Comparative Effects of Neural Mobilization and Proprioceptive Neuromuscular Facilitation in Patients with Bell’s Palsy
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Abstract
Background: Bell's palsy, characterized by sudden unilateral facial nerve paralysis, presents significant challenges in physical therapy and rehabilitation. Proprioceptive Neuromuscular Facilitation (PNF) and Neural Mobilization have emerged as potential interventions, yet their comparative efficacy remains underexplored. This study aims to fill this gap by evaluating the effectiveness of these treatments in improving facial function in patients with idiopathic Bell's palsy.
Objective: The primary objective of this randomized control trial (RCT) was to compare the effects of PNF and Neural Mobilization on physical and social functioning in patients with mild to moderately severe idiopathic Bell's palsy.
Methods: This RCT involved 36 participants, aged 25 to 45, diagnosed with idiopathic Bell's palsy, randomly allocated into two groups: PNF and Neural Mobilization, with 18 participants in each. The study spanned three weeks, with treatments administered 3-4 days per week. Conventional physiotherapy, including facial exercises and electrical muscle stimulation (EMS), served as the baseline treatment for both groups. The Shapiro-Wilks test assessed data normality, employing parametric tests for intra-group reliability analysis. The Mann-Whitney Test and Wilcoxon signed-rank test were utilized for inter and intra-group comparisons, respectively.
Results: Post-treatment, the PNF group exhibited significant improvements with a mean post-treatment House Brackmann Scale score of 90.28, compared to 73.61 in the Neural Mobilization group. Similarly, significant enhancements were noted in the Facial Disability Index, with both physical and social scores increasing from a median of 48 to 80 post-intervention. Statistical analysis revealed significant differences in treatment outcomes (p<0.001 for House Brackmann Scale; p<0.001 for Physical and Social FDI scores), favoring the PNF approach.
Conclusion: PNF was more effective than Neural Mobilization in improving the physical and social functions of patients with idiopathic Bell's palsy. This study underscores the potential of PNF as a superior treatment modality, advocating for its inclusion in conventional physiotherapy regimens for Bell's palsy patients.
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