不同振动频率的全身振动训练对脑卒中患者平衡和步行功能影响的Meta分析

doi:10.3969/j.issn.1006-9771.2026.00.004

Abstract

Abstract:

Objective To systematically evaluate the effect of whole body vibration training (WBV) at different vibration frequencies on balance and walking function in individuals with stroke.

Methods Randomized controlled trials (RCT) about the effect of WBV on post-stroke balance and walking function were retrieved from CNKI, VIP, Wanfang Data, CBM, PubMed, Embase and Cochrane Library databases from inception to April, 2026. Outcome measures included Berg Balance Scale (BBS), Functional Ambulation Category (FAC), and Timed Up and Go Test (TUGT). The methodological quality of the included studies was appraised using the Cochrane Risk of Bias Tool and the PEDro scale. Meta-analysis was performed using Stata 18.0.

Results A total of 22 RCT comprising 1 335 stroke patients were included, with PEDro scores ranging from five to nine. Meta-analysis demonstrated that compared with control interventions, WBV significantly improved BBS scores (WMD = 4.761, 95%CI 3.220 to 6.302, P < 0.001) and FAC scores (WMD = 0.537, 95%CI 0.239 to 0.835, P < 0.001), and significantly reduced the time of TUGT (WMD = -2.329, 95%CI -3.889 to -0.769, P = 0.003). Subgroup analyses revealed that low-frequency WBV (≤ 20 Hz) produced significant improvement in both balance and walking function relative to controls, whereas high-frequency WBV (> 20 Hz) did not reach statistical significance. Low-frequency WBV intervention was superior to high-frequency WBV in FAC scores (Q = 8.070, P= 0.005), whereas no statistically significant difference was observed between the low- and high-frequency subgroups in BBS and TUGT (P > 0.05). Meta-regression suggested that vibration frequency was not the primary source of heterogeneity; rather, the total number of training sessions and time since stroke might be potential influencing factors. Adverse events were mild and occurred exclusively in the high-frequency group.

Conclusion WBV can effectively improve post-stroke balance and walking function. Based on the limited available evidence, low-frequency WBV (≤ 20 Hz) is super to high-frequency WBV in both efficacy and safety. In addition, attention should be paid to the cumulative effect of total training volume, and the timing of intervention should be tailored to the patient's disease duration.

Key words: stroke, whole body vibration training, vibration frequency, postural balance, gait, meta-analysis

CLC Number:

R743.3

Che Furong, Pan Yi, Qi Senjie, Wen Xiaoni. Effects of whole body vibration training at different vibration frequencies on balance and gait in stroke patients: a meta-analysis[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(10): 1143-1153.

Figures/Tables 9

Table 1

Figure 1

Table 2

Figure 2

Figure 3

Table 3

Basic characteristics of the included literatures"

纳入文献	n(男/女)		年龄/岁		病程		干预措施		疗程	评价指标
纳入文献	C	T	C	T	C	T	C	T	疗程	评价指标
马飞翔等^[6](2023)	13/7	13/9	50.90±7.14	51.14±6.80	(107.90±35.52) d	(103.09±33.48) d	Ⅱ、Ⅲ	Ⅱ+7 Hz、3 mm的WBV	每周10次，4周	①③
马飞翔等^[6](2023)		14/6		49.35±8.10		(101.30±26.88) d		Ⅱ+15 Hz、3 mm的WBV
涂美等^[10](2021)	17	16	55.4±4.5	53.9±3.8	(10.0±2.3)个月	(11.4±4.4)个月	Ⅱ	Ⅱ+5 Hz、2 mm的WBV	每周5次，6周	③
		17		55.6±4.3		(11.7±3.1)个月		Ⅱ+5 Hz、2 mm的WBV
		16		57.2±4.0		(11.1±2.1)个月		Ⅱ+5 Hz、2 mm的WBV
王盛等^[11](2017)	8/6	9/6	62.50±7.78	57.67±11.55	(19.00±4.47) d	(21.50±5.71) d	Ⅱ、Ⅲ	Ⅱ+起始2 Hz、4 mm的WBV	每周5次，3周	①
宋云锋等^[12](2024)	36/32	35/23	49.76±7.55	49.43±7.12	—	—	Ⅰ、Ⅱ	Ⅰ+Ⅱ+20~35 Hz、2 mm的WBV	每周5次，12周	①
金振华等^[13](2019)	17/17	18/15	61.09±4.34	60.55±4.59	(67.79±4.03) d	(67.18±5.45) d	Ⅱ	Ⅱ+20 Hz、4 mm的WBV	6周	②
魏巍等^[14](2021)	19/11	18/12	50.28±6.17	49.62±8.48	(79.58±37.26) d	(82.72±30.81) d	Ⅰ、Ⅱ	Ⅰ、Ⅱ+30 Hz、2 mm的WBV	每周6次，4周	①
肖悦等^[15](2020)	9/6	8/7	59.13±10.88	60.93±9.98	(2.26±1.57)个月	(2.63±1.53)个月	Ⅱ、Ⅲ	Ⅱ+5/10/5 Hz、4 mm的WBV	每周6次，2周	③
胡川等^[16](2022)	13/10	14/9	62.42±9.34	60.35±11.63	(3.23±1.76)个月	(3.41±1.48)个月	Ⅱ	Ⅱ+5~8 Hz、2 mm的WBV	每周5次，4周	③
张国兴等^[17](2011)	6/4	7/3	59.5±11.9	60.7±10.3	(40.1±9.2) d	(38.54±10.3) d	Ⅱ、Ⅳ	Ⅱ+Ⅳ+20 Hz、5 mm的WBV	6周	①②
金振华等^[18](2019)	16/19	18/17	55.0±4.7	55.0±4.8	(63.5±5.0) d	(63.7±6.0) d	Ⅱ、Ⅴ	Ⅱ+Ⅴ+20 Hz、3 mm的WBV	每周5次，6周	①②
李岩等^[19](2021)	12/13	18/7	61.92±5.64	62.64±7.02	(53.28±11.72) d	(53.68±8.88) d	Ⅱ、Ⅲ	Ⅱ+12 Hz、2 mm的WBV	每周5次，8周	①
王伟国等^[20](2020)	26/17	27/16	59.83±6.52	60.15±7.8	—	—	Ⅱ	Ⅱ+5~8 Hz、2.5 mm的WBV	每周6次，12周	①
毛璐熙等^[21](2023)	52/18	55/15	48.64±8.25	50.51±9.86	(38.15±6.68) d	(40.53±6.17) d	Ⅱ	Ⅱ+8/20/20 Hz的WBV(间歇/连续)	每周5次，4周	①②
冯兵等^[22](2022)	26/22	27/21	62.22±6.18	62.22±5.23	(45.50±6.80) d	(44.50±7.60) d	Ⅱ	Ⅱ+15 Hz、5 mm的WBV	每周5次，4周	①
Irshad等^[23](2022)	25/18	23/20	—	—	—	—	Ⅱ、Ⅵ	Ⅱ+30/40/50 Hz、2.5/3.5/8 mm的WBV	每周5次，6周	①③
Lee等^[24](2015)	6/3	8/4	56.0±9.1	59.3±13.2	(18.0±10.9)个月	(19.0±9.1)个月	Ⅱ	Ⅱ+1~3 Hz、30 mm的WBV	每周3次，6周	①③
Lee等^[25](2017)	7/8	8/7	64.4±14.8	59.1±16.9	(25.3±12.2) d	(18.4±6.9) d	Ⅱ	Ⅱ(单次)+40 Hz的WBV	每周5次，2周	①②
Burq等^[26](2021)	19/13	21/11	55.06±11.48	54.56±8.85	(10.82±5.15)个月	(14.46±12.14)个月	Ⅱ	Ⅱ+20 Hz、3 mm的WBV	每周6次，2周	③
Marín等^[27](2013)	5/4	6/5	64.4±7.6	62.4±10.7	(4.3±3.0)年	(4.3±2.0)年	Ⅱ、Ⅲ	Ⅱ+5~21 Hz、4~6 mm的WBV	12周，17次	①
van Nes等^[28](2006)	14/12	16/11	62.6±7.6	59.7±12.3	(34.2±11.1) d	(38.9±9.2) d	Ⅱ、Ⅶ	Ⅱ+30 Hz、3 mm的WBV	每周5次，6周	①②
Brogardh等^[29](2012)	12/3	13/3	63.9±5.8	61.3±8.5	(33.1±29.2)个月	(37.4±31.8)个月	Ⅲ	25 Hz、3.75 mm的WBV	每周2次，6周	①③
Lau等^[30](2012)	32/9	26/15	57.4±11.1	57.3±11.3	(5.3±4.2)年	(4.6±3.5)年	Ⅷ	Ⅷ+20~30 Hz、0.44~0.60 mm的WBV	每周3次，8周	①

Table 3

Table 4

Table 5

Figure 4

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纳入文献	纳入与排除标准	随机分配	分配隐藏	基线相似	被试施盲	评估者施盲	退出率≤15%	意向治疗分析	组间统计比较	点测量和差异值	总分
马飞翔等^[6](2023)	√	√	√	√		√	√		√	√	7
涂美等^[10](2021)	√	√	√	√		√	√		√	√	7
王盛等^[11](2017)	√	√		√			√		√	√	5
宋云锋等^[12](2024)	√	√		√			√	√	√	√	6
金振华等^[13](2019)	√	√		√		√	√	√	√	√	7
魏巍等^[14](2021)	√	√		√			√	√	√	√	6
肖悦等^[15](2020)	√	√		√			√	√	√	√	6
胡川等^[16](2022)	√	√		√			√	√	√	√	6
张国兴等^[17](2011)	√	√		√			√	√	√	√	6
金振华等^[18](2019)	√	√		√			√	√	√	√	6
李岩等^[19](2021)	√	√		√		√	√		√	√	6
王伟国等^[20](2020)	√	√		√			√	√	√	√	6
毛璐熙等^[21](2023)	√	√		√			√	√	√	√	6
冯兵等^[22](2022)	√	√		√			√	√	√	√	6
Irshad等^[23](2022)	√	√		√		√	√	√	√	√	7
Lee等^[24](2015)	√	√		√		√			√	√	5
Lee等^[25](2017)	√	√	√	√		√	√	√	√	√	8
Burq等^[26](2021)	√	√		√		√	√	√	√	√	7
Marín等^[27](2013)	√	√	√	√		√	√	√	√	√	8
van Nes等^[28](2006)	√	√	√	√	√	√	√	√	√	√	9
Brogårdh等^[29](2012)	√	√	√	√	√	√	√	√	√	√	9
Lau等^[30](2012)	√	√	√	√		√	√	√	√	√	8

结局指标	纳入研究数/n	样本量/n	异质性检验		Meta分析结果		效应模型
结局指标	纳入研究数/n	样本量/n	I²值	P值	WMD(95%CI)	P值	效应模型
BBS	17^{[6,11-12,14,17-25,27-30]}	1062	89.3%	< 0.001	4.761(3.220~6.302)	< 0.001	随机
FAC	5^{[13,17-18,21,25]}	327	77.2%	0.002	0.537(0.239~0.835)	< 0.001	随机
TUGT	8^{[6,10,15-16,23-24,26,29]}	406	70.3%	0.001	-2.329(-3.889~-0.769)	0.003	随机

结局指标	亚组	纳入研究数/n	样本量/n	异质性检验		Meta分析结果			亚组间比较
结局指标	亚组	纳入研究数/n	样本量/n	I²值	P值	Z值	WMD(95%CI)	P值	Q值	P值
BBS	低频	10^{[6,11,17-22,24,27]}	594	79.2%	< 0.001	7.645	5.603 (4.166~7.039)	< 0.001	1.420	0.233
	高频	7^{[12,14,23,25,28-30]}	468	93.9%	< 0.001	1.962	3.374 (0.003~6.745)	0.050
	低剂量	9^{[11,14,21-22,24-25,27,29-30]}	509	89.5%	< 0.001	2.946	3.814 (1.277~6.352)	0.003	1.810	0.178
	高剂量	7^{[6,12,18-20,23,28]}	533	85.4%	< 0.001	7.069	5.887 (4.255~7.519)	< 0.001
FAC	低频	4^{[13,17-18,21]}	297	62.3%	0.047	5.408	0.660 (0.421~0.899)	< 0.001	8.070	0.005
	高频	1^[25]	30	-	-	-0.420	-0.100 (-0.567~0.367)	0.674
TUGT	低频	6^{[6,10,15-16,24,26]}	289	0.0%	0.525	-6.121	-2.737 (-3.614~-1.861)	< 0.001	0.450	0.505
	高频	2^[23,29]	117	94.8%	< 0.001	-0.043	-0.166 (-7.667~7.336)	0.965

Effects of whole body vibration training at different vibration frequencies on balance and gait in stroke patients: a meta-analysis

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