Combined Effects of Proprioceptive Neuromuscular Facilitation (PNF) and Neural Mobilization on Improving Facial Symmetry in Patients With Bells Palsy

NCT07758543 | Recruiting

• 1 other identifier: FUI/FUCP/CTR/Neuro/Mahnoor
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Bell's Palsy; Facial Paralysis; Facial Asymmetry

Keywords

Bell's palsy; facial paralysis; neural mobilization; proprioceptive neuromuscular facilitation

Outcome Measures

Primary Outcomes (2)

• Resting symmetry

  It is measured by sunny brook facial grading system(SFGS) SFGS Score= {Voluntary Movement Score} - {Synkinesis Score} - {Resting Symmetry Score} * Maximum score = 100 (Normal facial function) * Minimum score = 0 (Complete paralysis).

  4 weeks

• Severity of facial paralysis

  It is measured by Housebrackman scale Patients graded IV-VI show severe impairment Patients graded I-III have mild-to-moderate dysfunction

  4 weeks

Study Arms (2)

pnf and neural mobilization

EXPERIMENTAL

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

pnf alone

ACTIVE COMPARATOR

Rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session).

Procedure: GROUP B PNF GROUP

Interventions

GROUP A COMBINED THERAPY GROUP PROCEDURE

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.

pnf and neural mobilization

GROUP B PNF GROUP PROCEDURE

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.

pnf alone

Eligibility Criteria

• Age: 15 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Age 15-60 years.
• Both male and female.
• Patient diagnosed with bells palsy by neurologist or relevant specialist.
• Patients with moderate to severe Bell's palsy evaluated by Modified House-Brackman SCALE
• Patient without exposure to any other rehabilitation program
• Patients within the acute or subacute phases (within 6 months of onset)

You may not qualify if:

• Patients with a history of recurrent Bell's palsy or other neurological disorders (e.g., stroke, multiple sclerosis)
• Patients with pacemakers, metal implants or other contraindications for electrical muscle stimulation.
• Presence of facial trauma or surgical interventions that might interfere with rehabilitation outcomes.
• Co-existing medical conditions (e.g., diabetes mellitus, infections, or malignancies) that might impair nerve recovery or affect study outcomes

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

RECRUITING

MeSH Terms

Conditions

Bell Palsy; Facial Paralysis; Facial Asymmetry

Condition Hierarchy (Ancestors)

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

Central Study Contacts

Mahnoor Azhar, DPT

CONTACT

+92 3175868174; mahnoorazhar707@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 6, 2026
• First Posted: August 11, 2026
• Study Start: September 14, 2025
• Primary Completion (Estimated): December 10, 2026
• Study Completion (Estimated): January 10, 2027
• Last Updated: August 11, 2026

Record last verified: 2026-08

Locations

PA (1)