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.
Limei Gao, Yuwen Fan, Na Zhang et al.
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In 30 seconds
This systematic review and meta-analysis assessed randomized controlled trials of transcutaneous auricular vagus nerve stimulation (taVNS) paired with exercise training in people with stroke. Across 16 studies involving 708 patients, the combined intervention was associated with improvements in upper-limb motor function on three measures and in activities of daily living (ADL). For the Fugl-Meyer Assessment Upper Extremity, the standardized mean difference was 1.27 (95% CI, 0.89-1.66; P<.01). Subgroup analysis found a significant motor-function effect with intervention frequency of ≥4 sessions/wk; optimal stimulation and exercise protocols remain uncertain.
Key findings
- Upper-limb motor function improved on the Fugl-Meyer Assessment Upper Extremity (SMD=1.27; 95% CI, 0.89-1.66; P<.01).
- Improvements were also reported on the 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).
- ADL improved with taVNS paired with exercise (SMD=1.42; 95% CI, 0.70-2.14; P<.01).
- Intervention frequency of ≥4 sessions/wk was associated with a significant upper-limb motor-function effect (SMD=1.36; 95% CI, 0.90-1.82; P<.01).
Why it matters
The pooled findings suggest that pairing non-invasive auricular vagus nerve stimulation with exercise may support both arm function and daily activities after stroke. Reporting outcomes across several functional measures and examining session frequency offers useful evidence for rehabilitation research. However, the review identifies unresolved questions about stimulation settings and exercise protocols, so the results do not establish a single optimal regimen.
What to keep in mind
The abstract notes that further research is needed to determine optimal stimulation parameters and exercise protocols; the pooled results therefore do not establish an optimal intervention regimen.