Bell's PalsyNCT07758543
Combined Effects of Proprioceptive Neuromuscular Facilitation (PNF) and Neural Mobilization on Improving Facial Symmetry in Patients With Bells Palsy
A study testing GROUP A COMBINED THERAPY GROUP and GROUP B PNF GROUP in people with Bell's Palsy and Facial Paralysis, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
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… Read more about this study
- Who is it for?
- Ages 15 to 60 years
- Conditions the study is for
- Bell's Palsy, Facial Paralysis, Facial Asymmetry
- What is being tested?
- GROUP A COMBINED THERAPY GROUP and GROUP B PNF GROUP
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 38 participants
- Where
- 1 sitePakistan
- Study dates
- 14 Sep 2025to 10 Jan 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 to 60 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- 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)
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Foundation University College of Physical Therapy
Islamabad, 44000
Sana Khalid, MS-NMPT, +923444218174, sana.khalid@fui.edu.pk
About this study
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.
Read the detailed description
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).
- Conditions
- Bell's Palsy, Facial Paralysis, Facial Asymmetry
- Being tested
- GROUP A COMBINED THERAPY GROUP, GROUP B PNF GROUP
- Keywords
- Bell's palsy, facial paralysis, neural mobilization, proprioceptive neuromuscular facilitation
- Medical subject headings
- Bell Palsy, Facial Paralysis, Facial Asymmetry
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
GROUP A COMBINED THERAPY GROUPProcedure or surgery
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 GROUPProcedure or surgery
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.
| Study group | Role | What they receive |
|---|---|---|
| pnf and neural mobilization | Experimental | 1. Gentle facial nerve mobilization applied within pain free range (10-12 min/session, 6-10 repetition/technique,30-60 seconds/glide).
2. rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session) Receives: Procedure: GROUP A COMBINED THERAPY GROUP |
| pnf alone | Active comparator | Rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session). Receives: Procedure: GROUP B PNF GROUP |
What is being measured
The primary outcome is the main question the study is designed to answer.
Symmetry of face
It is measured by Sunnybrook facial Grading system (SFGS) SFGS Score = (Voluntary Movement Score) - (Synkinesis Score) - (Resting Symmetry Score) Minimum value: 0 (Complete paralysis) Maximum value: 100 (Normal facial function) Higher scores indicate a better outcome
Measured: 4 weeks
Severity of facial paralysis
It is measured by the House-Brackmann scale. Patients graded IV-VI show severe impairment, and patients graded I-III have mild-to-moderate dysfunction.
Minimum value: I (Normal facial function) Maximum value: VI (Total paralysis) Outcome interpretation: Higher scores indicate a worse outcome
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2026
- Study start14 Sep 2025
- Primary completion10 Dec 2026 (estimated)
- Study completion10 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Bell's PalsyStudies of the same condition, open and under way.
- More trials run by Foundation University IslamabadThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 38 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07758543
- Sponsor's protocol ID
- FUI/FUCP/CTR/Neuro/Mahnoor
- Status last verified
- Sep 2026
- First submitted
- 6 Aug 2026
- Last updated
- 15 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Combined Effects of Proprioceptive Neuromuscular Facilitation (PNF) and Neural Mobilization on Improving Facial Symmetry in Patients With Bells Palsy
- ClinicalTrials.gov ID
- NCT07758543
- Acronym / sponsor ID
- FUI/FUCP/CTR/Neuro/Mahnoor
- Conditions
- Bell's Palsy, Facial Paralysis, Facial Asymmetry
- Keywords
- Bell's palsy, facial paralysis, neural mobilization, proprioceptive neuromuscular facilitation
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 38 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 14 Sep 2025 (actual)
- Primary completion
- 10 Dec 2026 (estimated)
- Study completion
- 10 Jan 2027 (estimated)
- First posted
- 11 Aug 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| pnf and neural mobilization | Experimental | Procedure: GROUP A COMBINED THERAPY GROUP1. Gentle facial nerve mobilization applied within pain free range (10-12 min/session, 6-10 repetition/technique,30-60 seconds/glide). 2. rhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session) |
| pnf alone | Active comparator | Procedure: GROUP B PNF GROUPRhythmic initiation and resisted voluntary movements(3-5 rep/movement, 3-4 sets /session). |
Who may qualify
- Ages
- 15 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (6 listed)
- 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
Key exclusion criteria (4 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| GROUP A COMBINED THERAPY GROUPReceives 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. | Procedure or surgery | pnf and neural mobilization |
| GROUP B PNF GROUPReceives 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. | Procedure or surgery | pnf alone |
Primary outcome
Symmetry of face
Time frame: 4 weeks
It is measured by Sunnybrook facial Grading system (SFGS) SFGS Score = (Voluntary Movement Score) - (Synkinesis Score) - (Resting Symmetry Score) Minimum value: 0 (Complete paralysis) Maximum value: 100 (Normal facial function) Higher scores indicate a better outcome
Severity of facial paralysis
Time frame: 4 weeks
It is measured by the House-Brackmann scale. Patients graded IV-VI show severe impairment, and patients graded I-III have mild-to-moderate dysfunction. Minimum value: I (Normal facial function) Maximum value: VI (Total paralysis) Outcome interpretation: Higher scores indicate a worse outcome
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Sep 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing GROUP A COMBINED THERAPY GROUP and GROUP B PNF GROUP in people with Bell's Palsy and Facial Paralysis, run by Foundation University Islamabad at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 15 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Mahnoor Azhar, DPT (+92 3175868174, mahnoorazhar707@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Symmetry of face (time frame: 4 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2026.