Using upper-limb tendon/ muscle vibration for improving upper-limb functional motor performance in persons with chronic stroke: A systematic review and meta-analysis


Findings from recent studies suggest that tendon/muscle vibration treatment (T/MV) applied as an augmented sensory input may improve motor performance and reduce spasticity in individuals with stroke. We performed a systematic review and meta-analysis to evaluate the available evidence for the efficacy of T/MV for upper-limb functional movements in persons with chronic stroke. We searched the following databases from inception to September 2017: MEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (Wiley). We included randomized controlled trials (RCTs) comparing upper-limb T/MV to sham treatment/rest or conventional interventions in persons with chronic stroke. Our primary outcome was post-treatment upper-limb functional movement. Eight RCTs were included with a total of 211 participants. There was insufficient evidence for improvement in upper-limb functional movement (standard mean difference -0.32, 95% confidence interval (CI) -0.74 to 0.10, I2=25%, 6 trials, 135 participants). TM/V did not cause significant reduction in spasticity (4 trials). Movement time for reaching tasks significantly decreased after T/MV (standard mean difference -1.20, 95% CI -2.05 to -0.35, I2=65%, 2 trials, 74 participants). We did not find evidence to support the benefit of T/MV for persons with chronic stroke according to clinical outcome measurements for upper-limb functional movements. However, movement time for reaching tasks was significantly shorter after T/MV. A limited number of trials were identified; so, there is a need for larger, higher quality studies and to consider the clinical relevance of performance-based measurements that focus on timed functional movement tasks such as a reaching movement.

Acknowledgments: This work was supported by University of Manitoba Graduate Fellowship, Research Manitoba PhD studentship, and Natural Sciences and Engineering Research Council of Canada NSERC.