Skip to main content
OpenTrials
Recruiting

NCT Number: NCT07758543

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

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.

Recruiting

Interested in participating?

Request Info

Key information

Conditions

Bell's Palsy Bell Palsy Cranial Nerve Diseases DNA Virus Infections Facial Asymmetry Facial Nerve Diseases Facial Paralysis Herpesviridae Infections Infections Mouth Diseases Nervous System Diseases Neurologic Manifestations Paralysis Pathological Conditions, Anatomical Pathological Conditions, Signs and Symptoms Signs and Symptoms Stomatognathic Diseases Virus Diseases

Age range

15 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Foundation University College of Physical Therapy

Islamabad, 44000, Pakistan

Location status: Recruiting

Location contact

Sana Khalid, MS-NMPT

CONTACT

[email protected]

+923444218174

About this study

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).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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)

Exclusion criteria

  • 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

Treatment and study plan

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.

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.

Primary outcomes

  1. Resting symmetry

    Time frame: 4 weeks

    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).

  2. Severity of facial paralysis

    Time frame: 4 weeks

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

Study contacts

Contact information is provided by the study sponsor or research team.

Mahnoor Azhar, DPT

CONTACT

[email protected]

+92 3175868174

Sponsors and collaborators

Lead sponsor

Foundation University Islamabad

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2027
First posted
Aug 11, 2026
Registry last updated
Aug 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.