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).

Study Design And Setting: Prospective, blinded clinical trial. Facial-Nerve-Palsy Clinic.

Results: 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.