Does whole-body vibration training have a positive effect on balance and walking function in patients with stroke? A meta-analysis

Abstract

Objective: After a stroke, patients usually suffer from dysfunction, such as decreased balance ability, and abnormal walking function. Whole-body vibration training can promote muscle contraction, stimulate the proprioceptive system, enhance the muscle strength of low limbs and improve motor control ability. The study aims to evaluate the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke.

Methods: PubMed, CNKI, VIP, CBM, EBSCO, Embase and Web of Science were searched. According to the inclusion and exclusion criteria, randomized controlled trials on the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke were collected. The search time ranged from the date of database construction to November 2022. The included trials were evaluated by the Cochrane risk-of-bias tool. The meta-analysis was performed using two software packages, consisting of RevMan 5.4 and Stata 12.2. If the results included in the literature were continuous variables, use the mean difference (MD) and 95% confidence interval (CI) for statistics.

Results: (1) A total of 22 randomized controlled trials (RCTs) with a total of 1089 patients were included. (2) The results of meta-analysis showed that: compared with the controls, step length (MD = 6.12, 95%CI [5.63, 6.62], p < 0.001), step speed (MD = 0.14, 95%CI [0.09, 0.20], p < 0.001), cadence (MD = 9.03, 95%CI [2.23, 15.83], p = 0.009), stride length (MD = 6.74, 95%CI [-3.47, 10.01], p < 0.001), Berg Balance Scale (BBS) (MD = 4.08, 95%CI [2.39, 5.76], p < 0.001), Timed Up-and-Go test (TUGT) (MD = -2.88, 95%CI [-4.94, 0.81], p = 0.006), 10-meter Walk Test (10MWT) (MD = -2.69, 95%CI [-3.35, -2.03], p < 0.001), functional ambulation category scale (FAC) (MD = 0.78, 95%CI [0.65, 0.91], p < 0.001), Fugl-Meyer motor assessment of lower extremity (FMA-LE) (MD = 4.10, 95%CI [2.01, 6.20], p = 0.0001). (3) The results of subgroup analysis showed that, compared with other vibration frequencies, at 20-30 Hz frequency, WBV training had an obvious improvement effect only in TUGT. (4) The safety analysis showed that WBV training may be safe.

Conclusion: Whole-body vibration training has a positive effect on the balance and walking function of patients with stroke. Thus, whole-body vibration training is a safe treatment method to improve the motor dysfunction of patients with stroke.

Systematic review registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD4202348263].

Keywords: balance; meta-analysis; stroke; walking function; whole-body vibration training.

FIGURE 1

Study selection represented by PRISMA flowchart.

FIGURE 2

The risk assessment of bias by Cochrane. (A) This figure summarized the quality assessment of all included studies and presented an overall study quality assessment and risk of bias. Green means low risk of bias, red means high risk of bias, and yellow means ominous risk of bias. (B) This figure was presented separately for each included study and intuitively presented the quality assessment and risk of bias of each study. “+” Means low risk of bias, “–” means high risk of bias, and “?” means unknown risk of bias.

FIGURE 3

Forest plot of the effects of WBV training on walking spatiotemporal parament. (A) Step length (cm); (B) step speed (m/s); (C) cadence (step/min); (D) single support time(s); (E) double support time (s); (F) stride length (cm); and (G) step time (s).

FIGURE 4

Forest plot of the effects of WBV training on BBS.

FIGURE 5

Forest plot of the effects of WBV training on TUGT.

FIGURE 6

Forest plot of the effects of WBV training on 10MWT.

FIGURE 7

Forest plot of the effects of WBV training on FAC.

FIGURE 8

Forest plot of the effects of WBV training on FMA-LE.