Neurosomatic Massage therapy Provides Relief for Chronic Stroke Symptoms: A Case Study
Background: Stroke is considered a leading cause of adult disability and despite advances in treating stroke, severe disability remains a common outcome. The most prevalent deficit after stroke is hemiparesis of the contralateral upper limb. Common manifestations of upper extremity motor impairment include muscle weakness or contracture, changes in muscle tone, joint laxity, and impaired motor control. Joint subluxation and muscle contractures can also lead to nociceptive musculoskeletal pain. Little information is available on palliative and symptomatic care for post-stroke patients. !
Case Presentation: A 66 year-old female patient in the chronic stages of stroke recovery was treated bi-weekly for five weeks for symptoms related to an ischemic stoke. The patient presented with neck and shoulder pain and fatigue. The Western Ontario Shoulder Index and a Dynamometer were outcome measures for this study. Most treatment centered on reducing hypertonicity of muscles in the cervical region in order to mobilize the atlas and axis to a neutral position. Hot/cold therapy was used with myofascial release, skin rolling, friction w/fiber and x/ fiber, and decompression and mobilization of the atlanto-occiptital/atlanto-axial joint. Massage therapy was administered by a student near the end of her 2nd of 3 semesters in a 1,278 vocational massage therapy program.!
Results: The results indicated that massage therapy improved chronic neck pain and showed a downward trend in relieving shoulder pain as well as indirectly reducing fatigue and risk for future stroke by mobilizing the atlas and axis vertebrae.!
Discussion: Measurements showed a general increase in the impact her shoulder has on her quality of life. However, individual line-items related to the specific areas worked showed a decrease in impact from shoulder related QoL. A longer study with a larger population is needed to show more definitive results.