Extended 12-Week Analysis of Early Graded Proprioceptive Neuromuscular Facilitation versus Conventional Occupational Therapy in Facial Nerve Palsy: A Randomized Controlled Trial

Purpose: This study evaluates the therapeutic value of extending facial rehabilitation from 8 to 12 weeks. It serves as an extended longitudinal analysis of a randomized cohort to compare the definitive 12-week clinical endpoints of early graded Proprioceptive Neuromuscular Facilitation (PNF) versus conventional Occupational Therapy (OT) in patients with peripheral facial nerve palsy (FNP). Methods: A cohort of 60 patients with unilateral lower motor neuron FNP stratified by aetiology into post-operative surgical trauma (n=31) and idiopathic Bell?s Palsy (n=29) received either conventional OT (Group A) or graded PNF (Group B) three times weekly. Primary 8-week outcomes were previously published. This paper analyses the final, extended 12-week objective and psychosocial recovery profiles using the House-Brackmann Facial Nerve Grading System (HBFGS), Sunnybrook Facial Grading System (SBFGS), and the Facial Disability Index (FDI). Results: At 12 weeks, patients receiving graded PNF showed significantly greater recovery than those on conventional OT, with superior outcomes in facial nerve grading (p?=?0.004), facial symmetry (p?=?0.013), and physical function (p?=?0.034). Social function improved in both groups, but inter-group differences were not statistically significant (p?=?0.089). Conclusion: Graded PNF proved more effective than conventional OT for long-term rehabilitation in facial nerve palsy, supporting its adoption as a clinical standard to optimize functional recovery and psychosocial well-being.