FACIAL NEUROMUSCULAR RETRAINING VS CONVENTIONAL PHYSIOTHERAPY TO REDUCE SYNKINESIS AND IMPROVE FACIAL SYMMETRY IN FACIAL PALSY PATIENTS: A RANDOMIZED CONTROLLED TRIAL
Keywords:
Facial palsy; Facial nerve diseases; Facial paralysis; Neuromuscular re-education; Physical therapy modalities; Synkinesis; Facial asymmetryAbstract
Background: Facial palsy is a condition in the nervous system that affects the facial muscles resulting in muscle weakness, synkinesis and asymmetry of the face muscles. The treatment of facial palsy includes Facial Neuromuscular Retraining where there is the need of selective activation of muscles and control of movements.
Objective: To compare the effects of Facial Neuromuscular Retraining and Conventional Physiotherapy on synkinesis and facial asymmetry in patients with facial palsy.
Methodology: It was a study design which comprised of 60 patients with facial palsy ranging from 21 to 70 years. Equal distribution of subjects into two groups was done. Group A (n=30) subjects were subjected to FNMR treatment with selective movement control, motor control exercise, inhibition of synkinesis and mirror retraining. Group B (n=30) subjects were subjected to conventional physiotherapy involving facial exercise and massage. Subjects were treated for 4 weeks for 5 days in a week.
Results: Improvement in both SAQ and FDI scores (p < 0.001) was found for both groups. Group A demonstrated a decrease in the mean SAQ score from 60.07 ± 10.13 to 44.22 ± 11.03 and an increase in the mean FDI score from 53.87 ± 13.83 to 73.46 ± 12.40. Group B demonstrated a decrease in the mean SAQ score from 63.19 ± 12.85 to 52.22 ± 13.42 and an increase in the mean FDI score from 55.47 ± 11.19 to 65.73 ± 11.68. Significance between the two groups was found regarding SAQ scores (p = 0.014) and FDI scores (p = 0.016) after treatment. Difference in mean FDI improvement was in favor of Group A and was statistically significant (p = 0.001), while the difference in SAQ improvement did not reach significance (p = 0.091).
Conclusion: The two treatment approaches under study – Facial Neuromuscular Retraining Therapy and conventional Physiotherapy – have proven themselves effective in bringing about favorable results in the change of the parameters studied in the patients diagnosed with facial palsy. However, a greater degree of improvement and better outcomes were achieved with Facial Neuromuscular Retraining.
