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European Journal of Physical and Rehabilitation Medicine 2019 October;55(5):558-69

DOI: 10.23736/S1973-9087.19.05605-3

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Upper limb tendon/muscle vibration in persons with subacute and chronic stroke: a systematic review and meta-analysis

Niyousha MORTAZA 1 , Ahmed M. ABOU-SETTA 2, Ryan ZARYCHANSKI 2, 3, Hal LOEWEN 4, Rasheda RABBANI 2, 5, Cheryl M. GLAZEBROOK 6, 7

1 University of Manitoba, Winnipeg, MB, Canada; 2 George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada; 3 Department of Hematology and Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada; 4 College of Rehabilitation Sciences Librarian, Neil John Maclean Health Science Library, University of Manitoba, Winnipeg, MB, Canada; 5 Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; 6 Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada; 7 Health, Leisure, and Human Performance Research Institute, University of Manitoba, Winnipeg, MB, Canada



INTRODUCTION: Results of several recent studies suggest that tendon/muscle vibration treatment may improve motor performance and reduce spasticity in individuals with stroke. We performed a systematic review and meta-analysis to assess the efficacy of tendon/muscle vibration treatment for upper limb functional movements in persons with subacute and chronic stroke.
EVIDENCE ACQUISITION: We searched MEDLINE (Ovid), EMBASE (Ovid), and the Cochrane Central Register of Controlled Trials (Wiley) from inception to September 2017. We included randomized controlled trials comparing upper limb tendon/muscle vibration to sham treatment/rest or conventional interventions in persons with subacute and chronic stroke. Our primary outcome was upper limb functional movement at the end of the treatment period.
EVIDENCE SYNTHESIS: We included eight trials, enrolling a total of 211 participants. We found insufficient evidence to support a benefit for upper limb functional movement (standard mean difference -0.32, 95% confidence interval (CI) -0.74 to 0.10, I2 25%, 6 trials, 135 participants). Movement time for reaching tasks significantly decreased after using tendon/muscle vibration (standard mean difference -1.20, 95% CI -2.05 to -0.35, I2 65%, 2 trials, 74 participants). We also found that tendon/muscle vibration was not associated with a significant reduction in spasticity (4 trials).
CONCLUSIONS: Besides shorter movement time for reaching tasks, we did not identify evidence to support clinical improvement in upper limb functional movements after tendon/muscle vibration treatment in persons with subacute and chronic stroke. A small number of trials were identified; therefore, there is a need for larger, higher quality studies and to consider the clinical relevance of performance-based outcome measures that focus on time to complete a functional movement such as a reach.


KEY WORDS: Vibration; Upper extremity; Stroke; Rehabilitation; Systematic review; Meta-analysis

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