title: The efficacy of traditional Thai massage in decreasing spasticity in elderly stroke patients.
abstract: OBJECTIVE
  To study the efficacy of traditional Thai massage (TTM) versus conventional physical therapy (PT) programs in treating muscle spasticity, functional ability, anxiety, depression, and quality of life (QoL) in Thai stroke patients.
  
  
  METHODS
  This randomized controlled trial with a blinded assessor was carried out at the Department of Rehabilitation Medicine, Siriraj Hospital (Bangkok, Thailand). The study included 50 stroke (onset ≥ 3 months) outpatients experiencing spasticity at the elbow or knee muscles at a grade of ≥ 1+ on the modified Ashworth Scale who were ≥ 50 years old and able to communicate. The subjects were randomly allocated to the treatment group receiving TTM (24 subjects) or the control group receiving the PT program (26 subjects). Both groups received treatment (either TTM or PT) twice a week for 6 weeks. Spasticity grade, functional ability, anxiety, depression, and QoL were measured at Week 0 and Week 6.
  
  
  RESULTS
  At Week 6, the percentage of patients whose modified Ashworth Scale score had decreased by at least one grade was not statistically significant between the two groups. Both TTM and PT groups experienced a significant increase in functional ability and QoL, but no difference was found between the groups. Anxiety and depression scores showed a decreasing trend in the TTM group.
  
  
  CONCLUSIONS
  This preliminary report showed no evidence that TTM differed from the PT program in decreasing spasticity. However, both interventions may relieve spasticity, increase functional ability, and improve QoL after 6 weeks. Only TTM can decrease anxiety and depression scores. Further studies with adequate sample size are necessary.
authors.affiliation: Department of Rehabilitation Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Thanitta
authors.initials: T
authors.lastname: Thanakiatpinyo
authors.affiliation: Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Supakij
authors.initials: S
authors.lastname: Suwannatrai
authors.affiliation: Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Ueamphon
authors.initials: U
authors.lastname: Suwannatrai
authors.affiliation: Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Phanitanong
authors.initials: P
authors.lastname: Khumkaew
authors.affiliation: Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Dokmai
authors.initials: D
authors.lastname: Wiwattamongkol
authors.affiliation: Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Manmas
authors.initials: M
authors.lastname: Vannabhum
authors.affiliation: Department of Rehabilitation Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Somluck
authors.initials: S
authors.lastname: Pianmanakit
authors.affiliation: Department of Rehabilitation Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Vilai
authors.initials: V
authors.lastname: Kuptniratsaikul
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013785:Thailand; D016896:Treatment Outcome
keywords: anxiety; depression; massage; spasticity; stroke