Physiotherapy Rehabilitation of the Smile after Long-Term Facial Nerve Palsy using Video Self-Modeling and Implementation Intentions
Objective
To improve smiling after long-term facial nerve palsy (FNP). Physiotherapy rehabilitation of an adapted (more symmetrical) smile was investigated in FNP subjects 1 year post-onset, using video self-modeling (video replay of only best adapted smiles) and implementation intentions (preplanning adapted smiles for specific situations).
After video self-modeling: 1) reaction time (RT) to initiation of adapted smiles became 224 ms faster whereas RT for everyday (asymmetrical) smiles became 153 ms slower; 2) adapted smiles were completed 544 ms faster; 3) adapted smiles had higher overall quality, movement control, and symmetry ratings; and 4) Facial Disability Index scores also improved. Implementation intentions after video self-modeling ensured transfer of adapted smile to everyday situations.
Conclusion
Following intervention the smile improved, with significant changes in availability, execution speed, and quality.
Significance
This study supports these rehabilitation techniques to maximize quality of smiling following FNP.
EBM rating: B-2b
aSchool of Physiotherapy, The University of Sydney, Sydney, New South Wales, Australia
bSchool of Exercise and Sport Science, The University of Sydney, Sydney, New South Wales, Australia
cVMO, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
Reprint requests: Susan E. Coulson, School of Physiotherapy, Faculty of Health Sciences, Cumberland Campus, The University of Sydney, PO Box 170 Lidcombe, NSW 1825 Australia.
Dr Coulson was supported by funds provided for doctoral research from an Australian Postgraduate Award, The University of Sydney.
ABSTRACT