Marma therapy for stroke rehabilitation -- a pilot study

OBJECTIVE: To examine feasibility and acceptability issues and to gather preliminary outcome data to ascertain the numbers needed for a trial of Marma massage therapy for stroke rehabilitation.

DESIGN: Pilot non-randomized controlled trial, comparing standard care with standard care plus Marma therapy in post-stroke patients with a nested qualitative study.

PARTICIPANTS: Adult patients who had an infarction or haemorrhage at any brain location with a Barthel Index score of 75/100 or less.

METHODS: Feasibility was assessed in terms of recruitment and response rates and loss to follow-up, and acceptability was assessed by patient interviews (n=13). The main outcome measure was the Barthel Index.

RESULTS: The recruitment rate was 0.53 patients per week in a stroke unit with an admission rate of 15.1 per week, the response rate was 91% and the loss to follow-up 30%. Most patients believed that the massage was beneficial, and although some reported pain, all interviewed would choose it again. The effectiveness data showed no significant differences in changed scores. However, the secondary measure follow-up score differences of the Motricity Index at 6 and 12 weeks and the trunk control test at 6 weeks suggest a possible greater improvement in the intervention group (p<0.05, p<0.01).

CONCLUSION: There are grounds for a future trial of Marma therapy (n=172), which would be feasible and acceptable to patients.