Physiotherapy Case Study: Bell’s Palsy Treatment with Online Physiotherapy
by Physiotherapist Dr. Tanaya Sarnaik (PT) [BPT, MPT – Sports]
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Bell’s Palsy Treatment with Online Physiotherapy: ABSTRACT
Bell’s palsy (Facial palsy) can be unsettling with symptoms of facial droop, drooling, difficulty eating and drinking. Patients of facial nerve palsy also report inability to make facial expressions, such as smiling or frowning. Facial weakness sets in facial paralysis muscle leading to twitches in the face at times.
Mrs. Sharma (name changed), a senior citizen residing in the outskirts of Uttar Pradesh experienced (बेल्स पाल्सी) Bell’s Palsy symptoms. Owing to the lockdown due to COVID-19, she was unable to consult any Neurologist or General Physician for the condition. ReLiva Physiotherapist Dr Tanaya (PT) started the bell’s palsy physiotherapy treatment remotely via Online physiotherapy, helping speed up her recovery.
Bell’s Palsy Treatment with Online Physiotherapy: PREFACE
Facial droop due to Bell’s Palsy severely worried Mrs Sharma (name changed). An elderly lady was experiencing facial paralysis like symptoms. She was unable to see any doctor due to the lockdown for three days. Meanwhile, Mrs. Sharma tried some home remedies such as massage to the facial muscles and icing to relieve her condition but had no significant results with the same.
By the third day, her son found about ReLiva’s Telerehabilitation services for patients stuck at home due to COVID-19, in need of physiotherapy interventions. He approached ReLiva for Bell’s Palsy treatment for her mother over the internet.
Online Physiotherapy Appointment & Scheduling:
Mrs Sharma’s son connected with ReLiva for scheduling an appointment with the physiotherapist. Her appointment was scheduled at the earliest possible slot for consultation and assessment of the condition. They were informed about the session details, including duration (30-45 mins), preferred language (Hindi in this case), preferred mode of video consultation etc by the appointments team.
Online Physiotherapy Consultation:
Bell’s Palsy (Facial Palsy) History:
Mrs. Sharma was given a video call at the designated time for the Telephysio session. A general history of the patient was taken. It was noted that the onset of Bell’s Palsy symptoms was sudden in nature. The patient had observed these changes 3 days back while washing her face. The patient had no past history of the same. She also reported facial weakness and inability to make facial expressions. These symptoms continued to aggravate from the day of onset. No other complaints elsewhere were noticed.
Online Physiotherapy Assessment:
After history was taken, the patient was guided to take self-assessment for evaluating the grade of muscle impairment. The patient was informed and educated about the evaluation technique.
Movement analysis for individual facial muscles was done. The patient was asked to perform various facial expressions on each of the two sides of the face. The movements to be performed were explained and demonstrated by physiotherapist Dr Tanaya Sarnaik (PT), throughout the assessment. Each facial expression was observed and graded according to the level of impairment of facial muscles.
During the assessment it was observed that the right side showed more deviation as compared to the left side of the face. While assessing individual facial movements, it was noted that the level of impairment of facial muscles was Grade 4, (as per muscle weakness grading system).
Bell’s Palsy Treatment with Online Physiotherapy: Sessions
Based on the assessment, Mrs. Sharma was advised to perform a few exercises at home for 2-3 days till the next scheduled session.
The treating physiotherapist demonstrated all the prescribed facial exercises to the patient on the video call. The patient was counselled to understand that regular practise of these movements as per the dosage will help to improve her condition.
The patient was made to do these expressions/ facial exercises in front of the mirror so she could have a continuous visual feedback. She was to perform active movements of the left side and active assisted movements for the right side of the face. This was also constantly supervised by the physiotherapist during the session to ensure the patient was doing the movements correctly.
The primary goal of the treatment is to prevent further deterioration of the facial movements and thereafter to regain the muscle action.
- Special effort was made to communicate that “Exercise is Medicine” and that it should be taken in the prescribed dosage and frequency religiously.
- The patient was advised to repeat each exercise by herself as per the prescribed dosage each day until the next physiotherapy session.
- She was also advised to perform light massage technique on the affected side which was demonstrated during the session.
- Care givers (family members) were made aware and educated about the condition and the importance of exercise in the initial stage as well as till restoring the movement.
Follow up sessions were conducted every 3 days initially, to assess the progress of the condition and later sessions for addition of further treatment protocol.
Bell’s Palsy Treatment with Online Physiotherapy: CONCLUSION
Therefore, Online physiotherapy is a smart way to provide physiotherapy to patients who are unable to access physiotherapy treatment due to one reason or the other, including lockdown or social distancing due to COVID-19 outbreak. Dr Tanaya Sarnaik remarks, “Telerehabilitation appears to be the safest and easiest way to connect with a physiotherapist. A timely intervention from physio could go a long way in starting your treatment timely.” In this case, Online physiotherapy worked well to restore her movements and treat her condition so as to prevent them from aggravating further.
Since we believe in “EXERCISE AS MEDICINE” Telerehabilitation serves best to keep up with the goal. Irrespective of barriers such as COVID-19, Telerehabilitation helps you to be connected with the physiotherapist for treatment of several conditions in a completely safe manner.
If you, or someone you know would benefit from physiotherapy treatment and you do not have access to it right now, please register for an online physiotherapy session here or simply call us at +91 99209 91584 and we will connect you with a physiotherapist best suited for your requirement.
Related Case Studies for Online Physiotherapy:
Back Pain Treatment with Online physiotherapy
Shoulder Pain Treatment with Online Physiotherapy
Online Physiotherapy for Fracture Treatment: a Case Study
Hemiplegia Treatment: Online Physiotherapy
Other Reading:
Bell’s Palsy: Treatment with ReLiva Physiotherapy
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