Stroke Patients

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.