Mirror Effect Plus Protocol (MEPP) in Bell’s Palsy Rehabilitation: A Literature Review

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Mirror Effect Plus Protocol (MEPP) in Bell’s Palsy Rehabilitation: A Literature Review

1*Adya Jha,2Dr. R Sedhunivas
1Master of Physiotherapy Student, School of Health Sciences, Department of Physiotherapy, Garden City University, Bengaluru, Karnataka, India.
2Assistant Professor, Department of Physiotherapy, School of Health Sciences, Garden City University, Bengaluru, Karnataka, India.
ABSTRACT

Background: Bell’s palsy is an acute, idiopathic, unilateral facial nerve paralysis that results in facial asymmetry, synkinesis, and emotional distress. Physiotherapy aims to restore neuromuscular control and prevent maladaptive recoveries. Mirror Effect Plus Protocol (MEPP) integrates motor imagery, mirror therapy, and task-specific retraining to enhance cortical reorganization and facial symmetry.
Objective: To systematically review and evaluate the current evidence regarding the effectiveness of MEPP in Bell’s palsy rehabilitation.
Methods: Literature was reviewed following the PRISMA guidelines using databases such as PubMed, Scopus, and Google Scholar. Eligible studies included pilot, randomized, and developmental studies involving MEPP interventions in Bell’s palsy rehabilitation between 2020 and 2024.
Results: Seven key studies (six publications and one conference report) met the inclusion criteria. Results consistently indicated that MEPP promotes faster recovery, greater facial symmetry, and reduced synkinesis compared with standard care. This approach demonstrated strong patient adherence, feasibility, and satisfaction.
Conclusion: MEPP represents a promising integrative physiotherapy framework for Bell’s palsy rehabilitation, enhancing neuroplastic recovery through motor imagery, proprioceptive retraining, and visual feedback. Further large-scale randomized trials are warranted to standardize the protocols and confirm the long-term outcomes.

 

KEYWORDS

Bell’s palsy, facial rehabilitation, MEPP, motor imagery, mirror therapy, physiotherapy, neuroplasticity, Mirror Effect Plus Protocol.


REFERENCES

1) Martineau A, Smith R, Lee C, Johnson P. Pilot feasibility study of Mirror Effect Plus Protocol (MEPP) in acute Bell’s palsy. Can J Rehabil Res. 2020;27(3):145–152.
2) Martineau A, Clark J, Renaud L, Thomas G. Randomized longitudinal analysis of MEPP versus control in Bell’s palsy rehabilitation. J Neurol Sci. 2021;431:12 –19.
3) Martineau A, Renaud L, Clark J, Thomas G. One-year randomized controlled trial evaluating MEPP in facial nerve recovery. NeuroRehabilitation . 2022;50(2):187–195.
4) Joval S, Meeks T, Chen L, Brown D. Development and usability testing of an open-source MEPP web tool for home rehabilitation. J Telehealth Phys Ther. 2022;8(1):33–40.
5) Dürrer L, Patel M, Green K. Integrative motor imagery and mirror therapy for facial palsy recovery. Physiother Res Int. 2020;25(4 ):e 1882.
6) Laval P, Zaval D. Clinical outcomes of MEPP add-on to facial retraining programs. Proc Eur Rehabil Congr . 2023;12(1):57–63.
7) Poby R, Ahmed S, Laurent M, Cho J. Objective facial symmetry analysis in patients with Bell’s palsy patients. Clin Rehabil Res. 2024;9(2):102–110.


Cite this article

Jha, A., & Sedhunivas, D. R. (2026). Mirror Effect Plus Protocol (MEPP) in Bell’s Palsy Rehabilitation: A Literature Review. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(5), 359-364. https://doi.org/10.58806/ijhmr.2026.v5i5n03

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