Cerebrovascular and Autonomic Responses to Thai Traditional Massage in Patients with Ischemic Stroke

Abstract

Thai traditional massage therapy has shown potential in improving vascular and autonomic functions but the potential benefits of massage for patients with ischemic stroke are yet to be explored. PURPOSE: To determine acute effects of Thai traditional massage on cerebral blood flow velocity and heart rate variability in patients with ischemic stroke. METHODS: Thirteen patients (55±3 years) with a single episode of ischemic stroke due to thrombosis of cerebral arteries (onset ≤2 years) were randomly assigned into either Thai traditional massage (TTM; n=6) or sham control (CON; n=7) group. TTM consisted of petrissage, friction, and passive stretching on the whole body for 60 minutes. Cerebral blood flow velocity (CBFV) in the middle cerebral artery using the transcranial Doppler ultrasound and heart rate variability (HRV) using the frequency domain analysis were measured before and 0, 60, 120 min, and 24 hr after TTM or sham. RESULTS: CBFV increased (p<0.05) 60 min after TTM. This measure returned to baseline values within 120 min. High frequency (HF) component of HRV increased 0, 60, and 120 min after TTM (all p<0.05). There were no significant changes in total power (TP) and low frequency (LF) components as well as the LF:HF ratio of HRV. CBFV was positively associated with TP (r=0.74) and LF (r=0.63) components of HRV (all p<0.05) at 60 min post-TTM. No significant changes in these variables were observed during the sham control condition. CONCLUSIONS: Our study demonstrated that one session of Thai traditional massage acutely improves cerebral blood flow in patients with ischemic stroke possibly through increases in parasympathetic nervous activity. Acknowledgments: This study was supported by Government Research Budget Chulalongkorn University 2015 and The 90th Anniversary Research Fund, Chulalongkorn University, Thailand.