Kabat Technique and Neuromuscular Effect in Patients With Bell's Palsy

NCT04807491 | Completed

• 1 other identifier: REC/00659 Muhammad Kashif
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

Bell's palsy is the sudden one-sided peripheral weakness of seventh cranial nerve (Facial nerve), represents 50% to 75% of all etiologies with a rate of 58.2 to 8 new cases per 1 million per year. The objective is to compare the effects of Kabat techniques and Neuromuscular Re-Education on facial disability and synkinesis in patients with bell's palsy. A Randomized Control Trial was conducted on 20 participants, equally allocated in Kabat and PNF training group from February-2020 until December- 2020. Participants were selected according to inclusion and exclusion criteria on purposive sampling technique and randomization was done by sealed envelope method. The assessment was done after taking consent before the first and last session. The tools included Facial disability index, Sunnybrook facial grading system and synkinesis assessment questionnaire. Data were analyzed using SPSS v.20.

Conditions

Bell Palsy

Keywords

Bell Palsy; PNF; Kabat therapy; synkinesis

Outcome Measures

Primary Outcomes (1)

• SunnyBrook Facial Grading System

  the tool is used to assess changes from baseline to 4 weeks The Sunnybrook scale is a regional weighted scale based on evaluation of different regions including resting symmetry, symmetry of voluntary movement and severity of Synkinesis to form one single composite score from 0 to 100. It was devised and established at the Sunnybrook Health Sciences Centre in Toronto having an intraclass correlation coefficient (ICC) of 0.890. The Facial Grading System is a tool used for clinical evaluation of Facial Nerve function. It is intended to use on peoples with facial nerve weaknes.

  4 weeks

Secondary Outcomes (1)

• Facial Disability Index

  4 weeks

Other Outcomes (1)

• Synkinesis Assessment Questionnair:

  4 weeks

Study Arms (2)

Kabat Technique's

ACTIVE COMPARATOR

Kabat exercises on Upper fulcrum, Intermediate fulcrum and lower fulcrum

Other: Kabat Technique's

Neuromuscular Re-Education:

EXPERIMENTAL

For initiation, Facilitation, Movement control and movement control

Other: Neuromuscular Re-Education

Interventions

Kabat Technique's OTHER

As with all cranial nerves, some specific techniques can also be applied on the facial nerve to enhance responses and improve recovery; the most important are: The rhythmic start: shows and guides the subject into the movements and the scheme; agonist investigation utilizes sequential concentric and eccentric contractions; The inversion of the antagonist: reinforces responses through the induction phenomenon; Repeated contractions: calls for a response with repeated stretching that briefly enables movement; Isometric contractions: for stabilizing and reinforcing the response. Conventional therapy exercises

Kabat Technique's

Neuromuscular Re-Education OTHER

After the baseline assessment, the participant in the control will receive Neuromuscular Re-Education. The duration of session will be 45 minutes.Neuromuscular Re-Education: For initiation (acute phase): Active-assisted exercise,Massage and stretch for affected side.For Facilitation ,Active-assisted exercise.For Movement control:Massage and stretching for facial retraction,Assisted and active exercises on involved side. For Relaxation,Thermotherapy,Relaxation exercises,Alternating rhythmic movements. Conventional therapy exercises

Neuromuscular Re-Education:

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed cases of bell's palsy
• Non traumatic onset ( conditions like infectious, hypertensive patients, diabetic patients

You may not qualify if:

• History of significant psychiatric illness
• Upper motor neuron disease ( stroke, TBI, tumor)
• Non co-operative patients
• Post-surgical case

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Riphah International University

Islamabad, 44000, Pakistan

Location

Related Publications (12)

• Monini S, Iacolucci CM, Di Traglia M, Lazzarino AI, Barbara M. Role of Kabat rehabilitation in facial nerve palsy: a randomised study on severe cases of Bell's palsy. Acta Otorhinolaryngol Ital. 2016 Aug;36(4):282-288. doi: 10.14639/0392-100X-783.

  PMID: 27734980 BACKGROUND

• Nicastri M, Mancini P, De Seta D, Bertoli G, Prosperini L, Toni D, Inghilleri M, Filipo R. Efficacy of early physical therapy in severe Bell's palsy: a randomized controlled trial. Neurorehabil Neural Repair. 2013 Jul-Aug;27(6):542-51. doi: 10.1177/1545968313481280. Epub 2013 Apr 2.

  PMID: 23549520 BACKGROUND

• Ferreira M, Marques EE, Duarte JA, Santos PC. Physical therapy with drug treatment in Bell palsy: a focused review. Am J Phys Med Rehabil. 2015 Apr;94(4):331-40. doi: 10.1097/PHM.0000000000000255.

  PMID: 25785922 BACKGROUND

• Teixeira LJ, Valbuza JS, Prado GF. Physical therapy for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006283. doi: 10.1002/14651858.CD006283.pub3.

  PMID: 22161401 BACKGROUND

• Barbara M, Antonini G, Vestri A, Volpini L, Monini S. Role of Kabat physical rehabilitation in Bell's palsy: a randomized trial. Acta Otolaryngol. 2010;130(1):167-72. doi: 10.3109/00016480902882469.

  PMID: 19430987 BACKGROUND

• Sardaru D, Pendefunda L. Neuro-proprioceptive facilitation in the re-education of functional problems in facial paralysis. A practical approach. Rev Med Chir Soc Med Nat Iasi. 2013 Jan-Mar;117(1):101-6.

  PMID: 24505900 BACKGROUND

• Aranha VP, Samuel AJ, Narkeesh K. Correct the smile of a child by neuromuscular facilitation technique: An interesting case report. Int J Health Sci (Qassim). 2017 Apr-Jun;11(2):83-84.

  PMID: 28539869 BACKGROUND

• Manikandan N. Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial. Clin Rehabil. 2007 Apr;21(4):338-43. doi: 10.1177/0269215507070790.

  PMID: 17613574 BACKGROUND

• Mehta RP, WernickRobinson M, Hadlock TA. Validation of the Synkinesis Assessment Questionnaire. Laryngoscope. 2007 May;117(5):923-6. doi: 10.1097/MLG.0b013e3180412460.

  PMID: 17473697 BACKGROUND

• Neely JG, Cherian NG, Dickerson CB, Nedzelski JM. Sunnybrook facial grading system: reliability and criteria for grading. Laryngoscope. 2010 May;120(5):1038-45. doi: 10.1002/lary.20868.

  PMID: 20422701 BACKGROUND

• Fattah AY, Gurusinghe ADR, Gavilan J, Hadlock TA, Marcus JR, Marres H, Nduka CC, Slattery WH, Snyder-Warwick AK; Sir Charles Bell Society. Facial nerve grading instruments: systematic review of the literature and suggestion for uniformity. Plast Reconstr Surg. 2015 Feb;135(2):569-579. doi: 10.1097/PRS.0000000000000905.

  PMID: 25357164 BACKGROUND

• Kleiss IJ, Beurskens CH, Stalmeier PF, Ingels KJ, Marres HA. Synkinesis assessment in facial palsy: validation of the Dutch Synkinesis Assessment Questionnaire. Acta Neurol Belg. 2016 Jun;116(2):171-8. doi: 10.1007/s13760-015-0528-7. Epub 2015 Sep 16.

  PMID: 26377698 BACKGROUND

MeSH Terms

Conditions

Bell Palsy; Synkinesis

Condition Hierarchy (Ancestors)

Herpesviridae Infections; DNA Virus Infections; Virus Diseases; Infections; Mouth Diseases; Stomatognathic Diseases; Facial Nerve Diseases; Cranial Nerve Diseases; Nervous System Diseases; Dyskinesias; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Dr Aruba Saeed, PHD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 21, 2020
• First Posted: March 19, 2021
• Study Start: November 15, 2020
• Primary Completion: December 15, 2020
• Study Completion: December 30, 2020
• Last Updated: March 19, 2021

Record last verified: 2021-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)