The Mirror Effect Plus Protocol for acute Bell’s palsy: a randomised and longitudinal study on facial rehabilitation

Small but interesting evidences suggest that facial rehabilitation for acute Bell Palsy (BP) could improve facial outcomes in patients who benefited from optimal medication, but whose symptoms are still severe two weeks after BP's onset.This study aimed to provide preliminary evidence of the long-term effects of a new facial retraining based on motor imagery and mirror therapy, the Mirror Effect Plus Protocol (MEPP).Twenty BP patients received the standard medication for acute BP and were then randomly allocated to the treatment (MEPP) or control group, if their palsy was still at least moderate-to-severe at 14 days post onset. Three blind independent assessors graded the patients' evolution until 6 months after onset.Significant differences between the groups were not found for any measured variable; however, a trend toward better recovery was found in the treatment group for every measured variable. This trend grew bigger for patients with severe or total BP.This study suggests a promising effect of the MEPP on acute severe to total BP but requires further investigation with a larger number of participants.Facial rehabilitation should be considered as an adjunct to medication for acute and most severe degrees of BP.