up and evaluation of single versus multimodal approaches, including family involvement.