Effectiveness of Facial Neuromuscular Retraining with and without Mirror Visual Feedback in Patients with Bell's Palsy

Objective: Bell's palsy is one of the most frequent forms of facial palsy affecting 75% of the cases. Different physiotherapy techniques are utilized for treating Bell's palsy which aims to rebuild normal facial expressions and restore normal strength and function of facial muscles alongside decreasing all associated symptoms. This research was conducted to evaluate the effectiveness of facial neuro-muscular retraining with and without mirror visual feedback in patients with Bell's palsy. Methods: A randomized controlled trial was conducted. 64 subjects were recruited in the sample. Patients were randomly divided into two groups with 32 patients in each group. Both groups received Neuromuscular Retraining exercises (NMR). Group 1 received Mirror Visual Feedback (MVF) additionally. Facial symmetry and motor function of facial muscles was assessed by using Facial Disability Index (FDI) and House Brackmann Scale (HBS). Readings were taken at baseline and then at 3rd and 7th week follow ups. Research took 9 months duration to complete and data analysis was done using SPSS 22. Results: Results of the research demonstrated no significant difference of FDI-P, FDI-S and HBS score at baseline between both groups with p value being 0.893, 0.321 and 0.317 respectively. Significant difference was observed in FDI-P, FDI-S and HBS scores at 3rd week and 7th week follow up between 2 groups with p value being 0.00 for all outcome measures. Conclusion: Mirror Visual Feedback used in combination with NMR was found more effective in improving the facial symmetry and movement and in decreasing the functional disability than NMR used alone in Bell's palsy patients.