To investigate the efficacy of a wearable vibratory training system on the rehabilitation of upper limb dysfunction in patients during the post-stroke sequelae stage and its neural imaging mechanisms. Methods: Seventy-six patients with post-stroke sequelae who were hospitalized at Sichuan Bayi Rehabilitation Hospital from January to August 2022 were randomly divided into an experimental group and a control group, with 38 patients in each. Both groups received conventional rehabilitation treatments, while the experimental group additionally used the wearable vibratory training system for rehabilitation. The Modified Ashworth Scale (MAS) was used to assess muscle tone, the Modified Barthel Index (MBI) to evaluate activities of daily living, and the Fugl-Meyer Upper Extremity Scale (FMA-UE) to assess upper limb motor function before rehabilitation and after 1 and 2 months of treatment. Ten patients with post-stroke sequelae recruited from Weihai Municipal Hospital between July 2023 and April 2024 were given rehabilitation treatment using the wearable vibratory training system for 2 months. Diffusion Tensor Imaging (DTI) scans were performed before rehabilitation and 3 months after the start of treatment. Results: After one month of rehabilitation, both groups showed lower MAS scores (P<0.05) and higher MBI and FMA-UE scores (P<0.05) compared to their pre-treatment levels, but there were no significant differences between the groups (P>0.05). After two months of rehabilitation, the MAS scores continued to decrease, with the experimental group showing lower scores than the control group (P<0.05); the MBI and FMA-UE scores also increased, with the experimental group scoring higher than the control group (P< 0.05). DTI images indicated that the fractional anisotropy (FA) values in the affected hemisphere were significantly lower than those in the normal hemisphere (P<0.05), and after two months of treatment with the wearable vibratory training system, FA values in the affected side increased significantly (P<0.05). Conclusion: Treatment with the wearable vibratory training system can effectively improve upper limb dysfunction in patients during the post-stroke sequelae stage. The mechanism may be related to the repair of damaged neural fiber tracts following stroke.