Effects of electrical stimulation on house-brackmann scores in early bells palsy

ABSTRACT Limited evidence may support the application of electrical stimulation in the subacute and chronic stages of facial palsy, yet some physiotherapists in South Africa have been applying this modality in the acute stage in the absence of published evidence of clinical efficacy. This preliminary study's aim was to determine the safety and potential efficacy of applying electrical stimulation to the facial muscles during the early phase of Bells palsy. A pretest posttest control vs. experimental groups design composed of 16 patients with Bell's palsy of less than 30 days' duration. Adult patients with clinical diagnosis of Bell's palsy were systematically (every second patient) allocated to the control and experimental groups. Each group (n = 8) was pretested and posttested using the House-Brackmann index. Both groups were treated with heat, massage, exercises, and a home program. The experimental group also received electrical stimulation. The House-Brackmann Scale of the control group improved between 17% and 50% with a mean of 30%. The scores of the experimental group ranged between 17% and 75% with a mean of 37%. The difference between the groups was not statistically significant (two-tailed p = 0.36). Electrical stimulation as used in this study during the acute phase of Bell's palsy is safe but may not have added value over spontaneous recovery and multimodal physiotherapy. A larger sample size or longer stimulation time or both should be investigated.

[1]  I. Zompa,et al.  Symmetry and synkinesis during rehabilitation of unilateral facial paralysis. , 1995, The Journal of otolaryngology.

[2]  K F Clark,et al.  Effect of pulsed electromagnetic stimulation on facial nerve regeneration. , 1998, Archives of otolaryngology--head & neck surgery.

[3]  N. Surgery [Facial nerve grading system]. , 2006, Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery.

[4]  S. B. Kater,et al.  Suppression of neurite elongation and growth cone motility by electrical activity. , 1986, Science.

[5]  L. W. Shrode Treatment of facial muscles affected by Bell's palsy with high-voltage electrical muscle stimulation. , 1993, Journal of manipulative and physiological therapeutics.

[6]  Shafshak Ts The treatment of facial palsy from the point of view of physical and rehabilitation medicine. , 2006 .

[7]  K D Henry,et al.  Effect of number of home exercises on compliance and performance in adults over 65 years of age. , 1999, Physical therapy.

[8]  J. Gittins,et al.  Electrical stimulation as a therapeutic option to improve eyelid function in chronic facial nerve disorders. , 1999, Investigative ophthalmology & visual science.

[9]  J. W. House,et al.  Facial nerve grading systems. , 1983, The Laryngoscope.

[10]  Shrode Lw Treatment of facial muscles affected by Bell's palsy with high-voltage electrical muscle stimulation. , 1993 .

[11]  G. Alon,et al.  Effect of long-term electrical stimulation on motor recovery and improvement of clinical residuals in patients with unresolved facial nerve palsy , 2000, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[12]  H. Biller,et al.  Diverticulopexy and Cricopharyngeal Myotomy: Treatment for the High-Risk Patient with a Pharyngoesophageal (Zenker's) Diverticulum , 1989, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[13]  B. Segal,et al.  Minimizing synkinesis during rehabilitation of the paralyzed face: preliminary assessment of a new small-movement therapy. , 1995, The Journal of otolaryngology.

[14]  J. Niparko,et al.  Prognostic Value of Evoked and Standard Electromyography in Acute Facial Paralysis , 1992, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[15]  E. Peitersen,et al.  Bell's Palsy: The Spontaneous Course of 2,500 Peripheral Facial Nerve Palsies of Different Etiologies , 2002, Acta oto-laryngologica. Supplementum.

[16]  R. Tallis,et al.  Eutrophic electrical stimulation for Bell's Palsy , 1987 .

[17]  T. Shafshak The treatment of facial palsy from the point of view of physical and rehabilitation medicine. , 2006, Europa medicophysica.

[18]  Christian Hofer,et al.  A stimulator for functional activation of denervated muscles. , 2002, Artificial organs.

[19]  N. O'dwyer,et al.  Reliability of the “Sydney,” “Sunnybrook,” and “House Brackmann” Facial Grading Systems to Assess Voluntary Movement and Synkinesis after Facial Nerve Paralysis , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.