The location and the extent of damage to the brain from a stroke
vary incredibly. The effects each patient experience may be temporary
or permanent. Most suffer from some extent of hemiplegia, which
is paralysis on one side of the body as a result of a brain lesion.
The effects also range from almost imperceptible to severely disabling.
(Rattray, Ludwig, 2000). The signs and symptoms vary in each patient.
Initially the muscles on the affected side lack muscle tone, then
gradually spasticity (increased muscle tone) and reflex patterns
will develop. The client may neglect the affected side and may present
with an altered posture, leading to an altered gait, therefore creating
compensatory changes in the unaffected side. Seizures may occur
due to the brain lesion. There may be pain, swelling and sensory
loss. Visual impairment, speech difficulties and cognitive impairment
may occur. As well behavioural and emotional changes may be present,
as the patient copes with all these changes (Rattray, Ludwig, 2000).
Initially, rehabilitation efforts will focus on decreasing reflex
patterns and spasticity of the muscles to increase the patient’s
ability to function daily, as well speech therapy may be needed.
Massage therapy can reduce spasticity and reflex patterns, increase
the client’s awareness of the affected side and improve joint
and soft tissue health (Rattray, Ludwig, 2000).
Generally, a massage therapy treatment for a stroke patient focuses
on relaxation and slow, easy breathing techniques. Massage techniques
focus on improving circulation and overall tissue health. The massage
treatment will vary incredibly, depending on how the patient presents
and keeping in mind their individual limitations. For example, lymph
drainage techniques and cool hydrotherapy are used if there is swelling
present. Warm heat is used if there are contractured muscles. As
well, the positioning of the client will be individualized to the
client’s comfort level, trying to make the client feel as
secure as possible. The main goals are to decrease muscle tone,
spasticity and reflex patterns, increase joint health to improve
joint range of motion, and provide the patient with an overall feeling
of well being, emotionally and physically.
The patient should also be encouraged to participate in a modified
exercise program, which will increase joint health and movement,
increase strength in weakened muscles, stretch spastic muscles and
increase cardiovascular health. Self massage and self movement to
the affected side can be taught to the patient to do at home. Hydrotherapy
can be used at home to help improve tissue health. A local support
or social group such as Stroke Club, can also benefit the client
(Rattray, Ludwig, 2000). All of these things can greatly improve
the client’s quality of life, and make the activities of daily
living much easier.