Bruno Saragiotto talked to Mr Lázaro Teixeira who included one of the 15 most significant trails in physiotherapy, the 1958 trial evaluating physiotherapy for Bell’s palsy, in his Cochrane review.
Bruno: Could you explain what Mosforth and Taverner did in their study?
Lázaro: In 1958, Mosforth and Taverner tried to answer one of the oldest questions in neuromusculoskeletal physiotherapy – if the addition of electrical stimulation is worthwhile and if it helps the recovery of a peripheral neural lesion, in this case idiopathic facial palsy. They designed a randomised controlled trial to compare two groups of participants with acute cases of facial palsy. The study enrolled 86 people. The clinical outcomes of 44 people in the group that received auto-massage of the face, infrared radiation and electrical stimulation (interrupted galvanism) were compared to the results of the group (42 people) that received auto-massage alone. The physiotherapeutic treatment was continued until recovery, and then the participants were followed up 6 months and 1 year after their first visit. The outcomes were: electrical examination, grade of paralysis, time to begin improvement, time to complete recovery, and side effects.
Bruno: What was the main finding?
Lázaro: The study didn’t find significant differences between the 2 treatment groups for any outcomes after 6 months or 1 year.
Bruno: Why do you think the study is important?
Lázaro: This study evaluated physiotherapy for facial palsy and it was one of the first randomised controlled trials for any condition in the field of physiotherapy. Despite the age of the trial, it is still one of the best designed studies to evaluate treatments for idiopathic facial palsy. Mosforth and Taverner followed participants for 1 year. Even today, it is difficult to find studies in this area with long term follow ups. More than 55 years ago, Mosforth and Taverner concluded electrical stimulation is not recommended for the treatment of facial palsy and questioned its cost-effectiveness. This finding has been supported by subsequent studies.
Bruno: Lázaro, thank you for telling us about the Mosforth and Taverner trial.