073
98 Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3
ABSTRACT
Objectives: To study &compare the efficacy of taping protocol/Technique over Conventional
treatment technique protocol in Bells Palsy.
Materials and Method: The study was conducted on 30 subjects. Subjects were divided into two
groups. One group was given Electrical stimulation and exercises and other group was given electrical
stimulation , facial exercises and taping.
Results- There exists significant difference between post-treatment scores of both the groups. The
study concluded that the treatment of Es+facial exercise+tapping is effective in curing bell's palsy
Conclusion: Group B protocol is more effective for functional retraining than conventional treatment
in subjects with Bells Palsy.
Keywords: Bell's Palsy, Taping, Electrical Stimulation, Facial exercises
INTRODUCTION
Bells palsy, also known as acute idiopathic facial
paresis, is an idiopathic neuropathy of the facial nerve
(cranial nerve VII). It is a rapid onset facial paralysis
that is not life-threatening. While acute immune
demyelination triggered by a viral infection may be
responsible for Bells palsy, its exact cause is still
unclear. Bells palsy is usually self-limiting with the
majority of patients recovering spontaneously without
treatment within 6 months of onset of the disorder.
However, a recent study by Kanazawa et al (2007)
reported that recovery from Bells palsy in diabetics is
delayed, and the facial movement score remains low
in comparison with non-diabetics.1Facial paralysis has
been primarily considered a cosmetic inconvenience
with associated functional problems such as speech,
eating, facial asymmetry, drooling, and an inability to
close the eye on the paralyzed side .The patient with
facial paralysis cannot convey the normal social signals
of interpersonal communication. Incidence of Bells
Palsy is about 23/100000/annum.
Facial nerve is responsible for voluntary facial
movements,& can be tested by asking a patient to
perform movements such as wrinkling the brow,
showing teeth, frowning, closing the eyes tightly,
pursing the lips and puffing out the cheeks & noticing
asymmetry. The recovery phases of Bells palsy tends
to follow one of two pathways2
98
Alternative treatment,
Acupuncture,
Chiropractic manipulation,
Surgery.
8/1/2013, 8:31 AM
Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3 99
99
Prognosis
The potential outcome from Bells palsy is quite
hopeful. NINDS notes that the majority of all Bells
palsy sufferers improve dramatically, with or without
treatment, within two weeks. The Bells Palsy
Information Site notes that half of all people
contracting this condition recover completely within
a short time, and another 35 percent have good
recoveries within a year. The outlook for children is
better. Eighty-five percent of children with this disease
recover completely. Ten percent of the children who
contract Bells palsy will have mild weakness
remaining afterward, and 5 percent will have severe
residual facial weakness. Statistically, 7 percent of all
children that develop Bells palsy will have a recurrent
episode in the future.4
AIMS AND OBJECTIVES
To study& compare the efficacy of taping protocol/
Technique over Conventional treatment protocol.
HYPOTHESIS
Null Hypothesis (Ho)
Both taping protocol/Technique and Conventional
treatment protocol are equally effective in subjects with
Bells palsy .
8/1/2013, 8:31 AM
100 Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3
SURGICAL TAPE
MICROPORE TAPE
ELASTOPLAST
C. FACIAL MASSAGE
The patients often derive great comfort from
massage. The following manipulation can be
given:
1. STROKING
SUBJECTS
Subjects taken were 30 with age group 18-45 years
with a diagnosis of bells palsy of non-traumatic onset.
Subject pool was taken from CMC & Hospital
&consent form signed by them. Subjects were divided
100
2.
FINGER KNEADING
Small circular all over the affected side of the face
,care being taken not to stretch the muscles.
8/1/2013, 8:31 AM
Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3 101
3.
TAPOTEMENT
May be administrated in the from of tapping with
the finger tips quickly & lightly.
D. FACIAL EXERCISES
Post
Mean
117.8667
143.2
Variance
155.2667
184.7429
Observations
5. Chew gum.
15
Pearson Correlation
Df
14
t Stat
15
0.333768
6.512843
P(T<=t) one-tail
6.86E-06
t Critical one-tail
1.761309
P(T<=t) two-tail
1.37E-05
t Critical two-tail
2.144789
101
172.0667
370.8857
15
Pearson Correlation
142.2
309.3524
0.879939
Df
14
t Stat
12.61168
P(T<=t) one-tail
2.46E-09
t Critical one-tail
1.761309
P(T<=t) two-tail
4.93E-09
t Critical two-tail
2.144789
8/1/2013, 8:31 AM
15
102 Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3
69
78
72
78
72
74
90
100
95
88
85
98
Group II
143.2
172.0667
184.7429
309.3524
15
15
0
28
t Stat
5.02964
P(T<=t) one-tail
1.55E-05
t Critical one-tail
1.705616
P(T<=t) two-tail
3.11E-05
t Critical two-tail
2.055531
DISCUSSION
On the basis of analysis of result the alternating
hypothesis stating that Group B taping protocol is more
effective than conventional treatment protocol subjects
with bells palsy. Although both Group B taping
protocol & conventional treatment protocol were
effective for retraining but subjects in group b showed
better recovery than Group A in term of facial
symmetry & ability to perform functional activities
such as chewing, balloon blowing & speech. But taping
protocol being more effective , sequential & systematic
show better results. Also the intricacy of the movement
that can be achieved by the facial muscles should
preclude the use of maximum effort, gross exercises
where motor units other than those targeted are
recruited due to overflow. Basically taping help to
retrain paralyzed facial muscle maintaining symmetry
& facilitating the paralyzed muscle thereby preventing
over activity of normal muscle and act as a normal
mechanism by promoting the desired symmetrical
movement pattern that need to be repetitively
reinforced before it will be learned.
Conflict of Interest: No conflict of study is reported
for this study.
Source of Funding: No source of funding is reported
for this study
Ethical Clearance: Approved had been taken.
REFERENCES
1.
3.
4.
102
8/1/2013, 8:31 AM
Indian Journal of Physiotherapy & Occupational Therapy. July-September 2013, Vol. 7, No. 3 103
5.
6.
103
7.
8/1/2013, 8:31 AM
Reproduced with permission of the copyright owner. Further reproduction prohibited without
permission.