Multimodal Physiotherapy Management in Subacute Bell’s Palsy: A CARE-Compliant Case Report

Abstract

Background: Bell’s palsy is an acute peripheral facial nerve paralysis that causes facial asymmetry and functional impairment. Although spontaneous recovery commonly occurs during the acute phase, patients entering the subacute stage often experience slower recovery and may require targeted physiotherapy intervention. Evidence regarding multimodal physiotherapy approaches during the subacute phase remains limited.
Objective: This case report aimed to describe the clinical outcomes of multimodal physiotherapy in a patient with subacute Bell’s palsy.
Methods: This study was a CARE-compliant single-case report involving a 55-year-old woman diagnosed with left-sided Bell’s palsy approximately 10 weeks after symptom onset. The patient underwent multimodal physiotherapy consisting of infrared therapy, massage, manual lymphatic drainage, and mirror exercise for six sessions over three weeks. Outcomes were evaluated using the Numeric Rating Scale (NRS), Ugo Fisch Scale, and House–Brackmann Scale at baseline and after intervention.
Results: After six treatment sessions, movement pain and tenderness decreased from 1/10 and 2/10 to 0/10, respectively. The Ugo Fisch score improved from 35% to 60%, indicating clinically meaningful functional recovery. The House–Brackmann grade improved from grade IV to grade III. Subjectively, the patient reported improved eye closure, reduced facial stiffness, and better confidence during daily activities.
Conclusion: Multimodal physiotherapy may contribute to clinically meaningful improvements in facial motor function and pain reduction in patients with subacute Bell’s palsy. However, further studies with larger sample sizes and controlled designs are required to confirm these findings.