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Published in: Trials 1/2015

Open Access 01-12-2015 | Research

Acupuncture for the sequelae of Bell’s palsy: a randomized controlled trial

Authors: Hyo-Jung Kwon, Jun-Yong Choi, Myeong Soo Lee, Yong-Suk Kim, Byung-Cheul Shin, Jong-In Kim

Published in: Trials | Issue 1/2015

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Abstract

Background

Incomplete recovery from facial palsy results in social and physical disabilities, and the medical options for the sequelae of Bell’s palsy are limited. Acupuncture is widely used for Bell’s palsy patients in East Asia, but its efficacy is unclear.

Methods

We performed a randomized controlled trial including participants with the sequelae of Bell’s palsy with the following two parallel arms: an acupuncture group (n = 26) and a waiting list group (n = 13). The acupuncture group received acupuncture treatments for 8 weeks, whereas the waiting list group did not receive acupuncture treatments during the 8-week period after randomization. The primary outcome measure was change in the Facial Disability Index (FDI) social and well-being subscale at week 8. We also analyzed changes in the FDI physical function subscale, the House–Brackmann score, the Sunnybrook Facial Nerve Grading system, lip mobility and stiffness at 5 and 8 weeks after randomization. An intention-to-treat analysis was applied.

Results

The acupuncture group exhibited greater improvements in the FDI social score (mean difference, 23.54; 95 % confidence interval, 12.99 to 34.08) and better results on the FDI physical function subscale (mean difference, 21.54; 95 % confidence interval, 7.62 to 35.46), Sunnybrook Facial Nerve Grading score (mean difference, 14.77; 95 % confidence interval, 5.05 to 24.49), and stiffness scale (mean difference, −1.58; 95 % confidence interval,−2.26 to −0.89) compared with the waiting list group after 8 weeks. No severe adverse event occurred in either group.

Conclusion

Compared with the waiting list group, acupuncture had better therapeutic effects on the social and physical aspects of sequelae of Bell’s palsy.

Trial registration

Current Controlled Trials ISRCTN43104115.
Appendix
Available only for authorised users
Literature
1.
Adour KK. Current concepts in neurology: diagnosis and management of facial paralysis. N Engl J Med. 1982;307(6):348–51.CrossRefPubMed
2.
Peitersen E. Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl. 2002;122(549):4–30.CrossRef
3.
Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical practice guideline: Bell’s palsy executive summary. Otolaryngol Head Neck Surg. 2013;149(5):656–63.CrossRefPubMed
4.
Beurskens CH, Heymans PG. Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial. Aust J Physiother. 2006;52(3):177–83.CrossRefPubMed
5.
Devriese PP. Treatment of sequelae after facial paralysis: a global approach. J Laryngol Otol. 1998;112(5):429–31.PubMed
6.
Engstrom M, Berg T, Stjernquist-Desatnik A, Axelsson S, Pitkaranta A, Hultcrantz M, et al. Prednisolone and valaciclovir in Bell’s palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2008;7(11):993–1000.CrossRefPubMed
7.
McCaul JA, Cascarini L, Godden D, Coombes D, Brennan PA, Kerawala CJ. Evidence based management of Bell’s palsy. Br J Oral Maxillofac Surg. 2014;52(5):387–91.CrossRefPubMed
8.
Lockhart P, Daly F, Pitkethly M, Comerford N, Sullivan F. Antiviral treatment for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2009;7(4):CD001869.
9.
Salinas RA, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2010;3:CD001942.PubMed
10.
11.
Ross B, Nedzelski JM, McLean JA. Efficacy of feedback training in long-standing facial nerve paresis. Laryngoscope. 1991;101(7 Pt 1):744–50.PubMed
12.
Segal B, Hunter T, Danys I, Freedman C, Black M. Minimizing synkinesis during rehabilitation of the paralyzed face: preliminary assessment of a new small-movement therapy. J Otolaryngol. 1995;24(3):149–53.PubMed
13.
Beurskens CH, Heymans PG. Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability. Otol Neurotol. 2003;24(4):677–81.CrossRefPubMed
14.
White A, Hayhoe S, Hart A, Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ. 2001;323(7311):485–6.CrossRefPubMedPubMedCentral
15.
16.
Kim JI, Lee MS, Choi TY, Lee H, Kwon HJ. Acupuncture for Bell’s palsy: a systematic review and meta-analysis. Chin J Integr Med. 2012;18(1):48–55.CrossRefPubMed
17.
Chen N, Zhou M, He L, Zhou D, Li N. Acupuncture for Bell’s palsy. Cochrane Database Syst Rev. 2010;8:CD002914.PubMed
18.
He L, Zhou MK, Zhou D, Wu B, Li N, Kong SY, et al. Acupuncture for Bell’s palsy. Cochrane Database Syst Rev. 2007;4:CD002914.PubMed
19.
Xu SB, Huang B, Zhang CY, Du P, Yuan Q, Bi GJ, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ. 2013;185(6):473–9.CrossRefPubMedPubMedCentral
20.
Moher D, Schulz KF, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA. 2001;285(15):1987–91.CrossRefPubMed
21.
22.
MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, White A, et al. Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. J Altern Complement Med. 2010;16(10):ST1–14.CrossRefPubMed
23.
Kwon HJ, Kim JI, Lee MS, Choi JY, Kang S, Chung JY, et al. Acupuncture for sequelae of Bell’s palsy: a randomized controlled trial protocol. Trials. 2011;12:71.CrossRefPubMedPubMedCentral
24.
25.
VanSwearingen JM, Brach JS. The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system. Phys Ther. 1996;76(12):1288–98. discussion 98–300.PubMed
26.
Kuhweide R, Van de Steene V, Vlaminck S, Casselman JW. Ramsay Hunt syndrome: pathophysiology of cochleovestibular symptoms. J Laryngol Otol. 2002;116(10):844–8.CrossRefPubMed
27.
Linde K, Streng A, Jurgens S, Hoppe A, Brinkhaus B, Witt C, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA. 2005;293(17):2118–25.CrossRefPubMed
28.
WHO. WHO Standard Acupuncture Point Location in the Western Pacific region. 2008.
29.
Department of Acupuncture and Moxibustion in Korea. Textbook of Acupuncture and Moxibustion Medicine. Seoul: Jipmoondang; 2008.
30.
House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146–7.PubMed
31.
Jansen C, Jennekens FG, Wokke JH, Leppink GJ, Wijnne HJ. Lip-length and snout indices: methods for quantitative assessment of peri-oral facial muscle strength. J Neurol Sci. 1990;97(2–3):133–42.CrossRefPubMed
32.
Evans RA, Harries ML, Baguley DM, Moffat DA. Reliability of the House and Brackmann grading system for facial palsy. J Laryngol Otol. 1989;103(11):1045–6.CrossRefPubMed
33.
Jansen C, Devriese PP, Jennekens FG, Wijnne HJ. Lip-length and snout indices in Bell’s palsy: a comparison with the House grading system. Acta Otolaryngol. 1991;111(6):1065–9.CrossRefPubMed
34.
Higgins JPT, Green S, Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions, Cochrane book series. Chichester, England: Wiley-Blackwell; 2008.CrossRef
35.
White AC, Cummings M, Filshie J. An introduction to Western medical acupuncture. London: Churchill Livingstone; 2008.
36.
37.
Shafshak TS. The treatment of facial palsy from the point of view of physical and rehabilitation medicine. Eura Medicophys. 2006;42(1):41–7.PubMed
38.
Yamamoto E, Nishimura H, Hirono Y. Occurrence of sequelae in Bell’s palsy. Acta Otolaryngol Suppl. 1988;446:93–6.PubMed
39.
Birch S. A review and analysis of placebo treatments, placebo effects, and placebo controls in trials of medical procedures when sham is not inert. J Altern Complement Med. 2006;12(3):303–10.CrossRefPubMed
40.
Lund I, Naslund J, Lundeberg T. Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist’s perspective. Chin Med. 2009;4:1.CrossRefPubMedPubMedCentral
41.
Ceccherelli F, Gagliardi G, Rossato M, Giron G. Variables of stimulation and placebo in acupuncture reflexotherapy. J Altern Complement Med. 2000;6(3):275–9.CrossRefPubMed
42.
Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet. 1998;352(9125):364–5.CrossRefPubMed
Metadata
Title
Acupuncture for the sequelae of Bell’s palsy: a randomized controlled trial
Authors
Hyo-Jung Kwon
Jun-Yong Choi
Myeong Soo Lee
Yong-Suk Kim
Byung-Cheul Shin
Jong-In Kim
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0777-z

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