An interventional study of Exteroceptive Stimulation and Conventional Physiotherapy in Stroke and Facial Palsy, sponsored by University of Faisalabad. Completed at 1 site in Pakistan. Open to participants aged 40 Years to 55 Years. Per ClinicalTrials.gov, last updated 2026-06-03.
Sponsored by University of Faisalabad · Not applicable, Interventional, and Treatment
Stroke is a leading cause of long-term disability worldwide and frequently results in central facial palsy, which manifests as facial asymmetry, impaired muscle control, and reduced functional ability. These impairments can affect speech, emotional expression, and overall quality of life. Conventional physiotherapy is commonly used to manage post-stroke facial palsy; however, the additional benefit of sensory-based rehabilitation approaches remains insufficiently explored, particularly in clinical settings with limited resources.
This study was conducted to evaluate whether the addition of exteroceptive stimulation to conventional physiotherapy leads to greater improvement in facial symmetry and functional outcomes compared to conventional physiotherapy alone. Exteroceptive stimulation aims to enhance sensory input and facilitate neuromuscular activation, potentially improving motor recovery in affected facial muscles.
In this double-blind randomized controlled trial, a total of 36 participants diagnosed with post-stroke facial palsy were recruited and randomly allocated into two groups. The experimental group received exteroceptive stimulation in addition to conventional physiotherapy, while the control group received conventional physiotherapy alone. Both interventions were administered over a period of four weeks.
Outcome measures were assessed at baseline and at the end of the intervention period. The primary outcome was lip angle deviation, used as an indicator of facial symmetry. Secondary outcomes included facial function and disability assessed using standardized tools such as the Facial Disability Index and the Synkinesis Assessment Questionnaire.
The findings of this study aim to provide evidence on the effectiveness of integrating sensory-based techniques into routine rehabilitation programs for post-stroke facial palsy. The results may support the development of more comprehensive and effective rehabilitation strategies to improve patient outcomes.
Post-stroke facial palsy is a frequent neurological complication resulting from upper motor neuron lesions affecting facial nerve pathways. It commonly presents with facial asymmetry, impaired voluntary muscle control, and altered emotional expression. These deficits can interfere with communication, oral competence, and social interaction, ultimately impacting functional independence and quality of life. Despite its clinical importance, rehabilitation strategies targeting facial motor recovery remain relatively underdeveloped compared to limb rehabilitation.
Conventional physiotherapy approaches for facial palsy typically focus on facial muscle exercises, facilitation techniques, and functional retraining aimed at improving motor control and symmetry. While these approaches are widely used in clinical practice, their outcomes are often variable, and recovery may be incomplete. In recent years, there has been increasing interest in integrating sensory-based interventions into neurorehabilitation, based on the premise that sensory input plays a critical role in motor relearning and cortical reorganization.
Exteroceptive stimulation is a sensory-based intervention designed to enhance afferent input through external stimuli applied to the skin and underlying tissues. By increasing sensory feedback, it may facilitate neuromuscular activation, improve motor coordination, and support adaptive neuroplastic changes. Although such approaches have shown promise in broader neurorehabilitation contexts, their role in the management of post-stroke facial palsy has not been sufficiently investigated through controlled clinical trials.
This study was designed as a double-blind randomized controlled trial to examine the additional benefit of exteroceptive stimulation when combined with conventional physiotherapy. Participants diagnosed with post-stroke facial palsy were recruited from tertiary care settings and randomly assigned to one of two intervention groups using a computer-generated randomization process. Measures were taken to ensure blinding of participants and outcome assessors to minimize bias.
The intervention was delivered over a defined treatment period, with both groups receiving standardized conventional physiotherapy to ensure consistency of baseline care. The experimental group received an additional structured program of exteroceptive stimulation targeting affected facial regions. The protocol was designed to be feasible within routine clinical practice and reproducible in similar healthcare settings.
Outcome assessments were conducted at predefined time points using validated clinical instruments to capture changes in facial symmetry, functional ability, and associated complications such as synkinesis. The selection of these measures was based on their relevance to clinical presentation and their use in prior rehabilitation research.
Statistical analysis was performed to evaluate changes over time within each group and to compare differences between groups following the intervention period. Appropriate parametric tests were applied after assessment of data distribution. A threshold for statistical significance was established a priori.
This study aims to contribute to the existing body of evidence by providing controlled clinical data on the role of sensory-based adjunct therapies in facial rehabilitation following stroke. The findings are expected to inform clinical practice by clarifying whether the addition of exteroceptive stimulation offers meaningful benefits beyond conventional physiotherapy alone. Furthermore, the study may serve as a basis for future research exploring optimized rehabilitation protocols, longer follow-up durations, and larger multi-center trials.
8,255 studies on the registry are indexed under Stroke; 2,056 are open to participants now.
This study's enrollment of 36 is below the median of 49 across 6,024 interventional studies indexed under Stroke.
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Exteroceptive stimulation was applied to the affected side of the face using structured sensory techniques, including light touch, stroking, tapping, and graded pressure over the perioral, cheek, and nasolabial regions. The intervention was delivered by a trained physiotherapist in a standardized sequence to enhance sensory input and facilitate neuromuscular activation.
Other: Exteroceptive Stimulation · Other: Conventional Physiotherapy
Conventional physiotherapy included a structured facial rehabilitation program comprising facial muscle exercises, facilitation techniques, and functional retraining aimed at improving symmetry and muscle coordination.
Other: Conventional Physiotherapy
Exteroceptive stimulation was applied to the affected side of the face using structured sensory techniques, including light touch, stroking, tapping, and graded pressure over the perioral, cheek, and nasolabial regions. The intervention was delivered by a trained physiotherapist in a standardized sequence to enhance sensory input and facilitate neuromuscular activation. Each session lasted approximately 30-40 minutes and was administered 5 days per week for 4 weeks in a clinical setting. This intervention was provided in combination with conventional physiotherapy.
Conventional physiotherapy included a structured facial rehabilitation program comprising facial muscle exercises, facilitation techniques, and functional retraining to improve symmetry and coordination. Sessions were delivered by a qualified physiotherapist, lasting approximately 30-40 minutes, 5 days per week for 4 weeks. This intervention was provided alone in the control group and in combination with exteroceptive stimulation in the experimental group.
Change in Lip Angle Deviation
Lip angle deviation was measured using standardized facial symmetry assessment techniques to evaluate improvement in facial alignment.
Time frame: Baseline and Week 4
Facial Disability Index (FDI)
Assessment of physical and social function using validated scoring system (FDI-P, FDI-S, FDI-T). The Facial Disability Index is a validated scale used to assess functional limitations and social well-being in patients with facial disorders. It consists of two subscales: Physical Function and Social Function, which are combined to generate a total score. Scores range from 0 to 100, with higher scores indicating better functional status and improved quality of life.
Time frame: Baseline and Week 4
Synkinesis Assessment Questionnaire (SAQ)
Measurement of synkinesis severity using a structured questionnaire. The Synkinesis Assessment Questionnaire is a patient-reported outcome measure used to evaluate the severity of synkinesis. The total score ranges from 0 to 100, with higher scores indicating greater severity of synkinesis and worse clinical condition.
Time frame: Baseline and Week 4
Plan to share: No
Ran from Aug 2025 to primary completion in Dec 2025, 4 months.
Of 3,108 non-industry interventional studies with no phase under Stroke, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 46. This study's 4 months is below that.
Counting every sponsor, half of 3,252 studies reached it within 23 months; a quarter within 10 and three quarters within 46.
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This study is completed, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.
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University of Faisalabad