The effects of neck muscle vibration on postural orientation and spatial perception: A systematic review

Background. - Neck muscle vibration (NMV) is increasingly used for its modulation of body orientation and spatial perception, but its mechanisms of action are still not well known. Objectives. - To describe the effects of NMV on postural orientation and spatial perception, in both healthy people and patients with disturbed balance potentially related to distorted body orientation perception. Methods. - Following the PRISMA guidelines, a systematic search was performed using the databases MEDLINE, EMBASE, Cochrane library and PEDrO with the key words ((Postural balance) OR (Spatial reference)) AND (Neck muscle vibration) for articles published through to July 2016. Results. - A total of 67 articles were assessed; these exhibited wide heterogeneity and generally poor quality methodology. In healthy subjects, under bilateral NMV, the body tilts in the anterior direction (Level of Evidence LoE II). Under unilateral NMV, the visual environment moves towards the side opposite the vibration (LoE II) and the subject's experience of straight ahead is shifted towards the side of the vibration (LoE II). NMV also modulates both spatial and postural bias between stroke and vestibular patients. Discussion. - NMV modulates both spatial and postural bias and could thus be proposed as a tool in rehabilitative therapy. However, due to the heterogeneity of published data and the various significant shortfalls highlighted, current research does not allow clear guidelines to be proposed. (C) 2019 Elsevier Masson SAS. All rights reserved.