National Stroke Awareness Month, observed in May, aims to educate the public about warning signs, risk factors, and symptoms of stroke and also make people aware of treatment options following a stroke and the impact of strokes on survivors and their loved ones.
Immediate action is crucial to minimizing damage after a stroke. The sooner a stroke patient receives medical attention, the less likely they are to experience severe aftereffects. There are two stages of treatment after diagnosis: acute care and post-acute or chronic care. Massage therapy is not recommended as part of acute care immediately following a stroke and is in fact contraindicated due to the circulatory problems likely to be present in a stroke survivor. However, it can be an integral part of post-acute care.
Massage for Chronic Care After Stroke
Determining whether massage therapy can have a role in the post-acute or chronic care stage of treatment following a stroke depends on exactly what complications have been caused by the cerebrovascular accident (CVA). Not all CVAs leave lasting effects, but because strokes are a result of disrupted blood circulation to the brain, consequences may be physical, psychological, or both. Stroke complications, which might last only a few hours but may be present throughout the rest of an individual’s life, can include:
- Sensory damage, including numbness or vision loss
- Motor damage
- Partial or full paralysis of one side of the body
- Slurred speech or loss of language
- Memory loss
- Depression
Depending on the severity of the effects after a stroke, rehabilitation might include speech therapy, occupational therapy, physical therapy, or even surgery. So while any of the above issues may be routinely improved by massage therapy when taken on their own, the complexities of stroke generally call for a more in-depth treatment plan. Massage therapy should only be considered after consultation with or recommendation from a physician and/or the survivor’s full recovery team.
After consent from the stroke survivor and collaboration with other healthcare professionals involved in the recovery process, a massage treatment plan may commence. There is no typical approach to using massage for rehabilitation after a stroke, since there are different types of strokes and different types of complications following a CVA. However, there are many possible positive outcomes of incorporating massage into the healing process.
How Can Massage Therapy Benefit Stroke Survivors?
Success stories from using massage for rehabilitation after a stroke are currently largely anecdotal, but research does clearly support the use of massage for isolated issues that can arise after a stroke. Additionally, one active study in Sweden is specifically evaluating the use of touch massage for stroke patients. Researchers hypothesize the findings will support post-stroke massage therapy for increasing sensorimotor function, improving fine motor skills, decreasing anxiety and physiological stress, and improving overall health and quality of life.
Some specific benefits that may be derived from massage after stroke include:
- Increased serotonin levels: One of the most promising ways massage therapy can help an individual who has had a stroke is by increasing serotonin levels, or alleviating depression. Upping serotonin levels has been shown to reduce the risk of vascular problems—issues related to blood vessels—as a result of antidepressants. Higher serotonin levels, in addition to helping ease depression, may reduce risk of heart attack or stroke. Thus, receiving massage after a stroke may not only offer relief from depression, but also lessen the likelihood an individual may experience another stroke. Because depression is one predictive factor of stroke, it is possible massage may reduce the risk of CVA even before a first incident.
- Improved circulation: Stroke may cause swelling or inflammation in the body. Only after this has subsided may a massage practitioner use very light touch and gentle techniques, such as lymphatic drainage, to improve circulation in a stroke survivor. Improving circulation and regenerating muscle function can both help repair sensory damage.
- Regenerated muscle function: Massage, especially when used in conjunction with physical therapy, can improve range of motion and help a client regain muscle control. Deep tissue massage that encourages client movement can improve proprioception, which refers to the nerves and sensory end organs that guide how muscles in the body work with one another. Stretching with assistance from a massage practitioner can also be beneficial.
- Regained memory: Studies have supported using reflexology for both dementia and Alzheimer’s, and the effects of this practice may also be specifically indicated for memory-related results of a stroke. A massage therapist trained in reflexology may work points related to the brain, spine, neck, adrenals, and heart points. Stroke patients who have complete memory loss, or are unable to communicate clearly because of memory loss, should receive special consideration to ensure they are able to consent to treatment and offer signals about how the therapy is accepted.
- Reduced stress and anxiety: In addition to reducing depression, massage therapy frequently eases stress and anxiety in both healthy clients and those experiencing pain or illness. A 2005 study conducted on stroke patients who received slow-stroke back massage for just 10 minutes per day demonstrated positive results: both shoulder pain and anxiety were reduced. Though a stroke survivor may not feel stress or anxiety as a direct result of a stroke, they may be co-occurring mental health issues to address simultaneously with other physical health issues. Improving one’s overall mental well-being can only help to encourage healing in all capacities.
All massage after a stroke should be done with client activity and sensitivity in mind, in collaboration with a client’s other health care providers. With the right practitioner, integrating massage therapy with other aftercare following stroke can accelerate the healing process and encourage full mind-body wellness for survivors.
References:
- American Stroke Association (2017). About stroke. Retrieved from http://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp
- Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.), 197-198, 610. Clifton Park, NY: Milady.
- Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience, 115(10). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16162447
- Hernandez-Reif, M., Field, T., Krasnegor, J., & Theakston, H. (2001). Lower back pain is reduced and range of motion increased after massage therapy. International Journal of Neuroscience, 106(3-4). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11264915
- Hou, W. H., Chiang, P. T., Hsu, T. Y., Chiu, S. Y., & Yen, Y. C. (2010). Treatment effects of massage therapy in depressed people: A meta-analysis. Journal of Clinical Psychiatry, 71(7). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20361919
- Lämås, K., Häger, C., Lindgren, L., Wester, P., & Brulin, C. (2016, February 4). Does touch massage facilitate recovery after stroke? A study protocol of a randomized controlled trial. BMC Complementary and Alternative Medicine, 16. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743203
- Massage benefits stroke patients. (2009, March 18). Massage. Retrieved from https://www.massagemag.com/massage-benefits-stroke-patients-4160
- Vallet, M. (2011). A touch of compassion: Massage therapy and Alzheimer’s disease. Retrieved from https://www.amtamassage.org/articles/3/MTJ/detail/2495
- Werner, R. (2009). A massage therapist’s guide to pathology (Fourth edition), 302-307. Philadelphia, PA: Lippincott Williams & Wilkins.