Trends in Electric Stimulation for Facial Paralysis: Electronic Survey of Physical Therapists in Oregon and Rapid Review of the Evidence
Allison U Munn, MD1; Michelle U Cameron, MD, PT1,2; Myriam D Loyo, MD1
1Oregon Health and Science University, Portland, OR, 2Portland Vetereans Administration Hospital, Portland, OR
Background: The effectiveness of electric stimulation (ES) for treatment of facial paralysis remains controversial with some clinicians advocating for it and some against.
Objective: The purpose of this study was to examine current views of physical therapists (PTs) and physical therapy assistants (PTAs) in Oregon towards electric stimulation (ES) therapy for facial paralysis and to compare these results to current medical evidence.
Methods: An electronic survey was distributed to PTs and PTAs licensed in the state of Oregon. A MEDLINE search was also performed to identify and review human clinical trials using ES for facial paralysis.
Results: One hundred ninety-three therapists answered the survey (response rate 3.75%). Fifty-two of the respondents (27%) treat facial paralysis, of whom 21 (60%) use ES as a mode of treatment. Common reasons why therapists use ES were personal success with it (20/21, 90%), current scientific evidence (6/21, 30%), and referring physician and patients' request (6/21, 29%). Therapists treating facial paralysis who avoid ES for treatment do so because they believe research has shown it to be ineffective (6/12, 50%), the risks outweigh the potential benefits (4/12, 33%), or they lack equipment or training (5/12, 40%). Our review identified six human trials examining the use of ES for facial paralysis.
Conclusions: Rehabilitation service providers in Oregon have a divided opinion on the effectiveness and safety of ES in the treatment of facial paralysis. Additional clinical trials and practice guidelines would improve care for patients with facial paralysis
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