背景:面神经肌肉再训练(fNMR)是一种广泛用于治疗周围性面神经麻痹的非侵入性物理疗法。它由不同的干预方法组成,旨在减少疾病的衰弱后遗症。最近,在急性面神经麻痹和术后康复中使用镜像疗法已显示出有希望的结果,这表明它可以作为fNMR的辅助手段来治疗晚期瘫痪患者,比如麻痹者,早期,或者是慢性综合征.
目的:本研究的主要目的是比较在3个不同阶段的周围性面神经麻痹(PFP)后遗症患者中添加镜像疗法成分与fNMR的疗效。本研究的具体目标是测量联合治疗与fNMR单独对(1)参与者面部对称性和联合运动的影响,(2)参与者的生活质量和心理方面,(3)动机和治疗依从性,(4)面部麻痹的不同阶段。
方法:本研究是一项随机对照试验,比较了fNMR联合镜像疗法(实验组:n=45)与仅fNMR(对照组:n=45)对90例患者的疗效。发病后3-12个月出现后遗症的周围性面神经麻痹。两组均接受为期6个月的康复训练。面部对称和同质;参与者的生活质量;以及他们的心理因素,动机,和合规性将在基线(T0)进行评估,3个月(T1),6个月(T2),干预后12个月(T3)。结果测量是(1)面部对称性的变化和用面部分级工具评估的突触运动,(2)患者生活质量变化问卷,(3)标准化量表的治疗动机,以及坚持使用元数据进行治疗。面部对称性和联合运动的变化将由3名对小组分配视而不见的评估员判断。混合模型和Kruskal-Wallis,卡方,和多层次的分析将根据适当的变量类型进行。
结果:纳入将于2024年开始,预计将于2027年完成。最后一位患者将于2028年完成12个月的随访。我们希望纳入这项研究的患者在面部对称性方面有所改善,Synkinesis,和生活质量,无论小组分配。对于处于麻痹期的患者,可以注意到镜像疗法对面部对称性和联合运动的潜在益处。我们假设镜像治疗组的动机和依从性更好。
结论:本试验的结果可能为长期后遗症患者的PFP康复提供新的指导。它还满足了行为面部康复中对基于证据的可靠数据的需求。
■PRR1-10.2196/47709。
BACKGROUND: Facial neuromuscular retraining (fNMR) is a noninvasive physical therapy widely used to treat peripheral facial palsies. It consists of different intervention methods that aim to reduce the debilitating sequelae of the disease. Recently, the use of mirror therapy in the acute facial palsy and postsurgical rehabilitation contexts has shown promising results, suggesting its use as an adjunct to fNMR in treating patients with later stages of paralysis, such as the paretic, early, or chronic synkinetic.
OBJECTIVE: The main aim of this
study is to compare the efficacy of an added mirror therapy component with fNMR in patients with peripheral facial palsy (PFP) sequelae in 3 different stages. The specific objectives of this
study are to measure the effects of combined therapy compared to fNMR alone on (1) participants\' facial symmetry and synkinesis, (2) quality of life and psychological aspects of the participants, (3) motivation and treatment adherence, and (4) different stages of facial palsies.
METHODS: This
study is a randomized controlled
trial that compares the effect of fNMR combined with mirror therapy (experimental group: n=45) with fNMR alone (control group: n=45) in 90 patients with peripheral facial palsy presenting with sequelae 3-12 months after onset. Both groups will receive 6 months of rehabilitation training. Facial symmetry and synkinesis; participants\' quality of life; and their psychological factors, motivation, and compliance will be assessed at baseline (T0), 3 months (T1), 6 months (T2), and 12 months (T3) postintervention. Outcome measures are (1) changes in facial symmetry and synkinesis assessed with facial grading tools, (2) quality of life changes with patient questionnaires, and (3) therapy motivation with a standardized scale, as well as adherence to treatment with metadata. Changes in facial symmetry and synkinesis will be judged by 3 assessors blinded to group assignment. Mixed models and Kruskal-Wallis, chi-square, and multilevel analyses will be conducted according to the appropriate variable type.
RESULTS: Inclusion will start in 2024 and is anticipated to be completed in 2027. The 12-month follow-up will be completed with the last patient in 2028. We expect patients included in this
study to experience improvement in facial symmetry,
synkinesis, and quality of life, regardless of group assignments. A potential benefit of mirror therapy for facial symmetry and synkinesis could be noted for patients in the paretic phase. We hypothesize better motivation and adherence to treatment for the mirror therapy group.
CONCLUSIONS: The results of this
trial may provide new guidelines for PFP rehabilitation with patients dealing with long-term sequelae. It also fills the need for robust evidence-based data in behavioral facial rehabilitation.
UNASSIGNED: PRR1-10.2196/47709.