Caroline,
The use of STIMS (and exercise for that matter) to treat Bell's Palsy is quite controversal. Recent theories (Matsuyama,Japan '97) on the etiology of BP look at a strong correlation with HSV-1. The theory is that BP is an auto-immune demyelination of the facial nerve - thus the use of Anti-viral agents (acyclovir) as well as the traditional corticosteroid (predinisolone) early to control inflammation. Considering its etiology and the reported fact that 85% self recover within in a year is there any evidence that manual therapy is of use.
In fact where the problem may be confounded is when muscle activity is forced via exercise and particularly STIMS prior to return of the neural pathways. The biggest danger being synkinesis or incorrect muscle recruitment of the facial musculature, down the track this can cause more concern than the original complaint.
Where physio might be helpful is in facilitating return and assisting the recovery process, although I am not sure whether we can differentiate the physio from natural recovery, I dont think physios have fared too well in the controlled trials on BP.
Maybe someone out there can provide some evidence,
Cheers
Nathan Willits
PT, Australia
Original message--------
Hello,
Do anyone of you have any experience with electrostimulation in Bell'"s
palsy? During our training this treatment was mentioned but I never applied
it.
Thanks,
Caroline
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