title: Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial.
abstract: OBJECTIVE
  To determine the effect of facial neuromuscular re-education over conventional therapeutic measures in improving facial symmetry in patients with Bell's palsy.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Neurorehabilitation unit.
  
  
  METHODS
  Fifty-nine patients diagnosed with Bell's palsy were included in the study after they met the inclusion criteria. Patients were randomly divided into two groups: control (n = 30) and experimental (n = 29).
  
  
  METHODS
  Control group patients received conventional therapeutic measures while the facial neuromuscular re-education group patients received techniques that were tailored to each patient in three sessions per day for six days per week for a period of two weeks.
  
  
  METHODS
  All the patients were evaluated using a Facial Grading Scale before treatment and after three months.
  
  
  RESULTS
  The Facial Grading Scale scores showed significant improvement in both control (mean 32 (range 9.7-54) to 54.5 (42.2-71.7)) and the experimental (33 (18-43.5) to 66 (54-76.7)) group. Facial Grading Scale change scores showed that experimental group (27.5 (20-43.77)) improved significantly more than the control group (16.5 (12.2-24.7)). Analysis of Facial Grading Scale subcomponents did not show statistical significance, except in the movement score (12 (8-16) to 24 (12-18)).
  
  
  CONCLUSIONS
  Individualized facial neuromuscular re-education is more effective in improving facial symmetry in patients with Bell's palsy than conventional therapeutic measures.
authors.affiliation: Department of Physiotherapy, Manipal College of Allied Health Sciences, Manipal, Karnataka, India. mani.kandan@manipal.edu
authors.forename: N
authors.initials: N
authors.lastname: Manikandan
mesh_terms: D000328:Adult; D020330:Bell Palsy / Q000150:complications / Q000534:rehabilitation*; D005081:Exercise Therapy; D005146:Facial Asymmetry / Q000209:etiology / Q000534:rehabilitation*; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008405:Massage; D011446:Prospective Studies; D016896:Treatment Outcome