Effect of manual lymph drainage massage on hand edema and shoulder pain in hemiplegic-paretic patients post stroke

ABSTRACT

Shoulder pain and hand edema associated with hemiparesia and hemiplegia are common complications after the stroke and restricts the patient's daily activities. Therefore, this study was conducted to evaluate the effect of manual lymph drainage [MLD] massage on hand edema and shoulder pain in hemiplegic-paretic patients post stroke. In this randomized clinical trial study, 62 stroke patients with age ranging of 35-70 years and having shoulder pain and hand edema associated with hemiparesia or hemiplegia were selected and randomly divided into two groups of case and control. Then, manual lymph drainage massage [MLD] was performed in the case group for five sessions and each session last 20 minutes. The MLD was not performed for the control group. Sensory, affective, intensity and general condition of shoulder pain and also circle size of wrist and middle part of the arm were assessed using of McGill Pain Questionnaire-Short Form [MPQ-SF] and tape gauge, before and 24 hours after last session of MLD in both the case and control group. The acquired data were analyzed using independent t and paired t-tests. The means of sensory components of shoulder pain before and after massage was 2.3 +/- 0.9 and 1.3 +/- 0.4, respectively [p<0.05]. Based on the Visual Analogue Scale [VAS], the mean of shoulder pain intensity, after massage, in the case and control group was 3.3 +/- 1.2 and 4.8 +/- 1.5, respectively. The mean of arm circle size before and after massage in the case group was 29 +/- 4.6 and 28.1 +/- 3.9 centimeter, and in the control group was 29.4 +/- 4.1 and 29.7 +/- 3.9 centimeter, respectively [p<0.05]. Also, the mean of wrist circle size, before and after massage in case group was 17.2 +/- 1.1 and 16.4 +/- 0.9 centimeter, while in the control group, it was 16.9 +/- 0.8 and 17.1 +/- 1.1 centimeter, respectively [p<0.05]. Based on the results of this study application of MLD by the health care personnel would be effective in prevention or decrease of shoulder pain and hand edema