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Stroke is an acute neurological condition resulting from cerebral ischemia or hemorrhage, frequently leading to impaired motor function, increased muscle tone, and deficits in balance and gait. Spasticity is a common long-term complication in individuals with chronic stroke and significantly affects functional mobility and quality of life.
Percussion Massage Therapy (PMT) is an emerging intervention that combines principles of mechanical vibration and traditional soft tissue techniques. Although previous research has examined its effects in musculoskeletal and athletic populations, evidence regarding its use in individuals with chronic stroke remains limited.
The aim of this study is to investigate the effects of percussion massage therapy on muscle tone in individuals with chronic stroke and to determine whether changes in muscle tone are associated with improvements in gait and balance performance.
Stroke frequently results in persistent neuromuscular impairments, including increased muscle tone, altered motor control, and reduced postural stability. Spasticity, particularly in the chronic phase, contributes to joint stiffness, abnormal movement patterns, and decreased functional independence. Interventions targeting muscle tone reduction may therefore support improvements in gait and balance.
Percussion Massage Therapy (PMT) is delivered handheld mechanical devices that apply rapid, repetitive pressure pulses to myofascial tissues. These mechanical stimuli are thought to promote muscle relaxation, enhance proprioceptive input, modulate pain perception, and facilitate local circulation. By inducing mechanical deformation within soft tissues, PMT may influence neuromuscular activation patterns and reduce hypertonicity.
While studies have reported beneficial effects of massage and vibration-based interventions on muscle stiffness and functional performance in various populations, data specifically addressing individuals with chronic stroke are scarce. In particular, the relationship between PMT-induced changes in spasticity and functional outcomes such as gait and balance has not been adequately explored.
This study is designed to evaluate the effects of PMT on muscle tone in individuals with chronic stroke and to examine whether potential reductions in spasticity translate into measurable improvements in gait and balance performance. The findings are expected to contribute to the evidence base for adjunctive rehabilitation strategies in chronic stroke management
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Percussion Massage Therapy (PMT) | Experimental | Percussion Massage Therapy (PMT) |
|
| Conventional Rehabilitation | Experimental | Conventional Rehabilitation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| exercises | Other | Treatment for both groups will last for 6 weeks, 3 days a week, with each session lasting approximately 45-60 minutes. Assessment sessions will last 30-40 minutes and will be conducted independently of the treatment sessions. Assessment sessions will be conducted twice, before and after treatment. The Classical Physiotherapy Programme applied to both groups will consist of stretching exercises, strengthening exercises, walking and balance training, and neuromuscular electrical stimulation applied to the lower extremity muscles. Percussion Massage Therapy (PMT), which will be applied in addition to the experimental group, will be applied to the hip adductors, knee extensors, and ankle plantar flexors belonging to the lower extremity extensor synergy. Application Method: PMT will be applied to each muscle group of the lower extremity for 2-3 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| 10-Meter Walk Test: | a standard clinical measurement tool that objectively assesses an individual's walking speed. In the study area, the walking speed (m/s) is calculated by timing the middle 10 metres of a straight line. | 3 months |
| Myoton® PRO | measures muscle tone | 3 months |
| Timed Up and Go Test (TUG); | The Timed Up and Go Test (TUG) is a practical test that assesses functional mobility components such as rising from a seated position, walking a certain distance, turning around, and sitting back down. | 3 months |
| Berg Balance Scale (BBS) | The Berg Balance Scale is a clinical measure developed to assess static and dynamic balance and evaluate balance performance in activities of daily living. In stroke rehabilitation, the BBS is widely used to quantitatively determine balance impairment and monitor balance changes. It is one of the most frequently recommended balance assessment tools in stroke clinical practice guidelines worldwide and is associated with gait, fall risk, and postural control. | 3 months |
| Digital goniometer | Joint position sense and proprioception assessment will be performed using a digital goniometer for the hip, knee, and ankle joints. During measurement, the participant will be placed in the appropriate starting position, and the rele | 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sanko Unıversıty | Gaziantep | Gaziantep | 27090 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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The study will be conducted on stroke patients who apply to the Physical Therapy and Rehabilitation Research and Application Unit at Sanko University. Treatment and assessments will be carried out at this unit.
Participants meeting the inclusion criteria will be randomly assigned to two groups: the experimental group and the control group. Experimental Group: Classic physiotherapy treatment + Percussion Massage Therapy (PMT); Control Group: Classic physiotherapy treatment only.
For both groups, treatment will last for 6 weeks, 3 days per week, with each session lasting approximately 45-60 minutes. Assessment sessions will last 30-40 minutes and will be conducted independently of the treatment sessions. Assessment sessions will be conducted twice: before and after treatment.
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|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |