Massed Facial Retraining with EMG and Video Biofeedback improves Motor Function and reduces Synkinesia in Patients with chronic Facial Palsy

Introduction The Facial Nerve Center Jena held an intensive 10-day course of facial muscle training with EMG and video biofeedback for patients suffering from stable, chronic facial palsy with motor deficits and synkinesis. The therapeutic goals are to specifically elicit the response of the muscles responsible for facial mimic without unspecific reactions.

Material / methods Standardized photo series of 54 consecutive patients before (T0), at the beginning of (T1), at the end of (T2), and 6 months (T3) after the training were randomized and evaluated by two blinded experts to quantify the therapeutic effect using the Sunnybrook Facial Palsy Grading System (SFGS). For the comparison during the training period (T1-T2), before vs. during the training (T0-T1) and during vs. after the training (T2-T3), Wilcoxon test was used, and the effect size Cohen’s d was calculated.

Results In the 54 patients, SFGS improved from 53.39 (CI: 49.17 - 57.61) to 60.61 (CI: 56.54 - 64.68) during the training T1-T2 (p≤.001). With d = 1.36 a great training effect could be determined. There were no significant changes and no effects in the other evaluated periods T0-T1 and T2-T3 (mean T0: 52.49, T1: 53.47, p=.520, d = 0.13, and T2: 60.55, T3: 61.08, p = 0.34, d = 0.18). Subgroup analysis showed that the improvement is mainly due to an increase in the subscores for movements (p≤.001, d = 1.15), and synkinesis (p≤.001, d = 1.04).

Conclusion The intensive 10-day course improves motor deficits and reduces synkinesis, while there are no changes in the control periods before and after training.

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IZKF Jena

Publication History

Article published online:
10 June 2020