Authors (including presenting author) :
LAM WSV(1), CHAN HTF(1), NG KWC(1), NG CLC(2), LEUNG YHJ (3), FAN KMC (3), LY YFC (3), CHAN LCJ(2),TO WKR(1), MAK MYM(1)
Affiliation :
(1) Physiotherapy Department, Tuen Mun Hospital, (2) Physiotherapy Department, Pok Oi Hospital, (3) 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 exercise and functional electrical stimulation (FES). Acupuncture has been advocated as beneficial for facial nerve palsy in some studies.
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 patient 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) and number of treatment session. Clinical end point was completion of 6 treatment sessions or 90% subjective improvement. Paired t-test was use for within group analysis and 2‐way repeated measures analysis of variance (ANOVA) statistical test was used for between groups comparisons.
Result & Outcome :
18 patients (13 males, 5 females, mean age = 54.28) and 9 patients (7 males, 2 females, mean age = 52.00) were recruited in the FES and acupuncture group respectively. Mean number of treatment duration was 4.82 and 4.92 weeks for FES group and acupuncture group respectively. There was significant within group improvement in NGRCS in FES group (mean: 7.89, p< 0.001) and acupuncture group (mean: 9.11, p< 0.001). There was significant increase in SFGS in FES group (36.93 to 85.86, p< 0.001) and acupuncture group (43.89 to 92, p< 0.001). There was no significant difference in the degrees of improvement for both NGRCS and SFGS between two groups. Both acupuncture and FES were shown to be effective for patients with facial nerve palsy and acupuncture was as effective as FES.
