What is a stroke?
A stroke, or “cerebral vascular attack” is a devastating event in a person’s life. There is often little prior warning yet the after-effects can be widespread, severe and long-lasting.
The Stroke Association gives a simple yet helpful definition of a stroke on their website 1:
“A stroke is a brain attack. It happens when the blood supply to part of your brain is cut off. Blood carries essential nutrients and oxygen to your brain. Without blood your brain cells can be damaged or die.
This damage can have different effects, depending on where it happens in your brain. A stroke can affect the way your body works as well as how you think, feel and communicate.”
Some of the side effects of damage to the left hemisphere of the brain include:
- Reading, speaking and problem solving difficulties.
- Paralysis or weakness on the right side of the body.
And some of the side effects of damage to the right hemisphere of the brain are:
- Short term memory, visual and spatial difficulties.
- Paralysis or weakness on the left side of the body.
A stroke can affect the body, mind and emotions and consequently the quality of life of the person affected, as well as those around them such as family and friends.
Some of the conventional methods of after-care and rehabilitation include stretching, gentle exercise, physiotherapy, speech therapy, medication (to help with depression, pain relief and blood flow) as well as adaptations such as wheelchairs, walking aids, sticks, and rails in the home.
So how might holistic therapies fit into a rehabilitation programme, accelerate healing and improve the quality of life for a Stroke sufferer? I’m going to give a bit of background on three types of holistic therapy and look into any research available that suggests they may be of benefit to stroke sufferers.
The main aim of massage is relaxation of the entire body. Some of the movements used in massage are:
Effleurage: long and gliding strokes along the body which encourage relaxation, reduce tension and increase circulation of blood to the heart.
Petrissage: a kneading and squeezing action which works on muscle tension and smoothes out any lumps or impure substances from the muscles so that they work more efficiently.
Tapotement: gentle pounding of the body to warm up and revitalise the muscles.
Friction: work on the muscle fibres using circular or perpendicular motions.
Recent scientific studies have shown that when massaged, Stroke patients experienced increased mobility, decreased pain and decreased depression.
Dietrich Miesler, in his article ‘Stroke Rehab’2 says that massage influences the nervous system in a positive way and helps the body in its search for homeostasis, or balance.
“As long as blood is freely circulating, there is healing… blood provides oxygen, picks up nutrients, carries orders from the hormonal glands to anywhere in the body within seconds, provides temperature control, picks up debris from cell repair and replacement, carries the debris to the kidneys … and… drops off substances for chemical analysis and detoxification [to the liver).”
Miesler comments that massage provides ten times as much oxygen to the areas of the body that are worked on as would be received passively. He recommends that the pressure should not be too firm, as in the case of sports’ massage as, if you exert too much pressure on the muscles, you will hinder blood flow which will have a negative rather than positive effect. He also talks about working specifically on hands, arms and shoulders including the cervical spine at the neck, which can be thrown out of balance due to arm weakness and may lead to scoliosis of the upper spinal column.
In a study at the Hong Kong Polytechnic University in 20043, the effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients were recorded. Those in the massage group received ten minutes of slow, rhythmic back massage before bedtime for seven evenings in a row. Subjects in the control group just received standard care. Results of the study showed that those in the massage group had significantly lower pain, anxiety, blood pressure and heart rate, compared to those in the control group. The improvements were maintained for several days after the treatments.
In this study it is also suggested that deep or vigorous strokes are counterproductive and may cause more harm than good. Slow, soothing techniques and gentle stretching, on the other hand, help with flexibility and proprioception.
Although to the untrained eye Reflexology appears to be quite similar to massage, there is much more to it than simple massaging of the hands or feet. Reflexologists use specific techniques to link into and trigger reflex points which activate healing changes in all the different organs and systems of the body.
Many people have experienced Reflexology as having a profoundly relaxing effect, and it is thought that it can promote positive changes in levels of:
All of which are very familiar to those who have experienced a stroke.
In the 2011 study ‘Effects of Foot Reflexology on Fatigue, Sleep and Pain’ 4 it was concluded that Reflexology had a marked positive effect on fatigue and sleep and a slight effect on pain, making it a useful nursing intervention.
A 2006 study in China followed 33 patients, aged between 44 to 78 years, who had suffered a stroke within the previous five years. Reflexology was administered for 30 minutes daily for 2 to 7 months. After treatment over 33% of the recipients were symptom free, with normal limb function and independent daily life; 60% had improved limb function; and 6% were unchanged. The study concluded that Reflexology can repair damage in the brain and revive the limb and speech performance of patients who have had a stroke.
Another study, published in 20055, asked whether Reflexology could make a difference to activities of daily living (ADL) and fatigue after a stroke. 31 stroke survivors were treated with 40 minutes of reflexology twice a week for six weeks. Tests showed that after foot Reflexology, there was significant improvement in ADL with less physical, psychological, and neurosensory fatigue.
Acupressure, an ancient healing art in which the fingers gradually press key healing points all over the body on the meridian lines. It is effective in the relief of stress-related ailments and ideal for self-treatment, using the same points that Acupuncture does, but without the use of needles. Acupressure can also be incorporated into a massaging routine.
An article in the Journal of Clinical Nursing 6 in 2009 outlined a study on the effects of Meridian acupressure on the functions of affected upper extremities, activity of daily living and depression for 56 stroke patients in K Oriental hospital. Acupressure was applied every day for 10 minutes for two weeks. Routine care only was applied in the control group.
The results showed that Acupressure was an effective intervention for improving the movement of the affected areas, increasing activity of daily living and decreasing depression.
So, in conclusion, these three holistic therapies can have many positive effects on all the key problem areas in those suffering from the after-effects of a stroke, namely:
– Stimulating blood flow and therefore improving overall mobility.
-Decreasing fatigue by releasing muscle tension and toxins and reducing cortisol levels.
-Stimulating circulation, decreasing lactic acid build-up, delivering oxygen-rich blood to extremities and creating warmth.
-Reducing insomnia by creating a more relaxed state, both physically and mentally, and activating the parasympathetic nervous system which is responsible for allowing the body to relax.
-Alleviating sore, stiff joints and cramps through better blood supply and circulation.
-Physically stimulating the receptors of the nervous system, leading to a release of the mood-lifting chemicals serotonin and dopamine and a reduction in stress hormones adrenaline and cortisol.
Marie Long is a holistic therapist and spiritual artist living and working in North Suffolk. She gives talks, demonstrations and taster treatments to groups in the community. If you would like Marie to visit your group then please get in touch via www.magentatherapy.co.uk
1. Website of the Stroke Association: www.stroke.org.uk/what-stroke/what-stroke
2. ‘Stroke Rehab’, Miesler, D, www.daybreak-massage.com.
3. ‘The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients’, Mok, E and Woo, C P, Complementary Therapies in Nursing & Midwifery: 2004, Vol. 10
4. ‘Effects of Foot Reflexology on Fatigue, Sleep and Pain: A Systematic Review and Meta-analysis’ Lee, Jeongsoon; Han, Misook; Chung, Younghae; Kim, Jinsun; Choi, Jungson, Journal of Korean Academy of Nursing: December 2011
5. ‘The Effects of Foot Reflexology on ADL and Fatigue in Stroke Patients’, Song, Mi-Ryeong; Song, Hyeong-Mi, The Korean Journal of Rehabilitation Nursing: 2005
6. ‘Effects of Meridian Acupressure for stroke patients in Korea’, Kang, S K, Journal of Clinical Nursing: September 2009
© Marie Long 2017