Authors (including presenting author) :
LAM WSV(1), CHAN HTF(1), LEUNG YHJ (2), LY YFC (2),TO WKR(1), MAK MYM(1)
Affiliation :
(1) Physiotherapy Department, Tuen Mun Hospital, (2) Physiotherapy Department, Tin Shui Wai Hospital
Introduction :
Bell's palsy is the most common diagnosis associated with facial nerve paralysis referring for physiotherapy. It is typically a self-limiting condition, however, residual facial dysfunction is not uncommon. Conventional physiotherapy treatment includes facial care education, facial exercise, ice-cube massage and functional electrical stimulation (FES). Acupuncture has been advocated as beneficial for facial nerve palsy in some studies and utilized by physiotherapists in treating Bell’s palsy. The evaluation of their clinical effectiveness may help formulating a comprehensive physiotherapy intervention for patients with facial nerve palsy.
Objectives :
To evaluate the effectiveness of acupuncture in comparison to FES for patients with Bell’s palsy.
Methodology :
Patients aged above 18 with diagnosis of Bell’s palsy (idiopathic, unilateral lower motor neurone facial weakness) with symptoms onset within 14 days were recruited while those with complicated pathology were excluded. All patients received education on facial care and facial exercise with mirror in the initial session. Acupuncture treatment was provided to patients once a week for 6 consecutive weeks with consent from patients, otherwise, FES was provided as conventional treatment. For the acupuncture group, 5 acupuncture points (Sibai(ST2), Dicang(ST4), Jiache(ST6), Yangbai(GB14) and Hegu(LI4)) were needled and retained for 20 minutes. For the FES group, 6 surface electrodes were applied on the affected facial muscles for 20 minutes. Assessment was done in the initial and final session. Outcome measures were Numeric Global Rating of Change Scale (NGRCS), Sunnybrook Facial Grading Systems (SFGS). All cases with completed pre-post assessment were included in the analysis. Paired t-test was used for within group analysis and 2‐way repeated measures analysis of variance (ANOVA) statistical test was used for between-group comparisons.
Result & Outcome :
96 patients (46 males, 50 females, mean age = 54.85) and 25 patients (19 males, 6 females, mean age = 55.24) were recruited in the FES and acupuncture group respectively. Means of treatment session were 6.04 and 6.12 for FES group and acupuncture group respectively. There was significant within group improvement in NGRCS in FES group (from 0.027 to 8.32, p<0.001) and acupuncture group (from 0.00 to 8.87, p<0.001). There was significant increase in SFGS in FES group (from 44.93 to 88.88, p<0.001) and acupuncture group (from 40.88 to 91.42, p<0.001). The extent of improvement in acupuncture group was higher than that of the FES group in both NGRCS and SFGS but not reaching statistical significance. Both acupuncture and FES were shown to be effective for patients with facial nerve palsy.
