Efficacy of vibration therapy on physical function, activity and participation in people with stroke: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE: This study aimed to explore the effectiveness of vibration therapy (VT) in improving physical function, activity, and participation in people with stroke. METHODS: We searched six databases for randomized controlled trials (RCTs) investigating VT in people with stroke. The quality of included studies was assessed using the Cochrane Risk of Bias tool, and data were analyzed using RevMan and Stata. The quality of evidence was evaluated with the GRADEpro tool. RESULTS: Thirty-seven RCTs involving 1492 people with stroke were included. VT significantly improved physical function, including motor (SMD = 0.46, 95% CI 0.20-0.73), spasticity (SMD = - 0.64, 95% CI - 0.99 to - 0.29), balance (SMD = 0.52, 95% CI 0.19-0.85), and gait (SMD = - 0.41, 95% CI - 0.66 to - 0.16). Activity was also enhanced (SMD = 0.21, 95% CI 0.06-0.35), whereas participation did not show improvement (SMD = 0.01, 95% CI - 0.33 to 0.35). Subgroup analysis and meta-regression revealed that spasticity improvement was superior in people with chronic stroke (SMD = - 0.8, 95% CI - 1.19 to - 0.4). Single-session vibration time ≥ 20 min for gait (SMD = - 0.84, 95% CI - 1.36 to - 0.32), cumulative vibration time > 5 h for balance (SMD = 0.86, 95% CI 0.30-1.43), and intervention duration ≥ 4 weeks for spasticity (SMD = - 0.5, 95% CI - 0.81 to - 0.2) yielded pronounced improvements. CONCLUSIONS: Low to moderate quality evidence suggests that VT effectively enhances physical function and activity in people with stroke, while its impact on participation remains unclear. Moreover, VT produced superior spasticity relief in people with chronic stroke compared to those in acute and subacute phases; single-session vibration time ≥ 20 min for gait, cumulative vibration time > 5 h for balance, and intervention duration ≥ 4 weeks for spasticity were particularly effective.