Arnuphap Tanasakampai, PT, BS¹ , Paweena Kanyapila, PT, MS¹ , Chuenchob Nisamaneepong, PT, BS¹ , Nattakitta Suksophonthana, PT, MS¹

Objective: To evaluate the effectiveness of a structured home-based facial muscle exercise program incorporating mime therapy and the Kabat technique, supported by a logbook, in patients with Bell’s palsy receiving weekly remote monitoring.

Materials and Methods: An assessor-blinded randomized controlled trial was conducted in 60 patients with acute Bell’s palsy (House-Brackmann, HB grade 4-6 at entry), block-randomized into a control group (30 patients) or an experimental group (30 patients). All participants had received standard medical treatment, primarily oral corticosteroids, before randomization; this background treatment was therefore comparable between groups. The median time from symptom onset to enrollment (12.0 versus 11.5 days, p=0.941) and baseline severity (median HB grade 5 versus 4, p=0.124) were similar. All participants received facial muscle electrical stimulation as part of standard physiotherapy twice weekly for five weeks. The control group performed a standard facial muscle exercise program; the experimental group received a logbook containing a structured program. Both groups received the same weekly remote monitoring via the LINE application. Facial function was assessed at baseline and three months using the Sunnybrook Facial Grading System (SFGS), HB Scale, and Facial Disability Index (FDI). Satisfaction was assessed in the experimental group using a 6-point Likert scale.

Results: Both groups improved significantly (p<0.001). At three months, the experimental group showed greater improvement: SFGS adjusted mean difference 10.58 (95% CI 1.29 to 19.87, p=0.026) and FDI adjusted mean difference 13.77 (95% CI 5.68 to 21.86, p=0.001). Median HB grade was 1 versus 2 (p<0.001), and recovery to HB grade I-II was 100% versus 70% (p=0.002). Satisfaction was high (5.92±0.22).

Conclusion: The structured program enhanced short-term recovery beyond the standard program at three months; longer-term outcomes remain to be determined.

Received 8 June 2026 | Revised 20 July 2026 | Accepted 3 August 2026

J Med Assoc Thai 2026;109(8):654-63

DOI: 10.35755/jmedassocthai.2026.8.03511