Muscle strength after elastic resistance band exercise and hand massage in stroke patients
DOI: https://doi.org/10.56922/msc.v6i5.4217
Elastic Resistance Band Exercise Hand Massage Manual Muscle Testing Stroke
Abstract
Background: Stroke commonly causes upper-extremity weakness that can limit independence. Progressive resistance exercise may support motor recovery, while hand massage may provide complementary sensory stimulation and relaxation.
Purpose: To compare short-term changes in upper-extremity muscle strength between patients with stroke receiving combined elastic resistance band exercise and hand massage and those receiving standard hospital care.
Method: This quasi-experimental pretest-posttest study included 40 patients with stroke, with 20 in the intervention group and 20 in the control group. Allocation was non-random and based on odd/even identifiers. The intervention group received combined elastic resistance band exercise and hand massage for 10–15 minutes daily over 8 sessions, while the control group received standard hospital care. Upper-extremity muscle strength was assessed using Manual Muscle Testing (MMT). Wilcoxon signed-rank tests assessed within-group changes, and the Mann-Whitney U test compared post-test scores between groups.
Results: Upper-extremity muscle strength improved significantly in the intervention group (p < 0.001), while no significant change was observed in the control group (p = 0.083). At posttest, the intervention group had significantly higher muscle strength scores than the control group (p = 0.006).
Conclusion: Combined elastic resistance band exercise and hand massage were associated with greater short-term improvement in upper-extremity muscle strength than standard hospital care. Because allocation was non-random, the finding should be interpreted cautiously.
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References
Ada, L., Dorsch, S., & Canning, C. G. (2006). Strengthening interventions increase strength and improve activity after stroke: A systematic review. Australian Journal of Physiotherapy, 52(4), 241–248. https://doi.org/10.1016/S0004-9514(06)70003-4
An, S., & Kang, S. (2020). The effect of resistance exercise using elastic band on muscle strength, muscle tone, balance and gait in stroke patients. Journal of The Korean Society of Integrative Medicine, 8(1), 57–66.
Bohannon, R. W. (2005). Manual muscle testing: Does it meet the standards of an adequate screening test? Clinical Rehabilitation, 19(6), 662–667. https://doi.org/10.1191/0269215505cr873oa
Cabanas-Valdés, R., Calvo-Sanz, J., Serra-Llobet, P., Alcoba-Kait, J., González-Rueda, V., & Rodríguez-Rubio, P. R. (2021). The effectiveness of massage therapy for improving sequelae in post-stroke survivors: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(9), 4424. https://doi.org/10.3390/ijerph18094424
Central Java Provincial Health Office. (2023). Kasus stroke rawat inap [Inpatient stroke cases]. https://data.jatengprov.go.id/dataset/jumlah-kasus-stroke-rawat-inap-tahun-2023
Cuthbert, S. C., & Goodheart, G. J., Jr. (2007). On the reliability and validity of manual muscle testing: A literature review. Chiropractic & Osteopathy, 15, 4. https://doi.org/10.1186/1746-1340-15-4
Dorsch, S., Ada, L., & Alloggia, D. (2018). Progressive resistance training increases strength after stroke but this may not carry over to activity: A systematic review. Journal of Physiotherapy, 64(2), 84–90. https://doi.org/10.1016/j.jphys.2018.02.012
Doumen, S., Sorba, L., Feys, P., & Tedesco Triccas, L. (2023). Efficacy and dose of rehabilitation approaches for severe upper limb impairments and disability during early acute and subacute stroke: A systematic review. Physical Therapy, 103(4), pzad002. https://doi.org/10.1093/ptj/pzad002
Feigin, V. L., Brainin, M., Norrving, B., Martins, S. O., Pandian, J., Lindsay, P., Grupper, M. F., & Rautalin, I. (2025). World Stroke Organization: Global Stroke Fact Sheet 2025. International Journal of Stroke, 20(2), 132–144. https://doi.org/10.1177/17474930241308142
Harris, J. E., & Eng, J. J. (2010). Strength training improves upper-limb function in individuals with stroke: A meta-analysis. Stroke, 41(1), 136–140. https://doi.org/10.1161/STROKEAHA.109.567438
Huang, J., Ji, J.-R., Liang, C., Zhang, Y.-Z., Sun, H.-C., Yan, Y.-H., & Xing, X.-B. (2022). Effects of physical therapy-based rehabilitation on recovery of upper limb motor function after stroke in adults: A systematic review and meta-analysis of randomized controlled trials. Annals of Palliative Medicine, 11(2), 521–531. https://doi.org/10.21037/apm-21-3710
Ministry of Health of the Republic of Indonesia. (2022). Kenali stroke dan penyebabnya [Recognize stroke and its causes]. https://ayosehat.kemkes.go.id/kenali-stroke-dan-penyebabnya
Morris, S. L., Dodd, K. J., & Morris, M. E. (2004). Outcomes of progressive resistance strength training following stroke: A systematic review. Clinical Rehabilitation, 18(1), 27–39. https://doi.org/10.1191/0269215504cr699oa
Pollock, A., Farmer, S. E., Brady, M. C., Langhorne, P., Mead, G. E., Mehrholz, J., & van Wijck, F. (2014). Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews, 2014(11), CD010820. https://doi.org/10.1002/14651858.CD010820.pub2
Salter, K., Musovic, A., & Taylor, N. F. (2016). In the first 3 months after stroke is progressive resistance training safe and does it improve activity? A systematic review. Topics in Stroke Rehabilitation, 23(5), 366–375. https://doi.org/10.1080/10749357.2016.1160656
Saunders, D. H., Sanderson, M., Hayes, S., Johnson, L., Kramer, S., Carter, D. D., Jarvis, H., Brazzelli, M., & Mead, G. E. (2020). Physical fitness training for stroke patients. Cochrane Database of Systematic Reviews, 2020(3), CD003316. https://doi.org/10.1002/14651858.CD003316.pub7
Schinwelski, M. J., Sitek, E. J., Wąż, P., & Sławek, J. W. (2019). Prevalence and predictors of post-stroke spasticity and its impact on daily living and quality of life. Neurologia i Neurochirurgia Polska, 53(6), 449–457. https://doi.org/10.5603/PJNNS.a2019.0067
Veerbeek, J. M., van Wegen, E., van Peppen, R., van der Wees, P. J., Hendriks, E., Rietberg, M., & Kwakkel, G. (2014). What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLOS ONE, 9(2), e87987. https://doi.org/10.1371/journal.pone.0087987
Veldema, J., & Jansen, P. (2020). Resistance training in stroke rehabilitation: Systematic review and meta-analysis. Clinical Rehabilitation, 34(9), 1173–1197. https://doi.org/10.1177/0269215520932964
Wist, S., Clivaz, J., & Sattelmayer, M. (2016). Muscle strengthening for hemiparesis after stroke: A meta-analysis. Annals of Physical and Rehabilitation Medicine, 59(2), 114–124. https://doi.org/10.1016/j.rehab.2016.02.001
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