Massage of the right paralyzed half of the body after a stroke. Peculiarities of manifestation of right-sided strokes in elderly patients. Then they pass through the main muscles

One of the most important recovery procedures after a stroke is massage. With its help, it is possible to achieve positive results, significantly speeding up the patient’s rehabilitation period. Manual manipulation helps to establish metabolism between damaged tissues and restore lost body functions.

Is it possible to have a massage after a stroke?

The procedure has a beneficial effect on damaged nerve tissue and motor centers, helping to get rid of the negative consequences of hemorrhagic or ischemic stroke. Massage provides:

promotion muscle tone;
elimination of involuntary movements of the limbs, paresis, paralysis;
combating pathological tendon reflexes;
relieving pain during movements caused by muscle spasms;
elimination of the symptom of friendly movements.

Contraindications

Massage is an indispensable part of a person’s rehabilitation after a stroke, but it must be carried out by a specialist. Improper manual therapy can cause a deterioration in the patient’s condition and stimulate the onset of a period of exacerbation. Massage of the left or right side is considered a standard procedure in a complex of rehabilitation measures. However, it is contraindicated in dangerous conditions that pose a risk to human health or life. Massaging a bedridden patient with complete or partial paralysis of the limbs poses a threat. Other contraindications to manipulation are:

hypertension;
elevated temperature;
respiratory dysfunction;
pain in the head, in the region of the heart.

Achieving the best effect is achieved by combining several techniques. After an illness, a person may experience disturbances in motor reactions, which can be avoided by pre-warming the limb before the procedure. By rubbing and light stroking, tissue trophism is restored and pathological symptoms are removed. muscle tension. To prevent contractures (limitation of joint movement), attention should be paid to the extensors and flexors of the arms.

Massage therapy is a preparation for more active exercise. To train the patient before future loads, first knead the healthy part of the body, using relaxing manipulations. The session begins with a foot massage. Hypertonic muscles are relaxed through light superficial rubbing and stroking. Atrophy is affected by the same methods, but in an accelerated manner.

If the patient tolerates the sessions easily, the specialist adds kneading without displacement. First, atrophically stretched muscles are developed, and then tissues with hypertonicity are developed. The use of striking techniques after a stroke is prohibited. Let us consider in more detail the techniques of rehabilitation massage:

Stroking. It has a general tonic effect, causes the rejection of dead skin cells, and activates capillary blood circulation. Massage movements are performed with a relaxed palm moving in a spiral, zigzag or straight line. First, stroking is performed superficially, then the intensity is increased for more active influence on subcutaneous tissue and muscles. When stroking, no large skin folds.
Trituration. This technique is used to shift and stretch layers of tissue. Thanks to rubbing, it occurs accelerated recovery muscle elasticity and the affected area warms up deeply. The skin gathers in large folds. Manipulations are performed in a zigzag or straight line using the fingertips, heel of the palm or fists.
Vibrations. Perform with a relaxed palm making oscillatory movements. The massage therapist's hands move from the right side to the left and transmit vibration to the damaged area of the body. The effect of the technique depends on the amplitude and speed of the impact. Slow vibrations with a large amplitude tone the muscles, while fast and less intense vibrations relax them.
Point impact. In addition to standard manipulations, during rehabilitation they sometimes resort to methods of oriental therapy. Reflex acupressure after a stroke is based on irritation and activation of certain active points. Beneficial effects occur both on the muscular system and on the functioning of internal organs. The advantages of acupressure manipulation are absolute safety and effectiveness. However, if the procedure is performed incorrectly, it can cause a sharp deterioration in a person’s condition, so it is important that it be performed by a qualified specialist.

Restorative massage after a stroke

An individual approach to each patient and strict adherence to recommendations ensure the fastest possible recovery effect. Rehabilitation will be much faster and easier with massage than without it: positive changes can be noticed after 3-4 weeks. After 2–3 months, the patient will be able to independently perform accurate movements of the limbs.

However, in order to recover, it is necessary to combine massage techniques with other rehabilitation manipulations (physical therapy) and drug treatment. The choice of technique, determination of the start time and duration of massage sessions is carried out by a rehabilitation specialist together with the treating neurologist. The manipulation is carried out by a rehabilitologist or a hired experienced massage therapist.

Duration of sessions and massage course

The first sessions can begin immediately after normalization general condition the patient, when his heartbeat and breathing stabilize, his pulse and heartbeat are restored, and cerebral edema subsides. As a rule, the acute period takes 2–3 days for ischemic stroke and up to 5–7 days for hemorrhagic stroke. During this time, any type of rehabilitation is prohibited. First, the body must adapt to the changes that have occurred and restore basic vital signs.

Light massage can be started for the first time only 2-3 days after the attack. If the patient’s condition has not yet stabilized, it is better to wait a week. From 2–3 days, the patient can be turned on his side, gently stroking the skin in areas where redness is observed (sacrum, back, elbows, hip joints, shoulders, heels), and rub it with camphor alcohol. This will help prevent the formation of bedsores.

After a week, you should try again to perform an active massage, and after 15–20 days, expand the scope of the procedure. Only after a month has passed after the stroke is it possible to carry out a full-fledged recovery procedure. Massage should have a kind of dose - the norm. General techniques for bedridden patients are performed regularly 2–3 times a day, their duration is 3–5 minutes. It is better to organize special manipulations to restore the motor ability of paralyzed limbs daily, the total number of procedures is 20–30.

After the course, take a break for at least 3-4 weeks, during which the muscles will regain strength so that further more intense manual treatments will produce the expected effect. The first massage session should be short - no longer than 5 minutes. If it does not cause any negative effects, the duration is increased every day, bringing it to 15–20 minutes in the second week.

A full rehabilitation massage a month after a stroke, including general and special manipulations, takes about half an hour, and for severe movement disorders – an hour. The duration of sessions increases gradually. Any manual procedure in duration and intensity must be such that a specific patient can endure it, since this is a burden for the body.

After severe attacks with severe paralysis, you should start with the lightest and shortest massage. If the impairments are not so severe (weakness of the limbs, but maintaining the ability to move them, walk), you should not waste time on weak techniques. Patients who are undergoing full course rehabilitation, first they massage the whole body, only after that they move on to a specific problem part.

Rules

Massage after a stroke is carried out at home or in medical institutions, but always by a qualified specialist. During the procedure, manual manipulation (hand manipulation) and various devices such as massagers are used. The rehabilitologist, in tandem with the treating neurologist, determines the optimal volume, time, and frequency of procedures, based on the patient’s condition and the stage of his recovery.

First, the manipulations are carried out by a specialist, and after that the patient’s relatives can learn the correct technique in order to massage his body on their own. In 2-3 sessions, any person can learn how to properly perform recovery sessions. General rules carrying out the procedure:

so that the joints of the limbs are in a physiological position and the muscles can completely relax, a cushion is placed under them;
if the patient is lying on his back, a pillow is placed under his head, and a bolster is placed under his knees;
when the patient is positioned on his stomach, the head is turned towards the massage therapist, the arms are placed along the body and slightly bent at the elbows, and a cushion is placed under the knees;
massaging the outer part of the legs, the patient is placed on the healthy side;
if the back of the leg is being massaged, the patient is placed on his stomach, placing small pillows under the peritoneum, head and ankle joints;
if the functioning of the heart is impaired, the patient is massaged while lying on his back or side;
if synkinesis (cooperative movement of the limbs) occurs, the healthy arm/leg is fixed with a bag of sand or other contents.

Before you begin manual therapy, it is important to check whether the muscles on the affected side of the body are tense. To do this, use relaxation exercises, starting with a healthy limb. An arm or leg is relaxed when, when lifting and releasing it, it falls (it is important to protect the limb from bruising). Before starting the rehabilitation procedure, the massage therapist should wash and warm his hands. Fingers and palms should not be rough and nails should not be long, as this can injure the patient’s skin.

During the first few sessions, only the thigh and shoulder are massaged, and the patient is not turned onto his stomach. At the 4th–5th session, the massage therapist begins to use the patient’s chest, feet, legs and forearms. Starting from 5–8 manual therapy procedures, it is allowed to massage the lower back and back on the healthy side. Movements are performed along the lymphatic vessels to the nodes:

on the legs - from the feet to the inguinal and popliteal lymph nodes;
on the arms - from the hands to the elbow and axillary lymph nodes;
on the back - from the spine to the axillary lymph nodes;
on the chest - from the edges in both directions along the intercostal spaces to the armpits;
on the sacrum and lower back - towards the groin.

It is better to start the session in the morning, when the patient has undergone all hygiene procedures. In this case, the patient’s breakfast should be light. It is important to ensure that the procedure does not cause negative emotions person after a stroke. If massaging the body causes discomfort, pain, or negative dynamics are observed (increased heart rate, blood pressure), you should immediately stop exercising. The procedure ends with wrapping the patient's body in a blanket or warm towel.

Rehabilitation should begin small, gradually increasing the duration of sessions and their intensity. In the future, you can alternate therapeutic exercises with the patient’s independent exercises and massages. Before starting the session, it is important to warm up the patient’s body; the following methods are used for this:

warming the extremities with heating pads or a warm salt bath;
paraffin applications;
applying a cream with a warming effect or a special massage oil to the skin.

How to massage after a stroke

Today, there are several specially created products for rehabilitation massage that reduce skin irritation due to friction. Other drugs are used to relieve swelling, activate blood circulation, etc. Massage with the use of ointments, the effect of which negatively affects the heart rate, thereby causing various disorders. Massage ointments should not be used for any type of diaper rash or bedsores. Acceptable aids For manual sessions- This:

heparin ointment (used to relieve swelling);
Lazonil (necessary for insufficient blood circulation in certain areas of the body of a patient who has suffered a stroke);
special massage oils and creams (used in the absence of contraindications, they facilitate skin care and make the procedure more pleasant, but you should avoid products with a strong odor, which can cause headaches or increase blood pressure).

Each session must correspond to a certain sequence in strength and intensity: minimum-maximum-minimum. First, stroking is performed, followed by rubbing movements, kneading, and vibration. The session always ends with soothing, stroking manipulations. Tapping, chopping, patting, and other striking techniques are contraindicated during rehabilitation after a stroke.

For spastic muscles, massage should include superficial stroking, light vibration and rubbing. The outer surface of the arms, the front of the shin and backside The feet rarely experience spasms, so more active and rough rubbing and stroking can be used for them. The following parts of the body are prone to the spastic process:

on the hand - palm, inner surface hand, forearm and shoulder;
pectoralis major muscle;
plantaris muscle;
calf muscles;
quadriceps femoris muscle.

General

This type of massage is necessary for muscle relaxation, it has a calming effect, eliminates stagnation, improving the movement of lymph and the flow of blood and oxygen to the tissues. It is better to do it in the first half of the day, immediately after hygiene procedures. The sequence of manual impacts on the patient’s skin can be as follows:

certain areas of the body are stroked with palms and fingers in circular, longitudinal and transverse directions;
then the skin is rubbed with palms, ribs of hands or fists;
alternately tap the edge of the left and right hands over the entire kneading surface, creating vibration (intense impacts are prohibited);
lightly pinch the skin with the index, thumb and middle fingers;
The procedure ends with stroking.

Each action is performed for 1–2 minutes, and it is better to start with the torso (back, chest), then move on to the shoulders, arms, and then to the buttocks and legs. At this time, the patient should be in a safe position:

in mild forms of paralysis, it is allowed to turn the patient onto his stomach;
in severe cases with impaired swallowing, sessions can be carried out exclusively with the patient lying on his back and on his healthy side.

Legs

Massage at ischemic stroke necessarily includes kneading the limbs. The patient's position when massaging the inner and front surface of the thigh should be on his back. The procedure begins with stroking, the direction of movement should be from the knee to the groin (towards the regional lymph nodes). Proper foot massage after a stroke gives a relaxing effect. Then proceed to light rubbing with the palm or fingers. All movements alternate with stroking:

When working with the back of the thigh, the patient is placed on his side or stomach. The movements are carried out from the knee to the groin, while the muscles are easily stroked and rubbed. The buttock is massaged in the direction from the sacrum to the outer thigh.
The lower leg is massaged with the patient lying on his back. Deep stroking, rubbing, different kinds kneading. The main thing is to perform massage movements with the entire surface of the palms and fingers. Their direction should be from the ankle to the knee. The back of the lower leg, which is extremely spastic, is kneaded very carefully - using light, superficial movements.

During the massage, the limb is fixed: the heel is placed in the palm so that the patient’s fingers look up. With the other hand, the massage therapist kneads the leg, moving from the toes to the shin. Movements are performed exclusively with the fingers. It is important to remove attention to the interosseous spaces that are accessible when the patient's fingers are spread apart. Softer, more gentle manipulations are suitable for the side of the sole.

Hands

The permissible position of the patient after a stroke is lying on his back or sitting:

First of all, the shoulder (delto- and trapezius muscles) is warmed up. All techniques are performed intensively and in a certain order. The direction of movement is from the lower vertebrae of the neck to the deltoid muscle. Special attention pay attention to kneading the latter.
Next, the massage therapist moves on to the triceps. All manipulations are performed energetically. The movements are directed from the elbow to the shoulder joint along the outside of the arm.
Afterwards, massage the biceps with a little less intensity, since this muscle is very spastic. In this area, only superficial rubbing and stroking is performed. The direction of movement is from the elbow to the armpit along the outer edge of the shoulder. On the inside of the shoulder joint, manipulations are performed extremely carefully, since large vessels and nerves pass there.
When massaging the forearm, first work on the outer surface of the forearm. Both superficial and deep techniques of stroking, kneading, and rubbing are allowed. Movements are carried out towards the elbow joint from the forearm. The front part of the arm is spastic, so only gentle manipulations are allowed here. The direction of movement remains unchanged.
The hand and fingers are massaged, starting from the back, as the muscles are stretched. Movements smoothly move from fingers to hands. Intense rubbing and kneading are allowed. The surface of the palm is spastic, so manipulations should be gentle and superficial.

Backs

The patient should lie on his healthy side or stomach, turning his head towards the massage therapist. Place a pillow under your head. When performing the procedure, all techniques are used (rubbing, stroking, vibration, etc.), but it is important to control the intensity in order to avoid increasing muscle tone, while improving tissue nutrition. Movements should be directed along the lymph flow. Back massage is carried out from the center to the periphery to prevent an increase in intracranial and blood pressure.

Can massagers be used after a stroke?

High-quality vibrating massagers can be used at the stage when the patient has almost completely recovered motor functions. Using the device, a person who has suffered a stroke can perform self-massage. The disadvantage of the massager is the inability to control the intensity of the manual action. The device must be used carefully: if pain or skin irritation occurs, the intensity of the procedures should be reduced.

When choosing a massager, it is recommended to give preference to devices that are not too hard/rough. These can be ball devices or brushes with medium-hard bristles. It is important to consider that massagers made from natural materials may be allergenic, so they are first tested on a small area of the body.

Video

From a medical point of view, a stroke is a disease in which a circulatory disorder develops in the tissues of the brain or adjacent structures. This pathology may be of ischemic and hemorrhagic origin. The first group contains general signs lack of fluid flow in the vessel, which often results in metabolic disorders, for example, tissue respiration and nutrition. The second group is a disease that is manifested by the leakage of blood into the structures of the brain. This leads to disruption of basic functions, which are important for the existence of the individual.

If a person suffers a stroke, the consequences for the limbs are unfavorable.

This may manifest itself as monoplegia, hemiplegia and tetraplegia. The first symptom is externally manifested by the absence of movements of one limb, the other - the arms and legs on one side of the body, the third - all 4. Such consequences require immediate treatment. Post-stroke therapy includes the use of medications, physiological procedures, massage, and the like.

Preparing for a massage course after a stroke

Before using therapeutic massage of the arms and legs for people suffering from a stroke, preparation should be carried out. First you need to visit a doctor. Rehabilitologist after studying all the features of the neurological basis of the situation of each individual patient will prescribe an appropriate massage course. This procedure has a significant restorative effect on correct execution and compliance with all necessary rules. There is a list of acute conditions and chronic diseases, in which massage is not recommended, and sometimes even contraindicated. Since this type of physical activity can provoke a worsening of existing concomitant pathologies. Such diseases include colds and viral conditions, disorders of the cardiovascular system, some deficiencies from the gastrointestinal tract group, etc. Therefore, establishing contraindications and excluding their presence in a sick person is very important stage carrying out preparation activities.

Massage for post-stroke conditions differs from similar procedures performed to improve the somatic condition of the body in other diseases.

A person who will engage in this type of rehabilitation must have specialized skills in carrying out procedures, since knowledge about performing massage for somatic pathologies of other origins will not be enough.

Before performing a massage, you need to take care of a comfortable position in bed for the patient. It is worth noting that to prevent the formation of bedsores, it is necessary to change the spatial configuration of the body relative to the bed every 2-3 hours. When performing rehabilitation, the patient must take an optimally comfortable position to avoid deterioration of the somatic condition.

Goals of massage after stroke

Massage procedures in post-stroke situations are used to improve the general condition of the body and positive neurological changes at the local level. This type of rehabilitation helps achieve the following results:

stabilization of the hemodynamics of the circulatory system in general and the vessels of the upper and lower extremities in particular;
restoration of the activity of voluntary movements that the limb performed before the injury. This refers to actions from simple twitching of muscles of different groups to the establishment of normal reflexes of the system (for example, grasping);
avoiding the occurrence of contractures in areas of muscle fibers that were active in the past;
reduction of spasms of the affected limbs;
providing muscles with tone, improving their overall functioning, eliminating pain and discomfort that can often occur in the initial stages of the recovery process;
prevention of the formation of bedsores in areas of the body affected by the paralytic effect.

This list of goals is not complete, that is, it can be continued. This also includes improvement in overall well-being, recovery dynamics, recovery processes in the peripheral part nervous system. Massage is a good complement to medication and physiotherapeutic treatments and has a common positive influence for the whole body.

Basic requirements for massage after a stroke

Such a specific massage must be performed according to a specific algorithm, which is prescribed by the treatment protocol. It is recommended to start the first sessions of procedures with a few minutes (usually 3-5). With each subsequent time the time increases. However, at the beginning of the next meeting with the massage therapist, a functional status assessment is carried out and the possible changes in the body, determine the presence positive dynamics onset of improvement.

The sequence of massage movements and the intensity of their use are determined in each individual case by the characteristics of the patient’s disease. The techniques are performed in a certain algorithm and are repeated 3-4 times during the session. The procedure must be carried out in a warm, functionally adapted room, which has an air temperature of more than 20 C. Before starting the massage, the patient must take a shower, then rest for 20-30 minutes.

Since this type of activity is considered physical activity and the body needs time to recover. The number of sessions for each patient is selected by the doctor individually due to the characteristics of the damage to the limbs.

The main condition for such rehabilitation is its systematicity, that is, the need to carry out procedures after a certain period of time in accordance with the schedule.

It is also worth noting that the massage largely depends on the type of lesion. For ischemic stroke without noticeable complications, procedures begin 2-4 days from the onset of the disease, subject to general stabilization of the condition. If we are talking about hemorrhagic pathology, the start of classes is postponed to 5-8 days. This occurs due to the onset of relatively severe consequences and the patient’s relatively worse state of health.

Precautionary measures

There are a number of reservations and tips that should be followed when working on restoring the body of such a plan. First you need to make sure that the patient has no absolute or relative contraindications for massage. Work should begin when the patient has taken a shower and is comfortably seated on the massage table or the place where the procedure is to be performed. The body position is most often on the side, so you should carefully provide the body with such placement, taking into account the specifics of the work. The session begins when the muscles are relaxed. Movements should be smooth and not have a traumatic effect, since there is a potential danger of spasm. Also, rehabilitation should not be tiring. Exercise stress, which is allowed to be selected in proportion to so as not to deplete the body’s strength.

Hand massage

Rehabilitation therapy is applied to the entire affected part of the body. But special attention is paid to the limbs, where the manifestations of paralysis have the strongest effect. Massage of the arm after a stroke is carried out in accordance with a certain sequence, that is, movements are carried out from the torso to the axillary node and from the hand to the specified formation. The latter acts as a filter, purifying the liquid from harmful substances.

The pectoralis major muscle is massaged first. Movements begin from the beginning of formation, that is, from the edge that is closer to the sternum. Techniques should be predominantly in the areas of intercostal spaces. This promotes the flow of lymph from the said muscle to the axillary nodes.

When performing a hand massage, the person performing such a procedure must pay enough attention to the fingers, kneading each phalanx. Movements must be carried out from the tips to the pastern and wrist. The techniques are repeated several times alternately.

The forearms, that is, the area from the hand to the elbow, are also massaged along the course of the lymphatic system, starting from the bottom up. A special feature is the use large quantity circular movements in order to cover the space of the entire hand at the same time.

Shoulder massage is carried out towards the axillary lymph nodes, that is, from the elbow to the place where the arm is attached to the body. Particular attention is paid to the middle and upper third, since here the nerve bundle is especially close to the surface.

Massage techniques

Rehabilitation of a sick body is carried out using a specific procedure algorithm. In this case, a number of basic massage techniques are used, which include stroking, rubbing, kneading and vibration.

Stroking is initial stage performing a massage. It serves as an introduction, that is, for the body to adapt and the skin to get used to the hands. Affects the surface layers of the skin, improving local blood and lymph circulation there. It is carried out at the beginning, at the end, and also between the use of other techniques as a transitional link. The movements are carried out at a slow pace with a frequency of approximately 20-25 per minute.

Trituration affects not only the integument of the body, but also the subcutaneous fatty tissue. It is carried out through a relatively deeper impact on the anatomically affected areas. The movements do not necessarily coincide with the course of the lymphatic vessels. Reception improves blood circulation, increases local temperature, and helps improve the sensitivity of nerve endings due to their constant stimulation.

Kneading is considered a method of intensive exposure. At the same time, muscle structures that are located relatively deep are also included in the work. Increases trophic and metabolic processes, improves tissue respiration. As a result, regeneration processes are accelerated and performed with relatively greater intensity.

Vibrations Most often used at the end of a massage session to consolidate the effect. This technique has a positive effect on deep structures. In this case, the hand is placed on the skin in accordance with the internal projection of the structures that need to be influenced.

Self help

It is worth remembering that hand massage after a stroke at home differs significantly from such physiotherapeutic procedures for other pathologies of the human body. The peculiarity of performing such movements arises due to the varying degrees of damage to one or another muscle group. This refers to differential tension, relaxation, spasm or atrophy.

The work needs to start from the healthy side. That is, if the patient is the left hand, the movements are first performed on the right, gradually moving to the affected one. Actions should be gentle and non-traumatic.

Here it is important to prevent the possible occurrence of complications in the form of spasms when muscles respond to irritation by external factors with pathological reactions. Stressed areas must be affected especially gently and carefully, avoiding possible additional damage. If the muscle is atrophied, you can use massage movements of increased intensity to stimulate the sensitivity of the specified area.

Massage at home can be carried out after the person who will use such techniques has undergone specialized training. The duration of the procedure, intensity, sequence of techniques and general algorithm of actions are determined by the doctor and require strict implementation when conducting sessions outside the hospital.

Forecast

General prognosis about the patient’s condition and the possibility of his recovery along with the restoration of lost limb functions is positive. This factor depends on several criteria for the development of the disease itself. If the stroke was not severe and did not lead to complications, recovery of motor functions occurs relatively faster. In this case, the moment of identifying the damage and starting first aid is also important. The less time between these events, the more favorable the prognosis will be. The progress of recovery largely depends on treatment methods, physiotherapeutic procedures (including massage), their quality and intensity.

If, subject to all conditions of rehabilitation and application available methods recovery, improvement in motor functions of the limbs did not occur within 12 months from the moment of injury, the prognosis is not favorable. Under such circumstances, there is a large percentage that the lost functions will not return to normal, and paralysis of the limb will accompany the person for the rest of his life.

Stroke - serious disease, it takes a long period of time for a person to take his place in life, to be able to rejoice and receive pleasure from life. Great importance is attached to the rehabilitation period. You can help the patient restore impaired coordination of movements using therapeutic exercises and special massage after a stroke. In addition, it is recommended to go to a sanatorium that specializes in treating patients after a stroke. You need to follow a diet.

And the sooner the patient’s rehabilitation begins, the better. Initially, it is necessary to have therapeutic massage after a stroke performed by a professional. Then the patient's loved ones can do it themselves.

Target

Frequent accompaniments of a stroke are paralysis and muscle weakness. Massage after a stroke at home should help the patient:

normalize blood circulation in the limbs on the side that is paralyzed;
eliminate pain;
restore muscle tone;
restore movement of a paralyzed arm or leg;
reduce spasms in the limbs;
prevent the formation of bedsores.

Benefits of massage

After a stroke, massage is simply necessary. It allows you to improve blood flow in the extremities, which leads to a reduction in swelling in them and the elimination of harmful substances from the body. Internal organs establish normal functioning. The functioning of the gastrointestinal tract is restored, and as a result, constipation goes away, which is very important for stroke patients.

Nutrients in tissue and skin are starting to do better. This is a good prevention of bedsores. The patient experiences less pain and his health improves. There is a gradual restoration of the physiological nature of movements, improvement psychological condition patient, he has faith in recovery.

One of the main issues when carrying out rehabilitation measures to recover from a stroke is massage and when to start doing it after a stroke.

The sooner the faster the process will begin recovery.

The first procedures are prescribed by the doctor; the start of their implementation depends on the type of stroke. If the patient has an ischemic type of stroke, then the restoration process begins on the third day, for hemorrhagic stroke - a week after the patient is admitted to the inpatient department.

The first procedures last no more than 5 minutes and are carried out by a specialist as prescribed by a doctor. The optimal massage technique is selected for each patient. During the first sessions, you cannot turn the patient over on his stomach.

In general, the duration of each subsequent procedure increases by five minutes until it reaches half an hour. But here, too, each patient requires an individual approach. A restorative massage must be done every day for a month, then you need to stop for a while.

Manipulations begin with the upper joints of the shoulder or hip, depending on which limb is being massaged. Then we gradually go down to the arm or leg, respectively. Then a massage of the chest, back, feet and hands is added. When the procedure is completed, the patient should be given rest for at least a quarter of an hour.

Basic principles of therapeutic massage

How to massage? It is necessary to be guided by the basic principles of therapeutic massage.

The patient should lie horizontally, in a comfortable position with relaxed torso muscles. The lower limbs are lowered in relation to the upper body. Start massaging from the top with smooth, soft movements, gradually moving downwards. It is impossible to apply force when kneading or rubbing muscles, otherwise the intracranial or intracranial arterial pressure.

Massage for a stroke on the left side is done in places on the affected side, and for a stroke on the right side - vice versa. We repeat the massage up to 5 times, first only the affected limbs, then gradually new areas are involved.

In this case, the rubbing movement should predominate, and the course of lymph flow must be taken into account.

Massage after a stroke should be done using various techniques, changing them one after another. The following techniques are mainly used:

When stroking, you need to relax your palm and begin to slide it over the massaged area. The skin should not bunch up. When stroking superficially, muscles and fatty tissue are not captured. With deep it’s the other way around. The movements take the form of a spiral, zigzag or rectangle. The patient's blood flow improves with appropriate positive reactions the body for this.
The rubbing technique is performed with the tips of the fingers; to use this technique during massage, you can use the base of the palm, while at times it is allowed to clench your fingers into a fist. The specialist’s hands move in a zigzag or straight line. With this massage technique, tissues are heated.
When kneading, it should be remembered that this technique cannot be performed if the patient has spastic changes. After performing this technique, the patient’s muscle fiber elasticity increases.
When vibrating, the specialist relaxes his hand and then oscillatory movements, mainly in the direction from right to left, affects the massaged area.
Acupressure also helps with strokes. This is due to the fact that speech suffers with this disease. With acupressure massage of the face, irritation of the points occurs, as a result of which the patient retains speech function. Is it possible for relatives of the patient to do acupressure massage at home? No. It can only be carried out by a specialist who knows the massage points.

Massage a stroke patient at home

After the patient with a stroke is at home, rehabilitation measures for his recovery must be continued. To do this, you can agree with a visiting specialist, master and do the procedures yourself, or you can resort to help special massagers. If you decide to perform a massage on your own, then you need to know how to do it correctly at home.

Stroke and massage - these two concepts imply a difference in the method of carrying out the procedure from classical massage. Therefore, when carrying out it at home, especially if it is not done by a specialist, but by a person close to the patient, it is necessary to take into account some points. Without knowing them, you can only worsen the patient’s condition.

If the patient has a stroke on the right side, then the massage begins on the left. The half of the body that is injured should be warmed with a warm blanket or heating pads before the procedure. During massage, the technique of rubbing and stroking is used.

If the patient has paralysis right hand, then they begin to massage the left one. Light kneading is done.

The technique of rubbing and stroking is also used.

Then they move on to massaging the right limb. The hand should be moved to the side as far as possible with the palm with the fingers straightened up. Before the massage, it is necessary to straighten all joints. This position of the hand is fixed on a pillow or a special cushion. If the muscles are tense, then the effect should be delicate, stroking and rubbing lightly and slowly. If the muscles are atrophic and relaxed, then rubbing and stroking movements are done with greater speed.

The procedure begins with superficial stroking techniques; if the patient does not complain, then they move on to kneading and vibration techniques. But the muscles should not move. If restorative massage after a stroke is done at home, then people close to the patient should know that the muscles of the sole, surface of the palm, pectoral muscle, anterior surface of the forearm and shoulder, posterior surface of the lower leg, anterior surface of the thigh should be massaged only using light rubbing and stroking techniques, so how spastic components can develop in these areas.

When starting the procedure, it is necessary for the patient lying on his back to place a cushion under his knees, and there should be a small pillow under his head. A healthy limb is fixed using a weighting material. If the patient is lying on his stomach, then a pillow should be placed under him.

It should be noted that if there is a disease associated with the cardiovascular system, the patient must be placed on his side.

When performing a massage at home, you must adhere to the following sequence. The massage begins from the front surface of the thigh, then the front surface of the lower leg is massaged, after which we gradually go down to the foot. Then a massage of the pectoral muscle is done. After this, the procedure moves on to the hand. You need to start massaging your arm from the shoulder, gradually going down to the forearm, to the hands, and the procedure ends with your fingers.

After this, we move to the back of the leg. The sequence is the same as the front one. Then the back is massaged.

Contraindications

If we are restoring a patient after a stroke at home with the help of massage, we must be aware of its contraindications. Procedures cannot be performed if the temperature rises, if blood pressure has increased, the patient complains of headache or heart pain, or breathing problems.

Stroke is a disease in which the recovery process takes a long period of time. And very great importance How quickly a person recovers depends on the patient himself and on the close people around him.

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The main purpose of massage after an acute circulatory disorder in the brain is to stimulate the restoration of lost motor function of the limbs. It is used in combination with drug treatment and gymnastics. All movements should be gentle, taking into account muscle tone. The procedure is carried out with sequential massaging of the legs, arms, back and face area.

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The benefits of proper massage for the patient

The optimal option for recovery after a stroke is the development of limbs by a rehabilitation specialist, since depending on the area of brain damage, stage and concomitant pathologies, there are features of therapeutic exercises. With a qualified approach, massage helps solve the following problems:

restores coordination of movements;
prevents muscle atrophy, the development of joint stiffness, and the appearance of concomitant abnormal movements (syncinesia);
facilitates the resumption of walking and maintaining balance;
relieves or reduces pain;
helps normalize sensitivity and tendon reflexes;
improves the patient's psychological state;
activates the transmission of impulses from the affected limbs to the brain;
stimulates blood flow through arteries and outflow through venous and lymphatic vessels.

Key points of restorative massage after ischemic stroke

The consequences of acute cerebral ischemia are the destruction of some neurons with motor disorders in the limbs. Eat important feature post-stroke neurological lesions - the tone of muscles responsible for opposite functions changes differently. Most often, there is hypertonicity of the flexors on the arm, and hypertonicity of the extensors on the leg. This leads to the following consequences:

pressing the upper limb to the body;
flexion of the arm at the elbow and wrist;
extension of the leg at the knee joint and ankle.

Expert opinion

Alena Ariko

Expert in Cardiology

The basic rule of massage is to relax spastic muscles and tone relaxed ones. Without this, stroke massage is not only useless, but can lead to painful muscle spasms, limited range of motion in the joints and permanent deformation of the arm or leg.

Requirements for conducting

To relax muscle fibers, special techniques are used - correct position limbs, passive movements in joints. It is important to adhere to the following recommendations:

always start with a healthy limb to adapt the patient to massage;
the massage therapist’s hands should be warm and the room temperature should be comfortable;
the skin must be washed and dried well;
with severe spasticity may be necessary medicines(Sirdalud, Mydocalm, Baclofen) before massage or application of paraffin-ozokerite mixture;
all movements are smooth and low-intensity;
pain should not be allowed, as it causes muscle spasm;
sessions should be carried out in the morning.

Watch the video about massage techniques after a stroke:

Massage is called passive gymnastics; for a patient who has suffered a stroke, it represents a fairly high load, so you should not use intensive techniques or greatly delay the session. After the procedure, the patient needs complete rest for an hour.

Patient position

When massaging the limbs, the patient lies on his back with his head slightly elevated. Rollers are placed under the knees (they can be rolled up from a regular towel). If involuntary twitching of an arm or leg is observed, they are fixed using bags filled with sand. The outer surface of the thigh is massaged in the position on the healthy side, and the back - on the stomach. The back is also treated in the same positions.

In order to reduce muscle spasticity, the arm is taken away from the body as far as possible (very slowly), and the fingers are gently extended.

Before starting, the massage therapist supports the elbow of the affected limb and shakes it lightly, holding it by the hand. It is also useful to carry out passive movements in the shoulder joint with a very small amplitude, while simultaneously pressing on the area of attachment of the tendons (around the head of the humerus).

Relaxation of the muscles of the lower limb is achieved in the following ways:

hold the leg by the foot and carefully swing it to the sides, lift it and shake it (before each movement the patient takes a breath, and the effect itself occurs during the exhalation period);
The masseur presses on both sides with his hands knee joint, and then bends the leg at the knee and hip;
A gentle massage of the Achilles tendon is performed.

Duration and frequency of sessions

How to do it at home

Massage is more effective if it is performed regularly. In this case, it is necessary to carefully monitor the patient’s condition, avoiding overwork. This may be evidenced by:

pale skin;
frequent and shallow breathing;
accelerated

This is due to the fact that muscles get tired quickly during paralysis, metabolic processes they are slowed down, and intense impact leads to the accumulation of lactic acid and other metabolic products, causing discomfort and painful sensations. Therefore, the first sessions are short, and the strength of the massage movements is low; over time, they can be gradually increased, focusing on the patient’s well-being.

In any period after an acute disorder cerebral circulation Patting, vibration with the hand being lifted, sudden and intense movements are contraindicated.

Subsequence

It is advisable to start a massage session with a healthy leg in the following order: thigh, lower leg, foot. All movements are directed from bottom to top within the same anatomical zone. Then successive actions are carried out on:

anterior, posterior surface of the thigh;
shin;
foot and toes.

Next stage- pectoral muscle, shoulder, elbow joint, forearm, and then hand. The direction of the massage lines on the hand is from the fingers to the shoulder joint.

For arms and legs

When massaging the upper limb, first treat the area of the anterior pectoral muscle while lying on your back using very gentle techniques:

light stroking;
place the hand on the chest, press and move it to the sides without breaking away;
superficial rubbing.

Then they pass through the main muscles:

shoulder girdle from the head of the shoulder to the neck and back;
triceps and biceps;
back surface of the forearm (stroking, rubbing and kneading);
anterior muscle group from hand to elbow.

The palms are massaged with light movements, and the back of the hand with more intense movements. For severe spasticity, it is recommended to start with the fingers, move to the outer surface of the hand, and finish the massage with the palm. If there are pain points, they are worked out with additional kneading.

Lower limb massage plan:

anterior thigh– weak stroking with continuous, grasping movements, rubbing in semicircles;
inner surface– no more than half a minute, superficial massage from knee to thigh;
posterior muscle group– stroking and rubbing the gluteal region from the sacrum to the head of the femur and back, longitudinal and transverse effects on the thigh muscles;
shin– along the front surface, then less intensely – along the back, rubbing is longitudinal, spiral, transverse or semicircular;
foot– the back side from the fingertips to the ankle joint, the sole is massaged with comb-like movements, kneading the heel, carefully working out each finger.

For face

During a stroke, one of the disorders is asymmetry of the facial muscles and decreased sensitivity of the skin of the affected part. To speed up the recovery of facial muscles, the following massage techniques are used:

comb-like stroking of the entire scalp;
the palm should be placed on the forehead and 8-10 shifting movements should be made from the eyes to the edge of the hair growth (without lifting the brush from the skin);
then with both hands perform the same movement on the cheeks;
stroking the face from the middle of the forehead to the temples, cheeks from the chin to the ears, from the nose to the ears;
go through the area of the eye sockets with pinches;
point impact - the center of the bridge of the nose, the lower edge of the eye socket at the level of the pupil, near the wings of the nose, the center of the chin, circular movements for 15 seconds for each point;
rubbing the ears.

Watch the video about restorative gymnastics for face:

For the back

It is recommended to stroke and rub from bottom to top with a more thorough study of the thoracic and lumbar segments; they are passed with the thumbs at a distance of 2 cm from the center. Long-term massage of this area is not performed. The patient's position is usually on the stomach or healthy side. To make your hands glide easier, it is best to use baby oil without additives.

Contraindications

Massage should not be prescribed to patients if:

fever;
unstable;
increased risk of thrombosis (according to the results of a coagulogram);
high intracranial pressure, blood pressure readings more than 180/100 mm Hg. Art.;
acute infection or exacerbation of diseases of internal organs;
, renal and pulmonary failure;
decompensated diabetes mellitus;
inflammation of the skin or disruption of its integrity;
injuries;
blood diseases;
tumor neoplasms;
foci of suppuration.

Massage after a stroke improves blood circulation, microcirculation of tissue fluid, and restores impaired innervation. Correct techniques and techniques reduce muscle spasm, prevent atrophy and contractures. Irritation of skin receptors has a calming effect on the brain and accelerates the process of restoring lost functions.

It is important to determine changes in muscle tone before starting. Relaxing techniques are suitable for increased spasticity, and toning techniques are suitable for weakened muscle groups.

recovery at home

Ischemic stroke occurs as a result of sudden thrombosis of one or more arteries supplying the brain. Thrombosis often leads to ischemia - oxygen starvation of brain cells (neurons). If blood flow is not restored within several hours, some neurons die irrevocably, and some are in a so-called “stunned” state.

The goal of all restoration measures is to bring “stunned” neurons back to life. This can be done using constant nerve impulses from skin and muscle receptors to damaged brain cells. An almost ideal remedy for this is therapeutic massage.

Billions of nerve endings and receptors connect to muscles and skin. Massage, daily work on the same areas of the body sends a huge number of nerve impulses to the brain. This forces the neurons to work with redoubled force, “remembering” functions forgotten as a result of the stroke. The paralyzed, weakened left or right side of the body begins a gradual recovery thanks to massage.

Another rehabilitation mechanism is called neuroplasticity. It occurs when healthy brain cells begin to take on the tasks of their “comrades” who died after a stroke. Massage also has a beneficial effect on these processes.

Therapeutic effect of massage

The positive contribution of massage to the rehabilitation complex for patients after a stroke is undeniable. Most often, patients complain of the following symptoms:

Muscle weakness on the right or left - depends on which side is affected.
Paralysis of the arms and legs on one or both sides.
Decreased mobility
Insomnia
General weakness, sweating
Chronic constant pain
Decreased attention and memory loss

Recent studies by medical scientists have shown that after several courses of therapeutic massage, patients complain less about chronic pain syndrome, become more mobile, and get rid of depression.

Here's how massage therapy works:

performing massage for cerebrovascular accidents after ischemic stroke

Before signing up for a massage course after a stroke, you must consult with your doctor. There are many varieties, but during the post-stroke recovery period, it is therapeutic gentle massage that is indicated.

Features of massage after cerebral circulatory disorders:

where to carry out treatment

Therapeutic massage after cerebral circulatory disorders is best done in specialized rehabilitation institutions or in a clinic. At home, there are no special massage tables on which the procedure is much more convenient and correct.

For bedridden paralyzed patients, after discharge from the hospital, massage is possible only at home. However, it is best to constantly seek help from professionals. Of course, relatives, observing the work of a massage therapist from the outside, can remember certain techniques. But it is impossible to fully master the techniques and do them correctly without appropriate training. Inept massage techniques can injure weakened post-stroke patients.

To recover after a stroke, our readers recommend the training of neurologist-rehabilitation specialist Fyodor Bondarenko. At this rate, a lot of positive feedback. You can get acquainted with all the trainings of Fedor Bondarenko by clicking on the link -.

At first, the procedure may be a little painful and unpleasant, but by 3-4 sessions the discomfort should disappear. If this does not happen, be sure to let your massage therapist know. Perhaps you need more gentle techniques.

Massage in a rehabilitation center or at home is the most important part of the recovery complex after a stroke. Medical scientists have proven that patients who have undergone therapeutic massage throughout the early recovery period demonstrate better results in terms of motor activity and in the psycho-emotional sphere.