title: Physical therapy with drug treatment in Bell palsy: a focused review.
abstract: The physical therapy (PT) associated with standard drug treatment (SDT) in Bell palsy has never been investigated. Randomized controlled trials or quasirandomized controlled trials have compared facial PT (except treatments such as acupuncture and osteopathic) combined with SDT against a control group with SDT alone. Participants included those older than 15 yrs with a clinical diagnosis of Bell palsy, and the primary outcome measure was motor function recovery by the House-Brackmann scale. The methodologic quality of each study was also independently assessed by two reviewers using the PEDro scale. Four studies met the inclusion criteria. Three trials indicate that PT in association with SDT supports higher motor function recovery than SDT alone between 15 days and 1 yr of follow-up. On the other hand, one trial showed that electrical stimulation added to conventional PT with SDT did not influence treatment outcomes. The present review suggests that the current practice of Bell palsy treatment by PT associated with SDT seems to have a positive effect on grade and time recovery compared with SDT alone. However, there is very little quality evidence from randomized controlled trials, and such evidence is insufficient to decide whether combined treatment is beneficial in the management of Bell palsy.
authors.affiliation: From the Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal (MF, EAM, JAD, PCS); Department of Physiotherapy, North Polytechnic Institute of Health, CESPU-Gandra, Gandra, Portugal (MF); Higher Education Institute of Maia, Maia, Portugal (EAM); and Department of Physiotherapy, School of Health Technology of Porto, Institute Polytechnic of Porto, Porto, Portugal (PCS).
authors.forename: Margarida
authors.initials: M
authors.lastname: Ferreira
authors.forename: Elisa E
authors.initials: EE
authors.lastname: Marques
authors.forename: José A
authors.initials: JA
authors.lastname: Duarte
authors.forename: Paula C
authors.initials: PC
authors.lastname: Santos
mesh_terms: D020330:Bell Palsy / Q000188:drug therapy / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D005152:Facial Muscles; D006801:Humans; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results; D016896:Treatment Outcome