前庭电刺激对卒中后姿势与空间康复的治疗潜力：一项系统综述。

文献信息

中文摘要

背景： 卒中后姿势不对称和躯干控制受损很常见，并预示活动能力和功能独立性下降。前庭电刺激（GVS）提供了一种非侵入性替代方法，以最小不适改善视空间表现和平衡。本研究旨在系统综述前庭电刺激对卒中康复中姿势控制、平衡和空间定向的影响。方法：遵循PRISMA 2020指南，检索了1990年1月至2025年6月的数据库。结果：纳入18项研究，显示GVS改善卒中康复中的姿势控制、垂直感知、空间意识和推挤行为。18项研究符合纳入标准。发现GVS改善卒中康复中的姿势控制、垂直感知、视空间忽视和推挤行为。效应具有极性依赖性，并且在重复、任务整合的疗程中通常更强。然而，获益的持久性各不相同，长期结局仍未得到充分探索。结论：GVS持续改善卒中幸存者的垂直感知、视空间忽视和姿势控制，其效应受电极极性、刺激剂量和病变特征影响。重复、任务整合的疗程似乎是获得更持久获益所必需的。虽然GVS是常规神经康复的一种安全且可及的辅助手段，但长期疗效仍不明确，在常规临床使用前需要更大规模的对照试验。

英文摘要

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.