Effectiveness of Adjunct Physiotherapy in Enhancing Recovery from Bell’s Palsy: A Quasi- Experimental Study

Background: Bell’s palsy (idiopathic facial nerve paralysis) can lead to incomplete recovery and sequelae in a significant minority of patients. While corticosteroids are the mainstay early treatment, the role of adjunct physiotherapy (facial exercises and related rehabilitation) in improving outcomes remains under-investigated, especially in resource settings like Pakistan. Objective: To compare the degree of recovery in Bell’s palsy patients managed with standard medical therapy alone versus those receiving additional physiotherapy, in a quasi-experimental hospital-based study. Methods: A quasi-experimental study was conducted at a tertiary care hospital after approval from the Institutional Review Board. A total of 126 patients with acute unilateral Bell’s palsy were allocated to two groups (63 each). Group A received conventional medical therapy (corticosteroids ± antivirals), while Group B received the same plus structured physiotherapy. Outcomes were the House–Brackmann (H-B) grading and the Facial Disability Index (FDI), assessed at baseline and 3 months. Data were analyzed in SPSS v25 using t-tests, Mann–Whitney U, and chi-square tests; effect sizes and 95% confidence intervals were reported, with p<0.05 considered significant. Results: Of 126 enrolled patients (mean age 40.3±12.5 years; 54% male), 120 completed the 3-month follow-up (6 lost to follow-up, evenly from both groups). Baseline characteristics (age, sex distribution, side of palsy, and initial H-B severity) were comparable between groups (p>0.2 for all). At 3 months, complete or near-complete recovery (H-B grade I or II) was achieved in 53 patients (84.1%) in Group B, versus 42 patients (66.7%) in Group A (p=0.014). No serious adverse events were noted; all patients tolerated the interventions well. Conclusion: Adjunct physiotherapy significantly enhanced facial nerve recovery and functional outcomes in Bell’s palsy compared to medical therapy alone, supporting its integration into standard care. Further randomized studies are recommended to confirm these benefits and to optimize physiotherapy protocols for Bell’s palsy.