Efficacy and safety of whole-body vibration therapy for post-stroke spasticity: A systematic review and meta-analysis

Abstract

BackgroundOne of the main objectives of stroke rehabilitation is to alleviate post-stroke spasticity. Over the recent years, many studies have explored the potential benefits of whole-body vibration (WBV) treatment for post-stroke spasticity, but it is still controversial.ObjectiveThe current study aims to assess the efficacy and safety of WBV for post-stroke spasticity and determine the appropriate application situation.MethodsFrom their establishment until August 2022, the following databases were searched: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, China National Knowledge Infrastructure (CNKI), and Wanfang. Only randomized controlled trials (RCTs) that were published in either English or Chinese were taken into consideration. We independently filtered the research, gathered the data from the studies, and evaluated the research quality (Cochrane RoB tool) and the overall evidence quality (GRADE). Rev Man 5.4 software was utilized to conduct statistical analysis.ResultsIn this analysis, 11 RCTs with 475 patients that reported on the effectiveness of WBV therapy for post-stroke spasticity were taken into account. Compared to the control groups, the results revealed that WBV combined with conventional rehabilitation at a vibration frequency lower than 20 Hz (SMD = −0.58, 95% CI: −0.98 to −0.19, P = 0.004) was more effective in relieving upper (SMD = −0.53, 95% CI: −1.04 to 0.03, P = 0.03) and lower limb spasticity (SMD = −0.21, 95% CI: −0.40 to −0.01, P = 0.04); similarly, it was superior for patients aged under 60 years (SMD = −0.41, 95% CI: −0.66 to −0.17, P = 0.0008) with acute and subacute stroke (SMD = −0.39, 95% CI: −0.68 to −0.09, P = 0.01). The valid vibration for reducing spasticity was found to last for 10 min (SMD = −0.41, 95% CI: −0.75 to −0.07, P = 0.02). None of the included studies revealed any serious adverse impact.ConclusionModerate-quality evidence demonstrated when WBV was used as an adjuvant, vibration <20 Hz for 10 min was effective and secure in treating upper and lower limb spasticity in patients with acute and subacute stroke under the age of 60 years.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022293951.

Best Practice Guidelines for the Management of Patients with Post-Stroke Spasticity: A Modified Scoping Review

“…Highlighted details: The systematic review and meta-analysis by Zhang et al [ 26 ] critically assessed the impact of WBV on post-stroke spasticity. It analyzed 11 RCTs with a total of 475 patients, all of which were published in either English or Chinese.…”

Effects of whole-body vibration training on physical function, activities of daily living, and quality of life in patients with stroke: a systematic review and meta-analysis

“…The results of our analysis demonstrated the anti-spasticity effect of WBVT, which was also confirmed in previous studies ( Park et al, 2018 ; Yang et al, 2022 ). Since stroke patients may experience spasticity in various body parts ( Wissel et al, 2010 ), and a recent meta-analysis has confirmed the effectiveness of WBVT in both upper and lower extremity spasticity ( Zhang et al, 2023 ), it is essential to explore the effects of WBVT on spasticity in different body parts. However, most relevant trials did not report the specific spastic muscle groups assessed by MAS, making it difficult to determine the efficacy of WBVT for specific spastic muscles.…”

Immediate effects of a vibrating foam roller on dorsiflexion rom, balance, and gait in stroke patients: a randomized controlled trial

“…Whole-body vibration has been reported as effective and safe for treating spasticity in stroke patients ( Zhang et al, 2023 ). In another study, whole-body vibration rehabilitation demonstrated positive effects on the balance and gait of stroke patients ( Yin et al, 2023 ).…”