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Role of Electrical Stimulation Added to Conventional Therapy in Patients with Idiopathic Facial (Bell) Palsy

Tuncay, Figen, MD; Borman, Pnar, MD; Taşer, Burcu, MD; Ünlü, İlhan, MD; Samim, Erdal, MD

American Journal of Physical Medicine & Rehabilitation: March 2015 - Volume 94 - Issue 3 - p 222–228
doi: 10.1097/PHM.0000000000000171
Original Research Articles

Objective The aim of this study was to determine the efficacy of electrical stimulation when added to conventional physical therapy with regard to clinical and neurophysiologic changes in patients with Bell palsy.

Design This was a randomized controlled trial. Sixty patients diagnosed with Bell palsy (39 right sided, 21 left sided) were included in the study. Patients were randomly divided into two therapy groups. Group 1 received physical therapy applying hot pack, facial expression exercises, and massage to the facial muscles, whereas group 2 received electrical stimulation treatment in addition to the physical therapy, 5 days per week for a period of 3 wks. Patients were evaluated clinically and electrophysiologically before treatment (at the fourth week of the palsy) and again 3 mos later. Outcome measures included the House-Brackmann scale and Facial Disability Index scores, as well as facial nerve latencies and amplitudes of compound muscle action potentials derived from the frontalis and orbicularis oris muscles.

Results Twenty-nine men (48.3%) and 31 women (51.7%) with Bell palsy were included in the study. In group 1, 16 (57.1%) patients had no axonal degeneration and 12 (42.9%) had axonal degeneration, compared with 17 (53.1%) and 15 (46.9%) patients in group 2, respectively. The baseline House-Brackmann and Facial Disability Index scores were similar between the groups. At 3 mos after onset, the Facial Disability Index scores were improved similarly in both groups. The classification of patients according to House-Brackmann scale revealed greater improvement in group 2 than in group 1. The mean motor nerve latencies and compound muscle action potential amplitudes of both facial muscles were statistically shorter in group 2, whereas only the mean motor latency of the frontalis muscle decreased in group 1.

Conclusions The addition of 3 wks of daily electrical stimulation shortly after facial palsy onset (4 wks), improved functional facial movements and electrophysiologic outcome measures at the 3-mo follow-up in patients with Bell palsy. Further research focused on determining the most effective dosage and length of intervention with electrical stimulation is warranted.

From the Department of Physical Medicine and Rehabilitation, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey (FT); Department of Physical Medicine and Rehabilitation, Hacettepe University Medical Faculty, Ankara, Turkey (PB); and Department of Physical Medicine and Rehabilitation (BT) and Department of Otorhinolaryngology (İÜ, ES), Ankara Training and Research Hospital, Ankara, Turkey.

All correspondence and requests for reprints should be addressed to: Figen Tuncay, MD, Department of Physical Medicine and Rehabilitation, Ahi Evran University Training and Research Hospital, Bağbaşı Mahallesi Sahir Kurutluoğlu Cad. No: 100 40000 Merkez/KIRŞEHİR. Kırşehir, Turkey.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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