The Effect of Percussion Massage Therapy in Stroke Patients

The Effect of Percussion Massage Therapy on Muscle Tone, Walking and Balance Functions in Chronic Stroke Patients

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

Inclusion Criteria:

• Having had a unilateral stroke and being in the chronic phase (≥6 months, ≤2 years).
• Age: 40-65 years old.
• Hemiplegic patients with lower limb dysfunction.
• Mini-Mental State Examination (MMSE) score ≥24. Lower limb spasticity of 1-3 on the Modified Ashworth Scale (MAS).
• Full passive range of motion (ROM) in the hip, knee, and ankle joints.
• Ability to stand independently for at least 1 minute.

Exclusion Criteria:

• Individuals with neurological, orthopaedic, metabolic, and rheumatological conditions that may affect soft tissues.
• Patients who have undergone spasticity treatment or other therapies within the last three months.
• Individuals with lower limb injuries.
• Pregnant women.