title: Role of electrical stimulation added to conventional therapy in patients with idiopathic facial (Bell) palsy.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Figen
authors.initials: F
authors.lastname: Tuncay
authors.forename: Pinar
authors.initials: P
authors.lastname: Borman
authors.forename: Burcu
authors.initials: B
authors.lastname: Taşer
authors.forename: İlhan
authors.initials: İ
authors.lastname: Ünlü
authors.forename: Erdal
authors.initials: E
authors.lastname: Samim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D055815:Young Adult