Neuromuscular electrical stimulation and shortwave diathermy in unrecovered Bell palsy: A randomized controlled study

BACKGROUND: Unrecovered Bell palsy is difficult to treat, because until now in literature there is not a gold standard. This study aimed to evaluate the effectiveness of neuromuscular electrical stimulation (NMES) and shortwave diathermy (SWD) therapy for chronic Bell palsy. METHODS: After 5 months of conventional therapy, this 2-arm randomized controlled trial enrolled and randomly allocated 20 patients to a treatment group with NMES+SWD and supervised exercises (n = 10) or a sham group with supervised exercise alone (n = 10). The administration of NMES or sham NMES, as intervention, was performed 30 min/session, 5 sessions/wk, for 4 weeks. The primary outcome was assessed by Sunnybrook scale. The secondary outcomes were evaluated by the Kinovea©, a movement analysis software. All primary and secondary outcomes were measured at baseline (T0), at the end of 4-week treatment (T1). RESULTS: At the end of 4-week treatment, the patients in the treatment group did not achieve better outcomes in resting symmetry, but we observed an increase of the perceived a significant improvement (P < .05) for symmetry of voluntary movements by the Sunnybrook subscale, with a score of 55.4 ± 9 compared to 46.4 ± 3.7 to control group and an increase in zygomatic muscle movement symmetry ratio (P < .05) by Kinovea©. No adverse events occurred in either group. CONCLUSION: The improvements in the symmetry of voluntary movements demonstrated that combining diathermy with neuromuscular electrostimulation is valid and reliable in the treatment of chronic Bell palsy.