Effect of Transcutaneous Electrical Nerve Stimulation and Faradic Current Stimulation on the Recovery of Bell's Palsy

Emad Eldin Mohamed Abdelatief

doi:10.13189/saj.2020.080608

Abstract

Background: Bell’s palsy is one of the most common problems that affect motor neurons of facial muscles either unilateral or bilateral. It affects the function and quality of life frequently. Therefore, physiotherapists focus on restoring the facial function with different modalities. Electrical stimulation is one of these modalities included in the physiotherapy program to enhance recovery of Bell’s palsy. Purpose: The aim of this study was to examine the effect of transcutaneous electrical nerve stimulation and faradic current stimulation on the recovery of Bell’s palsy. Methods: One hundred and ninety-six patients from both genders with unilateral Bell’s palsy; their ages ranged from 15 to 60 years. They were divided randomly into four groups with forty-nine patients in each group. Group A received conventional therapy, group B received transcutaneous electrical nerve stimulation (TENS), group C received faradic current stimulation, and group D received TENS + faradic current. All patients were assessed at the initial treatment (after 2 weeks of onset), after one month, and at the end of the study by using the House Brackmann Scale (HBS) for the severity of symptoms and facial symmetry which consist of six grades from normal to total paralysis. Results: In group B, there was a statistically significant improvement in grade IV, V, and VI compared to groups A, C, and D while there was no statistically significant difference among the four groups on grade II and III. Conclusion: TENS is more effective in treating moderately severe dysfunctions as well as total paralysis than convention therapy, faradic current and TENS plus faradic current in patients with acute Bell’s palsy.

Highlights

Bell's palsy is an idiopathic paralysis that affects more than half of the lower facial muscles as a result of injury to the seventh cranial nerve, and its symptoms are either weakness in the facial muscles or complete paralysis [1]
Symptoms start quickly and lightly until it reaches total paralysis on one side of the face, and this occurs within hours to days, as the symptoms vary in severity from one person to another, and it is an accumulation of food in one side, difficulty with drinking, inability to raise an eyebrow, headache, high sensitivity to surrounding sounds loss of nasolabial groove and in some cases, loss of taste sensation [6]
If the movement of eyebrow and mouth completes 1 cm, this indicates that the functional movement of the face is normal with a total score of 8 while below this score (8/8) the dysfunction of facial muscles is graded from mild dysfunction to total paralysis [19,20, 21]

Summary

Introduction

Bell's palsy is an idiopathic paralysis that affects more than half of the lower facial muscles as a result of injury to the seventh cranial nerve, and its symptoms are either weakness in the facial muscles or complete paralysis [1]. It affects all age groups, including children, youth, adult, and older people, and its rate between men and women is equal, but it increases in the last stages of pregnancy, and its incidence worsens with diabetes patients [2,3]. Conclusion: TENS is more effective in treating moderately severe dysfunctions as well as total paralysis than convention therapy, faradic current and TENS plus faradic current in patients with acute Bell’s palsy

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