Vibrotactile stimulation for upper-limb neurorehabilitation and sensorimotor training: a systematic review of clinical and mechanistic evidence.

BACKGROUND

Vibrotactile stimulation (VTS) has emerged as a potential sensory-based adjunct to upper limb rehabilitation by providing additional afferent feedback and supporting sensorimotor rehabilitation. This systematic review aimed to synthesize clinical evidence on VTS for post-stroke upper-limb rehabilitation and complementary mechanistic and technological evidence from healthy participants, with emphasis on intervention characteristics, stimulation parameters, clinical outcomes, neurophysiological effects, usability and safety.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and was retrospectively registered with the Open Science Framework. PubMed, PEDro, Web of Science and Google Scholar were searched for English-language full-text studies published between January 2015 and January 2026. Search terms included combinations of stroke, VTS, vibration, tactile, somatosensory, haptic, upper limb and hand.

RESULTS

A total of 35 studies were included. Fourteen studies used direct upper-limb stimulation, six integrated VTS with robotic systems, two with virtual reality (VR), two with mirror visual feedback (MVF), seven with brain-computer interface (BCI) paradigms, and four with multimodal systems. Stimulation sites included the wrist, hand, fingers, fingertips, forearm, and upper arm, whereas reported frequencies, intensities, timing, and doses varied widely. Clinical studies suggested potential improvements in upper-limb motor function, sensory and proprioceptive function, spasticity, and affected-limb use, particularly when VTS accompanied active or task-oriented training. Mechanistic studies indicated that VTS may modulate sensorimotor rhythms, cortical activation, functional connectivity, and motor-imagery (MI)-related brain responses.

CONCLUSION

Current evidence suggests that VTS may support upper-limb functional recovery after stroke. However, confidence in the evidence remains limited by small samples, heterogeneous protocols, and the frequent use of multimodal interventions that do not isolate the contribution of vibration. Further adequately powered randomized controlled trials are needed to determine clinical efficacy and to identify the stimulation parameters and feedback architectures most likely to benefit people after stroke.