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Light Retrograde Massage for the Treatment of Post-Stroke Upper Limb Oedema: Clinical Consensus Using the Delphi Technique

Background: Oedema of the hemiplegic upper limb is a common complication following stroke and can restrict mobility and function. Limited evidence is available regarding the assessment and treatment of post-stroke upper limb oedema by occupational therapists. Objective: To determine consensus amongst occupational therapists with regard to the use of light retrograde massage for the treatment of post-stroke upper limb oedema. Method: A Delphi technique was used to gather opinion from a national sample of stroke occupational therapists. Two rounds of questionnaires were undertaken. Data were analysed from the 31 respondents to round two, using the chi-square goodness of fit to determine consensus in relation to statements about the use of light retrograde massage. Results: Of the 85 therapists who volunteered for the study, 58 returned round one questionnaires and 56 were eligible to participate. Most of the therapists who responded to round one (41/56, 73%) used light retrograde massage to reduce post-stroke upper limb oedema. Agreement regarding the definition and application of light retrograde massage was identified in round two. Conclusion: Despite a lack of evidence for the efficacy of light retrograde massage in stroke patients, this study found that it is often used in clinical practice and that consensus exists about many components of the treatment method. Further research is recommended to investigate the efficacy of light retrograde massage for reducing post-stroke upper limb oedema.