Therapeutic potential of galvanic vestibular stimulation for postural and spatial rehabilitation after stroke: A systematic review.

Abstract

Postural asymmetry and impaired trunk control are common after stroke and predict reduced mobility and functional independence. Galvanic vestibular stimulation (GVS) offers a noninvasive alternative, to improve visuospatial performance and balance with minimal discomfort. The present study aims to systematically review the effects of Galvanic Vestibular Stimulation on postural control, balance, and spatial orientation in stroke rehabilitation. Following PRISMA 2020 guidelines, databases were searched from January 1990 to June 2025. Eighteen studies were included, showing that GVS improves postural control, verticality perception, spatial awareness, and pusher behaviour in stroke rehabilitation. Eighteen studies met the inclusion criteria. GVS was found to improve postural control, verticality perception, visuospatial neglect, and pusher behaviour in stroke rehabilitation. Effects were polarity-dependent and generally stronger with repeated, task-integrated sessions. However, the durability of benefits varied, and long-term outcomes remain underexplored. GVS consistently improves verticality perception, visuospatial neglect, and postural control in stroke survivors, with effects influenced by electrode polarity, stimulation dose, and lesion characteristics. Repeated, task-integrated sessions appear necessary for more durable gains. While GVS is a safe and accessible adjunct to conventional neurorehabilitation, long-term efficacy remains unclear, and larger controlled trials are needed before routine clinical use.