The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis

Abstract

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I2 = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

Revisiting Spasticity After Stroke: Clustering Clinical Characteristics for Identifying At-Risk Individuals

“…However, the severity of stroke was added in the analyses based on the previous works. 15 It would be imperative to include the latter characteristic to explore its relevance in our data cohort. By selecting only patients with spasticity in the two-step clustering analysis (n = 98), there were a total of 3 clusters with good cluster quality (Average Silhouette = 0.7) and a ratio of sizes of 1.90.…”

“…The treatments include, but are not limited to, physical stretching, massage therapy, antispasmodic agents (for instance, oral baclofen), phenol neurolysis and intramuscular botulinum toxin injection. 14,15 The latter two interventions are considered localized and effective for spasticity after stroke.…”

Effectiveness and functional magnetic resonance imaging outcomes of Tuina therapy in patients with post-stroke depression: A randomized controlled trial

“…Routine rehabilitation, including the Brunnstrom Bobath, and proprioceptive neuromuscular facilitation therapies, which are mainly based on guided joint and separation movements for the improvement of physical dysfunction to achieve psychological modulation, is widely used for the treatment of patients with stroke ( 13 , 14 ). In China, Tuina therapy, a traditional Chinese qigong exercise-based alternative manual therapy used for improving depression and anxiety, has been used for the rehabilitation for patients with stroke ( 15 – 17 ). Tuina therapy involves pressing and kneading the acupoints on the posterior midline of the spine using the fingers, and rubbing along the Du meridian on the spine using the palms.…”

Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery

“…Therefore, improving limb motor function of stroke patients through rehabilitation is essential. Traditional rehabilitation therapy, including massage, acupuncture, physiotherapy, and electrical stimulation, has been widely employed in the clinical practice ( McCrimmon et al, 2015 ; Yang et al, 2016 ; Cabanas-Valdés et al, 2021 ). With the progress of science and technology, several potential neurological rehabilitations are being developed using new technologies to restore movement in the stroke patients.…”