Give me a kiss! An integrative rehabilitative training program with motor imagery and mirror therapy for recovery of facial palsy.

doi:10.23736/S1973-9087.19.05757-5

Paper

Give me a kiss! An integrative rehabilitative training program with motor imagery and mirror therapy for recovery of facial palsy.

Published Feb 1, 2020 · T. Paolucci, Alessia Cardarola, P. Colonnelli

European journal of physical and rehabilitation medicine

Q1 SJR score

48

Citations

3

Influential Citations

Full text

Semantic Scholar

Abstract

BACKGROUND Peripheral facial nerve palsy (FNP) can have various causes, such as Bell's palsy or after surgery for acoustic neuroma. Rehabilitation is often required but there is no evidence that any rehabilitation approach is more efficacious than another. AIM The purpose of this research was to determine the effects of neurocognitive-rehabilitative approach through mirror-therapy (MT) and motor-imagery (MI), integrated into the traditional rehabilitation with mime-therapy and myofascial-approach. DESIGN This study was designed as a double-blind, randomized, controlled-trial. SETTING This study took place from January 2016 to June 2018 at the Unit of Physical Medicine and Rehabilitation, Umberto I Hospital, Rome, Italy. POPULATION Twenty-two patients were randomized into two groups: mirror-therapy (N=11, MT and MI) and traditional-rehabilitative group (N=11, mime-therapy and a myofascial-approach). METHODS Outcome assessments were performed before treatment (T0), after one month (T1=10 session, twice/week), after the second and third months (T2=10 twice/week + 5 of MT+MI one/week and T3=10 twice/week + 5 of MT+MI 1/week), and at the 4-week follow-up (T4=2 months follow-up). RESULTS The analysis of the functional evaluations show that both groups experienced progressive improvement T0 to T3, with stabilization of the results at the follow-up. There was a significant difference in House-Brackmann-Scale scores between T0 and follow-up in favor of the experimental group. In terms of quality of life (FaCE scale), total scores and social function items improved in both groups from T0 to T3. The experimental group obtained better results with regard to quality of life and emotional depression. CONCLUSIONS The integrated use of MT and MI is efficacious in the rehabilitation of FNP, improving facial physical function. Further studies are needed to determine the predictive factors of the recovery of facial mimic. CLINICAL REHABILITATION IMPACT The ability of patients with unilateral facial paralysis to recognize and appropriately judge facial expressions and perceive the judgments of others remains underexplored. The likelihood of recovering near-normal facial-function after grade VI facial paralysis is low. Procedures, such as the immediate repair of the facial nerve with an interposed donor graft, might improve facial function in patients with partially injured facial nerves.

RCT

Study Snapshot

Key takeawayIntegrated use of motor imagery and mirror therapy improves facial physical function and quality of life in patients with peripheral facial nerve palsy.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Give me a kiss! An integrative rehabilitative training program with motor imagery and mirror therapy for recovery of facial palsy.

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Robotic and computerized mirror therapy research is of low quality, making it unreliable for rehabilitation professionals to recommend investment in these devices.

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A value of 46.5% or lower in electroneurography 10-14 days after facial palsy onset is a predictive factor for the development of facial synkinesis 12 months later.

Citations

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The Use of Mirror Therapy in Peripheral Seventh Nerve Palsy: A Systematic Review

Mirror therapy shows promising results in reducing pain, depression, and improving range of motion in patients with peripheral facial nerve palsy.

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An integrative rehabilitation approach using postural, neuromuscular, and dental interventions successfully treated sport-related dystonia in a professional soccer player, allowing him to return to play.

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Comparison of Objective Facial Metrics on Both Sides of the Face Among Patients with Severe Bell's Palsy Treated with Mirror Effect Plus Protocol Rehabilitation Versus Controls.

Mirror Effect Plus Protocol (MEPP) facial rehabilitation improves synchronization of both hemifaces in severe Bell's palsy patients, with motor adaptation in movement amplitude contributing to this improvement.

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Motor Imagery and Mirror Book Therapy effectively improved facial function and symmetry in patients with acute Bell's palsy compared to conventional electrotherapy.

Mesenchymal Stem Cell-Derived Exosomes Promote Recovery of The Facial Nerve Injury through Regulating Macrophage M1 and M2 Polarization by Targeting the P38 MAPK/NF-Κb Pathway

MSC-derived exosomes show potential in promoting facial nerve injury recovery and reducing inflammation by targeting the p38 MAPK/NF-b pathway.

Measuring the Potential Effects of Mirror Therapy Added to the Gold Standard Facial Neuromuscular Retraining in Patients With Chronic Peripheral Facial Palsy: Protocol for a Randomized Controlled Trial

Mirror therapy combined with facial neuromuscular retraining may improve facial symmetry, synkinesis, and quality of life in patients with peripheral facial palsy.