Choosing the best rehabilitation treatment for bell's palsy

E. Dalla Toffola, C. Tinelli, A. Lozza, M. Bejor, C. Pavese, I. Degli Agosti, L. Petrucci

Research output: Contribution to journalArticlepeer-review


Background. It is useful to perform neurophysiologic electromyography and electroneurography (EMG/ ENG) on patients with peripheral facial palsy during the acute phase of paralysis in order to assess the severity of their nerve lesion and thus plan rehabilitation treatment and evaluate its results. Aim. To evaluate the motor recovery of patients with Bell's palsy with respect to the severity of their neurological lesion and to compare the results of two different rehabilitation treatments, with electromyographic biofeedback (EMG-BFB) and mirror visual biofeedback (MIRROR-BFB), in patients with Bell's palsy and neurophysiologic pattern of axonotmesis. Study design. Cohort study on retrospective clinical records. Population. 102 patients with Bell's facial palsy were clinically assessed according to the House scale both during the acute phase of paralysis and 12 months after onset. Methods. All patients underwent EMG/ENG examination 3-4 weeks after the onset of paralysis; 29 patients had an EMG pattern of neurapraxia and were not given rehabilitation treatment; 73 patients who presented with signs of denervation had an EMG pattern of axonotmesis. The group, which was homogenous in terms of lesion severity, was divided into two parts: 38 patients were treated with electromyographic biofeedback (EMG-BFB) and 35 were treated with mirror visual feedback (MIRROR-BFB). Results. All 29 patients with neurapraxia made a full spontaneous recovery; Although the 73 patients with axonotmesis received different types of rehabilitation treatment, they obtained similar results regarding quality of recovery, development of synkinesis, rehabilitation timing and resources used. Conclusion and Clinical Rehabilitation Impact. Rehabilitation treatment is not necessary for patients with neurapraxia. The two biofeedback methods used to treat patients with axonotmesis resulted in similar rehabilitation outcomes.

Original languageEnglish
Pages (from-to)635-642
Number of pages8
JournalEuropean Journal of Physical and Rehabilitation Medicine
Issue number4
Publication statusPublished - Dec 2012


  • Bell palsy
  • Biofeedback
  • EMG/ENG evaluation
  • Facial paralysis
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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