Idiopathic facial palsy and physical therapy: an intervention proposal following a review of practice

Background: Idiopathic facial palsy (IFP) or Bell's palsy is a unilateral mononeuropathy of the lower motorneuron of the facial nerve, excluding tumor, infectious or traumatic causes. Objectives: To evaluate the efficacy of physical therapy on the outcome of IFP. Search strategy: The electronic databases MEDLINE, Cochrane Database of Systematic Reviews, PEDro and SPORTDiscus, were searched up to December 2009. Selection criteria: Studies included in this review were selected according to the following set of criteria: (1) the design was randomized controlled trial; (2) all participants had an IFP or paresis; (3) the intervention was any modality of physiotherapy (a combination of modalities was possible) except interventions such as acupuncture and osteopathic; (4) the studies were published between January 2000 and December 2009; (5) English language. Methods: The review authors extracted and analyzed the data independently, using the PEDro scale to assess the methodological quality of each eligibly study. Results: Only two eligible studies were identified and included in the review. Both studies were scored 5 out of 10 on the PEDro scale. Both studies found benefits from facial neuromuscular reeducation with mirror feedback in the acute or chronic phase of IFP. The results of these studies could not be pooled for metaanalysis, as the study interventions and assessment were heterogeneous. Conclusions: The experimental studies demonstrated moderate efficacy in the treatment of facial neuromuscular reeducation with mirror feedback in different phases of the paralysis.