Effect of Neural Mobilization in Bells Palsy: A Randomized Controlled Trial

Majmaah University

Status: Completed

Conditions: Bell Palsy

Treatments: Other: Neural Mobilisation; Other: Massage therapy; Other: Exercises; Diagnostic Test: Faradic electrical stimulation

Study type: Interventional

Funder types: Other

Identifiers

NCT04280120

MU-1441-99

Details and patient eligibility

About

Bells palsy is a sudden paralysis of half of the facial muscle. The BP is idiopathic and 70% responds well with drug therapy. There are many complementary therapies such as , tapping, electrical stimulation, and massage that adds to the recovery of condition. However, efficacy of neural mobilization in BP is not reported in the scientific literature.

Full description

Bells Palsy responds well with drug therapy such as prednisolone and antiviral drugs for the duration of 10-12 days. However, the administration of these drugs produce adverse side effect. Therapist use a number of techniques to maintain the physiological properties of facial muscles. However, adding a new technique would add to the arsenal of techniques available for the therapist. The research is intended to determine the effect of adding Neural mobilization in the recovery of Bells Palsy. A randomized controlled trail is intended to include 60 participants divided into two groups. Experimental group will receive Neural Mobilization with conservative treatment and control group will receive conservative treatment only.

Enrollment: 62 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The first episode of Bell's palsy.
• Modified House-Brackmann scale III-IV.

Exclusion criteria

• Diabetic
• Recurrent Bells palsy
• facial palsy
• History of stroke
• Any cerebrovascular accident
• epilepsy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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62 participants in 2 patient groups

Neural Mobilisation Group

Experimental group

Description:

1. Massage therapy. 2. Faradic electrical stimulation. 3. Exercises in front of the mirror. 4. Neural mobilization was applied by gently holding the lower part of the ear between the index finger and thumb. The thumb was placed at the opening of the external auditory meatus and the index finger placed behind the auricle of the ear (Figure 2). The intensity of auricular traction was determined by the patient reporting the level of discomfort. The patient tolerated 3-4 sets of gentle horizontal traction and circular movement 25 times each with 5 seconds rest.

Treatment:

Other: Neural Mobilisation

Other: Massage therapy

Diagnostic Test: Faradic electrical stimulation

Other: Exercises

Conservative group

Active Comparator group

Description:

1. Massage therapy consisting of tapping, effleurage and finger and thumb kneading for 15-16 minutes. 2. Faradic electrical stimulation with anode electrode at the back of the neck and cathode over the nerve trunk anterior to the earlobe. The cathodic pen electrode was used to locate the facial nerve trunk for stimulation manually. (Biphasic current, pulse time 300 microseconds, frequency 60 Hz, 20 contractions, Rest 10 seconds). The total treatment time was 15 minutes. 3. Exercises in front of the mirror like raising the eyebrow, clinching the teeth (patient trying to see his clenched teeth in the mirror), smiling and performing other facial expressions for 12-15 minutes.

Treatment:

Other: Massage therapy

Diagnostic Test: Faradic electrical stimulation

Other: Exercises