Neural Mobilisation in bells palsy . A scoping review

Neural Mobilisation in Bell’s Palsy: A Scoping Review Project Description This scoping review aims to systematically map and synthesize existing evidence on the use of neural mobilization (NM) as an intervention for Bell’s palsy, a condition characterized by acute idiopathic facial paralysis. Despite standard treatments (e.g., corticosteroids, antiviral therapy, and conventional physiotherapy), recovery outcomes vary, and residual deficits (e.g., facial asymmetry, synkinesis) persist in 20–30% of cases. Neural mobilization—a non-invasive manual therapy targeting neurodynamic dysfunction—has emerged as a potential adjunct therapy to improve facial nerve function and patient outcomes. However, evidence remains fragmented, with limited synthesis of its efficacy, protocols, or clinical applicability. This review will clarify the scope, gaps, and future directions for research and practice. Objectives Primary: Map the breadth and depth of literature on neural mobilization techniques for Bell’s palsy. Secondary: Identify types of NM interventions (e.g., slider vs. tensioner techniques) and their protocols. Summarize outcomes measured (e.g., facial symmetry, nerve conduction velocity, quality of life). Examine study designs, populations, and methodological quality. Highlight gaps in evidence and propose recommendations for future research. Inclusion Criteria Category Criteria Population Individuals diagnosed with idiopathic Bell’s palsy (all ages, acute/chronic). Intervention Neural mobilization techniques (e.g., neurodynamic gliding, tensioner/slider methods). Comparators Standard care, placebo, other therapies, or no intervention. Outcomes Functional recovery, pain, nerve conduction, patient-reported outcomes. Study Types Randomized/non-randomized trials, observational studies, case reports, grey literature. Language English. Timeframe Inception to March 2025. Exclusion Criteria Studies on facial palsy caused by non-idiopathic factors (e.g., trauma, tumors, stroke). Non-English publications, conference abstracts, letters, commentaries, or animal studies. Methodology Search Strategy: Databases: PubMed, Cochrane CENTRAL, EMBASE, Scopus, PEDro, CINAHL, Google Scholar (first 200 hits). Keywords: "Bell’s palsy," "facial paralysis," "neural mobilization," "neurodynamic," "nerve gliding," "manual therapy." MeSH Terms: Combined with Boolean operators (AND/OR/NOT). Screening: Two independent reviewers will screen titles/abstracts and full texts using PRISMA-ScR guidelines. Conflicts resolved by a third reviewer. Data Extraction: Chart study characteristics (design, sample size, intervention details), outcomes, and key findings. Quality Assessment: PEDro scale for RCTs; Joanna Briggs Institute (JBI) tools for non-randomized studies. Synthesis: Thematic analysis of NM techniques, outcomes, and clinical implications. Significance Clinical: Inform evidence-based use of NM in Bell’s palsy rehabilitation. Research: Identify gaps (e.g., lack of RCTs, standardized protocols) to prioritize future studies. Policy: Support guideline development for integrative therapies in facial nerve rehabilitation. Keywords Bell’s palsy, facial paralysis, neural mobilization, neurodynamic therapy, scoping review.