A) Characteristic sign and symptoms in paralysis:
1. Patient may present as monoplegia (only one limb affected), hemiplegia (one half of body affected with or without involvement of face), paraplegia (both lower limbs affected), or with facial paralysis in which one side of face is affected.
2. General signs include stiffness, loss of all movements of affected limb, loss of individual muscle tone and function, muscle wasting etc. Patient may be unable to walk on his own, may not be able to speak properly and clearly, or experience loss of grip etc.
3. Commonest cause of it is hypertension. Malignant rise in blood pressure leads to hemorrhage in brain and resultant blood clot may press upon nerve fibers causing paralysis of concerned muscles or group of muscles supplied by that nerve. Other causes like multiple infarcts, embolism etc may also lead to paralysis.
4. Slowly the patient recovers from acute stage with partly regaining of some of lost functions like able to speak more clearly, slightly more powerful grip etc. If attack is very mild in nature complete recovery within few days with or without medication is possible.
5. CT scan or MRI brain is the choice of investigation and is helpful to rule out causes like hemorrhage, thrombosis, embolism etc.
6. Though massage is helpful in paralytic patient, if patient presents in acute stage with signs like very shiny skin without application of oil, heaviness in body with more heaviness in affected limb, very cold affected limb, overall signs of indigestion etc then massage is contraindicated.
B) Aim of massage:
1. The disease is difficult to treat and recovery being very slow, main aim of massage is to increase overall body strength as it will provide nourishment to muscles, ligaments etc through increased blood circulation..
2. The unctuous and hot nature of oil will also aim to reduce dryness of stiff muscles, making it soft help to reduce muscle tension and regain its tone.
3. Due to nourishment provided by massage, recovery of lost movements of body and functions might be aimed faster.
C) Process of massage:
1. Body area to be massaged: Usually full body massage is advisable as proper massage will not only provide nourishment to affected body part but will also reduce stress and strain over unaffected part which bears more workload.
2. Direction of massage movements: a. From above down wards especially over limbs and back. b. Individual muscles that are very rigid due to dryness should be massaged with use of fingers giving more pressure, vibrations over it to help more absorption of oil and reduce stress. c. In chronic cases, more friction should be used. d. If CT scan/MRI report shows blood clot in a area in brain, more oil should be used over same part of head and slightly more pressure or friction could be applied over it to help absorption of oil and reduce clot.
3. Useful massage tips: a. Usually in a paralytic patient, massage over limbs in a direction from below upwards should be avoided b. More oil should be massaged in and around navel as well as below navel up to toes in lower limbs in all paralytic patients. c. Oil should be sufficiently warm at the time of massage. d. More quantity of oil as well as more warm oil should be massaged over stiff or rigid muscles in chronic cases. e. Use of thumb over individual muscle or ligaments with pressure and friction is useful. Disease being difficult to treat, regular massage for longer duration like 3-6months or more should be given. Also massage over affected part for longer periods is advisable as compared to other body parts. Daily oil massage will not only act as therapeutic tool and help in faster recovery but will also prevent further attacks.
D) Use of different oils for massage:
1. Oil used for massage should be hot in nature and should be preferably prepared by addition of herbal drugs as per advice of expert physician.
2. Use of herbal drugs like asparagus racemosus, Sida cordifolia etc should be used with sesame oil as base during preparation of medicinal oil as these drugs provide overall nourishment to body especially to body parts like muscles, ligaments etc commonly affected in paralysi