Transcutaneous Auricular Vagus Nerve Stimulation Paired With Exercise Training for Upper Limb Motor Function and Activities of Daily Living After Stroke: A Systematic Review and Meta-analysis

IF 4 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2026-10-01 Epub Date: 2026-03-20 DOI:10.1016/j.apmr.2026.03.008

Limei Gao BS, Yuwen Fan BS, Na Zhang PhD, Lu Chen PhD

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引用次数: 0

Abstract

Objective

To evaluate the safety and efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) paired with exercise training on upper limb motor function, Activities of Daily Living (ADL) and adverse events , and to assess the impact of device parameters on rehabilitation outcomes, in patients with stroke through a meta-analysis.

Data Sources

A systematic literature search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure, and Wanfang Database from inception to November 2025.

Study Selection

Randomized controlled trials were included to evaluate the effects of taVNS paired with exercise training in patients with stroke.

Data Extraction

Two researchers independently extracted relevant data (sociodemographic characteristics, study characteristics, stimulus parameters, and outcome indicators). The methodological quality of the included studies was assessed using the Cochrane Risk of Bias 2.0 tool. Any discrepancies were resolved through discussion or consultation with a third researcher.

Data Synthesis

Sixteen original studies involving a total of 708 patients with stroke were included. The results showed that patients receiving taVNS paired with exercise training had significant improvements in upper limb motor function, as assessed by the Fugl-Meyer Assessment Upper Extremity (standardized mean difference [SMD]=1.27; 95% confidence interval [CI], 0.89-1.66; P<.01), Wolf Motor Function Test (SMD=1.46; 95% CI, 0.74-2.17; P<.01), and Action Research Arm Test (SMD=4.51; 95% CI, 2.73-6.29; P<.01). TaVNS paired with exercise also exhibited beneficial effects on ADL (SMD=1.42; 95% CI, 0.70-2.14; P<.01). Subgroup analysis indicated that an intervention frequency of ≥4 sessions/wk had a significant effect on upper limb motor function (SMD=1.36; 95% CI, 0.90-1.82; P<.01).

Conclusions

TaVNS paired with exercise training can effectively improve upper limb motor function and ADL, with a significant effect when the intervention frequency is ≥4 sessions/wk. Further research is needed to determine the optimal stimulation parameters and exercise protocols.

查看原文本刊更多论文

经皮耳迷走神经刺激配合运动训练对中风后上肢运动功能和日常生活活动的影响：一项系统回顾和荟萃分析。

目的通过荟萃分析，评价经皮耳迷走神经刺激（taVNS）配合运动训练对脑卒中患者上肢运动功能和日常生活活动的安全性和有效性。数据来源系统检索PubMed、Cochrane Library、Embase、Web of Science、CINAHL、CNKI、万方数据库自成立至2025年11月的文献。研究选择纳入随机对照试验来评估taVNS与运动训练对脑卒中患者的影响。两名研究人员独立提取相关数据（社会人口统计学特征、研究特征、刺激参数和结果指标）。采用Cochrane风险偏倚2.0工具（ROB 2.0）评估纳入研究的方法学质量。任何差异都通过与第三位研究者的讨论或咨询来解决。16项原始研究共涉及708例脑卒中患者。结果表明,患者接受taVNS搭配运动训练在上肢运动功能有显著改善,评估的FMA-UE (SMD = 1.27;95%可信区间 = 0.89 - 1.66;P < 0.01), WMFT (SMD = 1.46;95%可信区间 = 0.74 - 2.17;P < 0.01)和ARAT (SMD = 4.51;95%可信区间 = 2.73 - 6.29;P < 0.01)。TaVNS与运动配对对ADL也有有益的影响（SMD = 1.42;95% CI = 0.70-2.14;P < 0.01）。亚组分析显示，干预频率≥4次/周对上肢运动功能有显著影响（SMD = 1.36;95% CI = 0.90-1.82;P < 0.01）。结论TaVNS配合运动训练可有效改善上肢运动功能和日常生活活动能力，干预频率≥4次/周时效果显著。需要进一步的研究来确定最佳的刺激参数和运动方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.