Effects of exercises on Bell's palsy: systematic review of randomized controlled trials.
OBJECTIVE
This study examined the effects of facial exercises associated either with mirror or electromyogram (EMG) biofeedback with respect to complications of delayed recovery in Bell's palsy.


METHODS
Patients with unilateral idiopathic facial palsy were included in this review.


METHODS
Facial exercises associated with mirror and/or EMG biofeedback as treatment.


METHODS
Report of facial symmetry, synkinesis, lip mobility, and physical and social aspects.


RESULTS
Four studies of 132 met the eligibility criteria. The studies described mime therapy versus control (n = 50), mirror biofeedback exercise versus control (n = 27), "small" mirror movements versus conventional neuromuscular retraining (n = 10), and EMG biofeedback + mirror training versus mirror training alone. The treatment length varied from 1 to 12 months.


CONCLUSIONS
Because of the small number of randomized controlled trials, it was not possible to analyze if the exercises, associated either with mirror or EMG biofeedback, were effective. In summary, the available evidence from randomized controlled trials is not yet strong enough to become integrated into clinical practice.
Universidade Estadual de Londrina, Londrina, Brazil. jeffcar@uel.br
Jefferson Rosa
JR
Cardoso
Elsie Cobra
EC
Teixeira
Michelle Damasceno
MD
Moreira
Francis Meire
FM
Fávero
Sissy Veloso
SV
Fontes
Acary Souza
AS
Bulle de Oliveira
D020330:Bell Palsy / Q000628:therapy*; D001676:Biofeedback, Psychology; D004576:Electromyography; D005081:Exercise Therapy; D005152:Facial Muscles / Q000502:physiology; D006801:Humans; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome