Response of axonal regeneration in chronic Bell's palsy to low intensity shockwave therapy: Randomized control trial

Abstract

Background: Bell’s paralysis is an acute paralysis onset due to idiopathic facial nerve inflammation It is the commonest cause of lower motor neuron facial paralysis with an annual rate of 15-30 per 100,000. Objectives: Our aim of the study to detect the difference of axonal regeneration response in chronic Bell’s palsy to low intensity radial shock wave therapy and kabbat exercises Patients and methods: 60 chronic bell’s palsy patients (six months post injury) with age 35-60 years old randomly allocated to one of two groups; group A [Shock Wave (SW)](n=30) treated with low intensity shock wave plus kabbat exercises and facial muscle exercise for six weeks. KE (kabbat exercise) group (n=30) treated with kabbat exercises plus sham treatment by a shock wave and facial muscle exercise for six weeks. patients were assessed by electrophysiological study (Amplitude and degeneration index of facial nerve). The assessment was done before and after treatment. Results: The degeneration index decreased significantly in group A (p < 0.001), but not in group B (p = 0.295). The amplitude of the facial nerve was low at baseline, indicating severe axonal degeneration. After treatment, amplitude increased significantly in the two groups; however, the significance was higher in group A (SW) than in group B (KE)(p < 0.001). Conclusion: low-intensity shock wave therapy is a safe and effective treatment of chronic Bell’s palsy after 6 months from the onset.

Keywords

• chronic bell’s palsy extracorporeal shockwave therapy
• kabbat exercises exercise therapy
• nerve conduction study