Efficacy of Manual Massage Therapy on Spasticity in Patients with Central Nervous System Disorders: A Systematic Review and Meta-Analysis

Spasticity is a debilitating complication in patients with upper motor neuron syndrome (UMNS), including stroke, cerebral palsy, and spinal cord injury. While massage therapy is widely used in rehabilitation, evidence regarding the efficacy of "manual" massage techniques—excluding instrument-assisted soft tissue mobilization (IASTM)—remains fragmented. The objective of this systematic review and meta-analysis is to evaluate the effects of manual massage on spasticity, range of motion, and motor function in patients with UMNS. We searched major electronic databases for randomized controlled trials (RCTs) published between 2016 and 2026. Studies utilizing instruments (e.g., Graston, IASTM) were excluded to isolate the therapeutic effect of manual touch. The primary outcome is the severity of spasticity measured by the Modified Ashworth Scale (MAS) or Tardieu Scale. Secondary outcomes include gait parameters (speed, TUG), motor function (GMFM, FMA), and physiological signals (sEMG). This study aims to provide high-quality, evidence-based guidelines for clinicians and bodywork practitioners.