Kabat Rehabilitation Versus Kinesiology Taping in Bell's Palsy

This single-blinded randomized clinical trial will be conducted at the University of Lahore Teaching Hospital, Lahore. Participants aged 30-50 years diagnosed with unilateral Bell's palsy will be recruited using purposive sampling. After obtaining informed consent, 38 eligible participants will be randomly allocated into two parallel groups using the lottery method.

Group A will receive conventional therapy (facial massage and electrical muscle stimulation) combined with Kabat rehabilitation using proprioceptive neuromuscular facilitation (PNF) techniques.

Group B will receive conventional therapy combined with kinesiology taping applied according to a standardized protocol targeting affected facial muscles.

Treatment will be administered for 8 weeks, 5 sessions per week, with each session lasting approximately 40 minutes. Assessments will be conducted at baseline, at 4 weeks, and at 8 weeks. Data will be analyzed using SPSS version 27.0.

• Conventional Facial Therapy (Other), also known as Electrical Muscle Stimulation, Facial Massage: Conventional therapy will consist of facial massage and electrical muscle stimulation (EMS). Massage techniques will include light stroking, tapping, and kneading of affected facial muscles for approximately 5 minutes. Electrical muscle stimulation will be delivered using interrupted galvanic current with a pulse width of 150 μs, frequency of 1-10 Hz, and intensity of 2-5 mA for 15 minutes. Small surface electrodes will be placed on key facial muscles including frontalis, zygomaticus major, orbicularis oris, and mentalis. Total duration of conventional therapy will be approximately 20 minutes per session.
• Kabat Rehabilitation (Other), also known as Proprioceptive Neuromuscular Facilitation (PNF): Kabat rehabilitation will be administered using proprioceptive neuromuscular facilitation (PNF) techniques. Manual resistance will be applied to stimulate contraction of affected facial muscles through three fulcrum points (upper, intermediate, and lower). Each muscle group (frontalis, corrugator supercilii, orbicularis oculi, procerus, orbicularis oris, and mentalis) will perform 10 repetitions for 2 sets. The Kabat component will last approximately 20 minutes per session. Treatment will be provided 5 sessions per week for 8 weeks.

Primary outcomes

• Facial Asymmetry (Sunnybrook Facial Grading System) [Baseline, 4 weeks, and 8 weeks]: Scores range from 0 to 100, where higher scores indicate better facial symmetry.

Secondary outcomes

• Functional Disability (Facial Disability Index - FDI) [Baseline, 4 weeks, and 8 weeks]: Assesses physical and social well-being related to facial function. Higher scores indicate better function.

Sex: All, ages: 30 Years to 50 Years

Inclusion Criteria:

Age between 30-50 years Both genders Unilateral Bell's palsy House-Brackmann grade greater than 3 Sufficient physical and mental ability to follow instructions

Exclusion Criteria:

Facial skin lesions or contraindications for procedures Cranial or facial trauma within past 3 months Prior episodes of facial paralysis Craniofacial deformities or degenerative diseases Head and neck malignancy Active infection History of upper motor neuron lesion

• Atif, M. M., Hussain, K., Naeem, I., Asghar, Z., Batool, F., Butt, S., & Khalil, A. (2024). Prevalence of Recurrent Bell's Palsy: Prevalence of Recurrent Bell's Palsy. Pakistan Journal of Health Sciences, 50-54.
• Athawale, V. K., Bawiskar, D. P., & Phansopkar, P. A. (2021). Rehabilitation of a Patient with Bell's Palsy. Journal of Evolution of Medical and Dental Sciences, 10(20), 1551-1555.
• Amjad, A., Iqbal, M. H., Jamil, A., Kamran, S., Maqbool, S., & Akbar, M. (2024). Comparative Effects of Kabat Rehabilitation and Kinesiotaping on Functional Disability, Synkinesis and Patient Satisfaction in Patients with Bell's Palsy. Journal Riphah College of Rehabilitation Sciences, 12(1).
• Alqahtani SY, Almalki ZA, Alnafie JA, Alnemari FS, AlGhamdi TM, AlGhamdi DA, Albaqami LO, Ibrahim M. Recurrent Bell's Palsy: A Comprehensive Analysis of Associated Factors and Outcomes. Ear Nose Throat J. 2024 Nov 25:1455613241301230. doi: 10.1177/01455613241301230. Online ahead of print. PMID 39587480
• Alanazi F, Kashoo FZ, Alduhishy A, Aldaihan M, Ahmad F, Alanazi A. Incidence rate, risk factors, and management of Bell's palsy in the Qurayyat region of Saudi Arabia. PeerJ. 2022 Oct 6;10:e14076. doi: 10.7717/peerj.14076. eCollection 2022. PMID 36221264
• Al Najim, M. M., & Marah, L. D. H. A. (2025). Identifying Key Risk Factors for Bell's Palsy and Insights from a Retrospective Analysis. Central Asian Journal of Medical and Natural Science, 6(2), 586-593.
• Al-Hasan, H. K. J., Al-Salim, A. A., & Haji, S. A. (2023). Prevalence of facial nerve palsy in the neuro-medicine private clinic. Romanian JouRnal of neuRology, 22(2), 137.
• Ahmed, S., Shahid, A., & Waheed, A. (2023). Effectiveness of Kabat Exercises along with Mirror Therapy in Bell's Palsy. Journal of Health and Rehabilitation Research, 3(2), 1288-1293.
• Adhikari, S. P., Chaudhary, M., & Dev, R. (2020). Kabat interventions integrated with facial expressive and functional exercises for better and speedy recovery in bell's palsy; a pre-post design. Journal of Chitwan Medical College, 10(4), 71-76.
• Abioke UB, Anosike W, Olaniyi AO, Okwuowulu IL, Mandal M, Eze CY. Physiotherapy Management of Bell's Palsy in an Elderly Patient: A Case Report. Cureus. 2025 Jul 15;17(7):e88045. doi: 10.7759/cureus.88045. eCollection 2025 Jul. PMID 40821194