Abstract Background and aims One of the most challenging sequelae after stroke is spasticity-related increased muscle tone, which impairs normal muscle function. The aim of this study is to analyze the effects of functional massage combined with eccentric exercise compared with eccentric exercise alone on lower-limb hypertonia due to spasticity in individuals with chronic stroke. Methods This is a crossover study randomized controlled trial.Primary outcome measure was muscle tone assessed by modified-Ashworth scale (MAS) and MyotonPRO. Secondary outcomes measures were lower limb range of motion (ROM)/inclinometer, gait speed assessed by 4-meter walking test (4-MWT) at confortable/fast pace, functionality of lower limb assessed by 30-second sit-to-stand and Fugl-Meyer Assessment, self-perceived emotional burden using Depression, Anxiety and Stress Scale-21 and quality of life and health status using EQ-5D-5L and EQ-5D. Results Eight individuals participated (75% men, mean age 66.75±8.24). Clinical improvements were observed in muscle tone decrease (MAS/MyotonPRO), with large effects (ES0.8), and ROM improvements in hip-adduction and ankle-dorsiflexion (ES=1.14). A slight increase in the normal average speed in the 4MWT was observed, which is clinically relevant. According to perceived emotional load, no significant changes were detected. Finally, with regard to quality of life, the subjective score on the EQ-5D improved slightly after the combined intervention. Conclusions This study demonstrates that combining functional massage with eccentric exercise leads to improvements in muscle tone—particularly in the semitendinosus and medial gastrocnemius muscles—as well as in ankle dorsiflexion and walking speed. Longer-term studies are needed to confirm these findings. Conflict of interest Name of author:nothing to disclose
Cabanas-Valdés et al. (Fri,) studied this question.