Cranial Nerve Examination in Physical Therapy Practice: Survey-Based Insights and Clinical Relevance

Abstract

Background: Cranial nerves (CN) are essential for sensory and motor functions in the head and neck and are vital in neurological assessments. In musculoskeletal and orthopedic practice, especially among physiotherapists, recognizing CN dysfunction is crucial for safe and accurate diagnosis. A variety of diseases and traumas can cause CN disorders, often requiring imaging and detailed clinical evaluation. CN injuries occur in a significant percentage of craniocerebral trauma cases. While data on CN-related conditions such as trigeminal neuralgia exist, there is limited information on CN assessment practices among physical therapists in Karachi. This study highlights current practices to support evidence-based assessment and improved patient care. Objective: This study aims to assess clinical physical therapists' practices regarding cranial nerve examination. Methods:  A descriptive cross-sectional survey was conducted among 65 physical therapists practicing in Karachi, Pakistan. Participants were recruited through purposive sampling from hospitals, rehabilitation centers, and private clinics. Data were obtained using a structured, self-administered online questionnaire adapted from prior research. Statistical analyses, including descriptive measures, Chi-square tests, independent t-tests, and one-way ANOVA, were performed in SPSS version 21, with significance set at p < 0.05. Results: The results show that physical therapists most were quite sure (55.4%) or sure (33.8%,) of their ability to conduct a cranial nerve examination, though the examination was used only rarely or occasionally by most (41.5% and 35.4%). Years of experience and CNE training showed no significant association with ability, use, or perceived relevance. Age and clinical experience, however, correlated positively with ability to conduct CNE and with interpreting findings. Conclusion: The results of this study showed that the PTs are confident in their ability to assess cranial nerve but they rarely applied it routine clinical assessment of patient. This gap underscores the need to translate knowledge into clinical practice.