Abstract
The purpose of the present study was to compare the proprioceptive neuromuscular facilitation and neuromuscular re-education with conventional treatment and home based exercise plan along with facial nerve stimulation for reducing facial disability in patients with Bell’s Palsy. In the present study, purposively selected 20 patients (both male and female) with Bell’s palsy with age group 20-70 years were considered. Further, the patients were allocated equally into two treatment groups. In Group-A, patients were treated with Proprioceptive Neuromuscular Facilitation (PNF) and Neuromuscular Re-Education (NRE) along with interrupted galvanic stimulation, facial massage and home based exercises. In Group-B, patients received the treatment of interrupted galvanic stimulation and manual facial massage along with home based facial exercises program in front of mirror. The outcome measures included Facial Disability Index-Physical Function (FDI-PF), Facial Disability Index-Social Function (FDI-SF), Synkinesis Assessment Questionnaire (SAQ) and Sunnybrook Facial Grading Scale (SFGS). In results. it was found that in pre-intervention condition, no significant differences were noted in FDI-PF, FDI-SF, SAQ and SFGS between these two groups. However, significant differences (p<0.001) were observed in FDI-PF, FDI-SF and SFGS in post intervention condition between the patients treated in Group-A and Group-B. Statistically significant increase (p<0.001) was found in FDI-PF and SFGS and significant decrease (p<0.013-0.001) was found in FDI-SF and SAQ between pre- and post-intervention in Group-A. Statistically significant decrease (p<0.003-0.001) was found in FDI-PF, FDI-SF, SAQ and SFGS between pre- and post-intervention in patients treated in Group-B. From the findings of the study it could be concluded the treatment protocol comprised of PNF and NRE along with interrupted galvanic stimulation, facial massage and home based exercises was more effective than only interrupted galvanic stimulation, facial massage and home based exercises in improving facial symmetry and reducing facial disability in patients with Bell’s palsy.
 Keywords: Proprioceptive neuromuscular technique, Neuromuscular re-education technique, Interrupted galvanic stimulation, Facial massage, Home based exercises, Bell’s palsy, Facial disability, Synkinesis.
Highlights
Bell's palsy, is the facial paralysis which is caused by dysfunction of Cranial Nerve VII, the Facial Nerve (May and Hughes, 1987)
In post intervention condition, significant differences (p
Comparisons of pre- and post-intervention values of FDI-PF, FDI-SF, Synkinesis Assessment Questionnaire (SAQ) and SFGS in patients with Bell’s palsy in Group-A were shown in table 2
Summary
Bell's palsy, is the facial paralysis which is caused by dysfunction of Cranial Nerve VII, the Facial Nerve (May and Hughes, 1987). It is named after Sir Charles Bell, a Scottish surgeon, neurologist and anatomist. It is known as Idiopathic Facial Palsy. Population studies showed an average incidence of 20 to 30 cases per 100,000 populations (Katusic et al, 1986) It is the most common cause of acute unilateral facial paralysis, thought to cause between 60 and 75% of all unilateral facial palsy cases. Loss of control of the muscles on one side of the face is the main physical presentation (Peitersen, 2002)
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