An interventional study of GROUP A COMBINED THERAPY GROUP and GROUP B PNF GROUP in Bell's Palsy, Facial Paralysis and Facial Asymmetry, sponsored by Foundation University Islamabad. Recruiting at 1 site in Pakistan. Open to participants aged 15 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-09-15.
Sponsored by Foundation University Islamabad · Not applicable, Interventional, and Treatment
Bell's palsy is an acute,unilateral facial paresis that significantly affects patient's facial symmetry,motor function and quality of life.The primary goal of this randomized controlled trial is to determine if integrating the targeted neural mobilization with proprioceptive neuromuscular facilitation improves facial symmetry and motor function more effectively than using pnf alone.participants allocated to either experimental group receiving neural mobilization and pnf or control group receiving pnf alone.after approval from ERC FUSH, participants are assessed using housebrackman scale and sunnybrook facial grading system(scales to asses the degree of severity of facial paralysis) at first and fourth week of intervention application.data will be analysed using spss v.22.
Bell's palsy is an acute lower motor neuron facial nerve paralysis caused by dysfuntion in facial nerve (cranial nerve 7), leading to impairements in facial expression,speech, eating and psychological wellbeing, ultimatemately affecting the quality of life. Despite the individual benefits of rehabilitation techniques like facial proprioceptive neuromuscular facilitation and neural mobilization,there is limited evidence about the combined effects of these two verses pnf alone in the rehabilitation of bell's palsy. This randomized controlled trial is conducted in foji foundation hospital ,rwp, for the duration of one year after approval including a sample size of 36 patients. Sampling technique would be purposive.After ethical approval from ERC FUSH ,eligible participants will be allocated in two groups via coin toss method.the participants would be assessed through house brackman scale and sunny brook facial grading system (scales to asses the degree of severity of facial paralysis) at fisrt and forth week of intrvention application (3 sessions per week,30-45 minutes per seesion, for consecutive four weeks).
85 studies on the registry are indexed under Bell Palsy; 30 are open to participants now.
This study's planned enrollment of 38 is close to the median of 42 across 70 interventional studies indexed under Bell Palsy.
Browse Bell Palsy studies →Foundation University Islamabad is the lead sponsor of 255 studies on the registry; 142 are open to participants now.
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Exclusion Criteria:
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Contraindication
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Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
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1. Gentle facial nerve mobilization applied within pain free range (10-12 min/session, 6-10 repetition/technique,30-60 seconds/glide). 2. rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session)
Procedure: GROUP A COMBINED THERAPY GROUP
Rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session).
Procedure: GROUP B PNF GROUP
Receives proprioceptive neuromuscular facilitation (pnf), neural mobilization and conventional therapy. DESCRIPTION * PNF using rhythmic initiation and resisted voluntary movements directed at the frontalis, orbicularis oculi, zygomaticus major and minor, orbicularis oris and buccinator; three to five repetitions per pattern, three to four sets per session. Progression governed as tolerated with resistance and repetitions increased as recovery allowed. * Gentle facial nerve mobilization within a pain-free range, ten to twelve minutes per session; six to ten repetitions per technique or thirty to sixty seconds per glide, advancing glide range as tolerated. * Conventional therapy; clinic-based facial expression exercises with interrupted galvanic stimulation (rectangular waveform, 100 ms, 3 sets × 30 contractions), 2-3 sessions weekly, 15-20 minutes; plus daily home facial exercises with mirror feedback (smiling, blinking, puckering), 10-15 minutes.
Receives proprioceptive neuromuscular facilitation and conventional therapy. DESCRIPTION * Proprioceptive neuromuscular facilitation, using rhythmic initiation and resisted voluntary movements. Progression governed by the participant's tolerance and motor control, with resistance and repetitions increased as recovery allowed. * Conventional therapy: clinic-based facial expression exercises with interrupted galvanic stimulation (rectangular waveform, 100 ms, 3 sets × 30 contractions), 2-3 sessions weekly, 15-20 minutes; plus daily home facial exercises with mirror feedback (smiling, blinking, puckering), 10-15 minutes.
Symmetry of face
It is measured by Sunnybrook facial Grading system (SFGS) SFGS Score = (Voluntary Movement Score) - (Synkinesis Score) - (Resting Symmetry Score) Minimum value: 0 (Complete paralysis) Maximum value: 100 (Normal facial function) Higher scores indicate a better outcome
Time frame: 4 weeks
Severity of facial paralysis
It is measured by the House-Brackmann scale. Patients graded IV-VI show severe impairment, and patients graded I-III have mild-to-moderate dysfunction. Minimum value: I (Normal facial function) Maximum value: VI (Total paralysis) Outcome interpretation: Higher scores indicate a worse outcome
Time frame: 4 weeks
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