The effect of galvanic vestibular stimulation on postural balance in Parkinson’s Disease: A systematic review and meta-analysis
Author(s)
Type
Working Paper
Abstract
People with Parkinson’s disease (PD) experience postural imbalance, leading to considerably increased risk of falls. Galvanic Vestibular Stimulation (GVS) is postulated to modulate postural balance in humans and improve it in PD. This systematic review and meta-analysis investigate the effects of GVS on postural balance in PD. Six separate databases and research registers were searched for cross-over design trials that evaluated the effects of GVS on postural balance in PD. We used standardized mean difference (Hedges’ g) as a measure of effect size in all studies. We screened 223 studies, evaluated 14, of which five qualified for the meta-analysis. Among n = 40 patients in five studies (range n= 5 to 13), using a fixed effects model we found an effect size estimate of g = 0.43 (p < 0.001, 95% CI [0.29,0.57]). However, the test for residual heterogeneity was significant (p < 0.001), thus we used a random effects model and found a pooled effect size estimate of 0.62 (p > 0.05, 95% CI [– 0.17, 1.41], I2 = 96.21%). Egger’s test was not significant and thus trim and funnel plot indicated no bias. To reduce heterogeneity, we performed sensitivity analysis and by removing one outlier study (n = 7 patients), we found an effect size estimate of 0.16 (p < 0.05, 95% CI [0.01, 0.31], I2 = 0%). Our meta-analysis found GVS has a favourable effect on postural balance in PD patients, but due to limited literature and inconsistent methodologies, this favourable effect must be interpreted with caution.
Date Issued
2022-03-25
Citation
2022
Publisher
Cold Spring Harbor Laboratory
Copyright Statement
© 2022 The Author(s). All rights reserved. No reuse allowed without permission.
Identifier
https://www.medrxiv.org/content/10.1101/2022.03.25.22272947v1
Publication Status
Published