Table 1.

Detailed Characteristics of Studies Evaluating Focal Mechanical Vibration Therapy in Post-Stroke Patients.

Title, Author, Year of Publication, Study Type	Inclusion and Exclusion Criteria, No. of Participants	Intervention	Outcomes	Results
Focal vibration of the plantarflexor and dorsiflexor muscles improves post-stroke spasticity: a randomized single-blind controlled trial Chen Y.L. et al. (2022) RCT [45]	Inclusion: —First ischemic or hemorrhagic stroke diagnosis—Age 25–80 years—Stroke onset between 1 month and 2 years prior—MAS score between 1+ and 3—Able to follow verbal commands and sign consent forms—Able to lie prone/supine for 30 min. Exclusion:—Ankle muscle contracture on the affected side—Peripheral neuropathy—Changes in medication for spasticity or botulinum injections < 3 months prior—Contraindications for focal vibration—Participation in other clinical trials—MMSE < 18.	15 daily sessions of 30 min each CON group: Bobath therapy and motor relearning. FV_GM and FV_TA groups: Focal vibration at 3 mm amplitude and 40 Hz frequency added to conventional protocol (30 min therapy +20 min vibration).	Primary outcome: Reduction in spasticity (MAS). Secondary outcomes: Reduction in ankle clonus (Clonus Test), improvement in walking function (FAC).	Significant difference found in remission rates for MAS and Clonus Test scores in the vibration groups compared to the control group. The control group showed better improvement in walking capacity, while the FV_GM group demonstrated reduced gastrocnemius rigidity, spasticity, and ankle clonus. Total participants: 69.
Focal Muscle Vibration and Progressive Modular Rebalancing with neurokinetic facilitations in post-stroke recovery of the upper limb Celletti C. et al. (2017) RCT [15]	Inclusion: —First ischemic or hemorrhagic stroke diagnosis—Stroke onset at least one year prior. Exclusion: —Significant cardiovascular complications—Peripheral arterial disease—Cognitive deficits preventing simple commands—Prior treatments with FMV and RMP. Participants included: 18.	Two weekly sessions of one hour over 6 weeks. FMV + RMP group: Focal vibration at 0.2–0.5 mm amplitude, 100 Hz frequency, for three sets of 10 min each, with 1 min rest intervals + progressive modular rebalancing exercises focusing on upper limb kinetic chains. RMP + CP group: RMP exercises + traditional physiotherapy. CP group: Traditional physiotherapy.	Primary outcome: Upper limb functionality (WMFT). Secondary outcomes: Reduction in spasticity (MAS), reduction in pain (VAS), increase in muscle strength (MI).	Upper limb functionality improved most in the FMV + RMP and FMV + CP groups (FMV + RMP: p = 0.027; FMV + CP: p = 0.026; CP: p = 0.109). Spasticity reduction observed in all groups with varying degrees of success (FMV + RMP: p = 0.027; FMV + CP: p = 0.026; CP: p = 0.042). Pain decreased and muscle strength increased in the FMV groups.
Short-Term Effects of Focal Muscle Vibration on Motor Recovery After Acute Stroke: A Pilot Randomized Sham-Controlled Study Toscano M. et al. (2019) RCT [16]	Inclusion: —Age > 18 years—Diagnosis of first confirmed stroke—Motor deficits in upper and/or lower limbs—Ability to contract affected muscles isometrically. Exclusion: —History of TIA—Patients with aphasia, neglect, or apraxia—Cerebral venous thrombosis. Total participants: 22.	Three sets of 10 min each, with 1 min rest intervals, for 3 consecutive days. Study group: Focal vibration at 0.2–0.5 mm amplitude, 100 Hz frequency, applied to the belly of the affected muscle in supine position, with isometric contraction. Control group: Sham treatment.	Outcomes: —Stroke severity (NIHSS)—Motor and functional improvement of limbs (Fugl-Meyer + MI)—Reduction in spasticity (MAS).	Patients treated with rMV showed significant clinical improvement compared to the control group in NIHSS (p < 0.001), Fugl-Meyer (p = 0.001), and Motricity Index (p < 0.001).
Focal muscle vibration in the treatment of upper limb spasticity: a pilot randomized controlled trial in patients with chronic stroke Caliandro P. et al. (2012) RCT [17]	Inclusion: —Patients with chronic spastic hemiplegia/hemiparesis—Stroke onset at least one year prior (ischemic or hemorrhagic). Exclusion: —Cardiovascular complications within the last 12 months—Upper limb botulinum injections within the last year—Surgery within the last year—MMSE < 23. Participants included: 49.	Three sets of 10 min each, with 1 min rest intervals, for 3 consecutive days. Study group: Focal vibration at 0.2–0.5 mm amplitude, 100 Hz frequency, applied to the muscle belly in supine position, with isometric contraction. Control group: Sham treatment.	Primary outcome: Upper limb functionality (WMFT). Secondary outcomes: Reduction in spasticity (MAS), reduction in pain (VAS).	Significant improvement in WMFT scores for the study group (p = 0.006), but no significant changes in MAS or VAS scores.
Short-term effect of local muscle vibration treatment versus sham therapy on upper limb in chronic post-stroke patients: a randomized controlled trial Costantino C. et al. (2017) RCT [18]	Inclusion: —Chronic ischemic or hemorrhagic stroke survivors—Stroke onset at least 12 months prior—Unilateral upper limb spasticity (MAS 1-4)—No cognitive impairments. Exclusion: —Participation in other treatment programs—Inflammatory joint diseases—Neoplastic diseases—Use of anticoagulants or antiepileptics—Hearing aids—Artificial cardiac pacemakers—Recent trauma—Joint prostheses—Recent botulinum toxin treatments—Metal implants. Participants included: 32.	Three weekly sessions of 30 min over 4 weeks. Study group: Focal vibration at 0.2 mm amplitude, 300 Hz frequency, applied to triceps brachii and radial wrist extensors. Control group: Sham treatment.	Primary outcome: Grip strength (Hand Grip Strength Test). Secondary outcomes: Reduction in spasticity (MAS), reduction in disability (QuickDASH, FIM, FMA-UE, JTT), reduction in pain (NRS).	Significant improvements in all measured outcomes for the study group compared to the control group. Both paretic and non-paretic hands showed improvements in the study group.
Is two better than one? Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function: A pilot randomized controlled trial Calabrò R.S. et al. (2017) RCT [19]	Inclusion: —First ischemic stroke in left hemisphere, with onset at least 3 months prior—Deficits in shoulder abductors, flexors, and elbow extensors—Spasticity in biceps brachii, pectoralis major, latissimus dorsi (MAS 1+ to 3)—Age 50–80 years—Caucasian ethnicity. Exclusion: —Neurodegenerative diseases or concurrent surgeries—Severe cognitive or language deficits—Systemic or osteo-articular conditions—Central or peripheral sensitivity impairments—Concurrent use of medications for spasticity. Participants included: 20.	Five weekly sessions of one hour over 8 weeks. Robotic rehabilitation (RR): Repetitive exercises for shoulder and elbow movements. Focal mechanical vibration (FMV): Applied to antagonist muscles during RR (triceps brachii, supraspinatus, deltoid) with amplitude set between 0.2–0.4 mm and frequency of 80 Hz.	Primary outcomes: Reduction in spasticity (MAS), reduction in cortical excitability (SICI), reduction in spinal motor circuit excitability (HMR). Secondary outcomes: Upper limb functional recovery (FMA-UE), reduction in disability (FIM), improvement in mood and anxiety (HRS-D, HRS-A).	After 8 weeks, all study group patients achieved the minimum goal of reducing MAS scores by 1 point and at least a 15% reduction in SICI and HMR values. Significant differences between groups were observed in all primary and secondary outcomes (p < 0.001).

Legend: FAC: Functional Ambulation Classification, FIM: Functional Independence Measure, FMV: Focal Mechanical Vibration, FMA-UE: Fugl-Meyer Assessment for Upper Extremities, HMR: Hoffman’s Reflex Measurement, HRS-D: Hamilton Rating Scale for Depression, HRS-A: Hamilton Rating Scale for Anxiety, JTT: Jebsen-Taylor Hand Function Test, MAS: Modified Ashworth Scale, MI: Motricity Index, MMSE: Mini-Mental State Examination, NIHSS: National Institutes of Health Stroke Scale, NRS: Numerical Rating Scale, QuickDASH: Disabilities of the Arm, Shoulder, and Hand (Quick form), RMP: Progressive Modular Rebalancing, SICI: Short Interval Cortical Inhibition, VAS: Visual Analog Scale, WMFT: Wolf Motor Function.