The Effects of Vibration Therapy on Activities of Daily Living After Stroke: A Systematic Review and Meta-Analysis

Background/Objectives: Activities of daily living (ADL) are critical for independence after stroke, yet many survivors remain functionally limited. Vibration therapy (VT), including whole-body and focal modalities, has been proposed as an adjunct to enhance recovery, but effects on ADL remain unclear. This study aimed to evaluate the overall effectiveness of VT on ADL and to identify moderating factors. Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Thirteen controlled trials (12 RCTs, 1 nRCT) involving VT in stroke were included. Standardized mean differences (Hedges' g) were synthesized using random-effects models. Meta-regression and subgroup analyses examined moderators such as session number, vibration parameters, stroke stage, and ADL subdomains. Risk of bias was assessed with RoB 2 and ROBINS-I. Results: VT produced a small but significant effect on ADL (Hedges' g = 0.19; 95% CI: 0.06-0.33; p = 0.008), though significance was lost after adjustment for publication bias. Heterogeneity was moderate (I² = 34%). Session number was the only significant moderator (p = 0.045), explaining ~24% of variance, with the greatest benefit in the 13-24 session range (g = 0.34; 95% CI: 0.05-0.63). Subgroup analysis showed improvement in physical function/mobility (g = 0.32; p = 0.048), but not in self-care or quality-of-life outcomes. Other parameters were not significant moderators. Conclusions: VT confers modest benefits for ADL after stroke, particularly in mobility-related domains. Session number appears clinically important, with 13-24 sessions suggesting an optimal dose window.