title: Are corticosteroids useful in all degrees of severity and rapid recovery of Bell's palsy?
abstract: Conclusions The results provide preliminary evidence that corticosteroids were not effective in all grades of dysfunction and for achieving a rapid remission in the early phase of BP, highlighting the need to define standard and rigorous criteria to prescribe corticosteroids in these patients. Objectives The main aim of this study was to investigate whether the use of corticosteroids better associated than paralleled with neuromuscular training (C + FNT) is more effective than facial neuromuscular training (FNT) applied alone, in terms of recovery degree and facial symmetry during the early phase of Bell's palsy (BP). Patients and methods A prospective single-blinded study involved 73 patients: the C + FNT group (n = 42; median age = 37.5 years) and FNT group (n = 31; median age = 49.0 years). Patients were assessed before and 6 weeks after treatment by House-Brackmann (HB-FGS) and Sunnybrook Facial Grading System (SB-FGS). Results Recovery degree and facial symmetry improved significantly in both groups (p < 0.001), without differences between groups (p > 0.05). However, the C + FNT group displayed better outcomes for cheek (p = 0.004) and mouth (p = 0.022) resting symmetry at SB-FGS, instead of compared to the FNT group. The corticosteroids had no significant effect on all recovery degrees (p = 0.992) and rapid remission (p = 0.952). Multiple linear regression analysis showed that the type of intervention was not a significant predictor for recovery degree (p = 0.917).
authors.affiliation: a Research Centre in Physical Activity, Health and Leisure, Faculty of Sport , University of Porto , Porto , Portugal ;|b Department of Physiotherapy, Paredes and Vila Nova De Famalicão , North Polytechnic Institute of Health, CESPU , Portugal ;
authors.forename: Margarida
authors.initials: M
authors.lastname: Ferreira
authors.affiliation: c Department of Public Health - Occidental Oporto , Portugal ;
authors.forename: Machado J
authors.initials: MJ
authors.lastname: Firmino
authors.affiliation: d Research Center in Sports Sciences, Health and Human Development (CIDESD) , University Institute of Maia (ISMAI) , Portugal ;|e National Institute on Aging, National Institutes of Health , Bethesda , MD , USA ;
authors.forename: Elisa A
authors.initials: EA
authors.lastname: Marques
authors.affiliation: a Research Centre in Physical Activity, Health and Leisure, Faculty of Sport , University of Porto , Porto , Portugal ;|f Department of Physical Therapy, School of Health Technology of Porto , Polytechnic Institute of Porto , Vila Nova De Gaia , Portugal.
authors.forename: Paula C
authors.initials: PC
authors.lastname: Santos
authors.affiliation: a Research Centre in Physical Activity, Health and Leisure, Faculty of Sport , University of Porto , Porto , Portugal ;
authors.forename: José A
authors.initials: JA
authors.lastname: Duarte
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D020330:Bell Palsy / Q000188:drug therapy* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Facial palsy; House-Brackmann Facial Grading System; Sunnybrook Facial Grading System; medical therapy; muscular training