2011, Number 2
<< Back Next >>
Arch Neurocien 2011; 16 (2)
Rehabilitation of synkinesis and facial asymmetry in patients with peripheral facial paralysis with the biofeedback electromyographic technique
Rodríguez-Ortiz MD, Mangas-Martínez S, Ortiz-Reyes MG, Rosete-Gil HS, Vales-Hidalgo O, Hinojosa-González R
Language: Spanish
References: 26
Page: 69-74
PDF size: 118.38 Kb.
ABSTRACT
Objective: to present the program of rehabilitation of chronic peripheral facial paralysis and data obtained as a result of the investigation conducted by the laboratory of Facial Paralysis and Applied Psychophysiology of Psychology Faculty, UNAM, in collaboration with the Department of INNN Otoneurology.
Material and methods: a longitudinal study was conducted which evaluated 16 patients referred from the INNN. Eight had synkinesis. All were rehabilitated with the technique of electromyographic Biofeedback (BFB/EMG). The psychophysiological recording was performed with an electromyograph and surface electrodes. The treatment consisted of two phases, assessment and training. Training consisted of ten sessions per affected muscle group, divided into a relaxation phase of open eyes and closed eyes, and an activation phase of rehabilitation exercises. Statistical analysis was performed with Student’s t test for related samples, evaluating the differences in muscle activity (mV) relaxation condition before and after treatment, between patients with synkinesis and those without the disorder; the same test was used to compare the activity at the beginning and end of treatment in the performance of rehabilitation exercises
Results: Significant differences were found (p=0.000) comparing before and after treatment, reducing involuntary movements in relaxation phase in patients with sinkinesis in the affected hemiface and increased activity in all muscle groups.
Conclusion: the BFB/EMG technique may decrease the occurrence of synkinesis after treatment.
REFERENCES
Simón MA, Amenedo E, editores. Manual de psicofisiología clínica. Madrid: Ediciones Pirámide, 2001.
Noya M, Pardo J. Diagnóstico y tratamiento de parálisis facial. Neurología 1997; 12(1):22-30.
Rahman I, Sadiq A. Ophthalmic management of facial nerve palsy: a review. Surv Ophthalmol 2007; 52(2):121-44.
Lunan R, Nagarajan L. Bell’s palsy. A guideline proposal following a review of practice. J Paediatr Child Health 2008; 44: 219–220.
La Touche R, Escalante A, Linares M, Mesa J. Efectividad del tratamiento de fisioterapia en la parálisis facial periférica. Revisión sistemática. Rev Neurol 2008; 46 (12): 714-8.
Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol 2008; 265:743-52.
Ogita S, Terada K, Niizuma T, Kosaka Y, Kataoka N. Characteristics of facial nerve palsy during childhood in Japan: frequency of varicella–zoster virus association. Pediatr Int 2006; 48: 245-9.
Tiemstra J, Khatkhate N. Bell’s Palsy: diagnosis and management. Am Fam Physician 2007; 76 (7):997-1002.
Harrison D. Surgical correction of unilateral and bilateral facial palsy. Postgrad Med 2005; 81:562–7.
Shafshak, T. The treatment of facial palsy from the point of view of physical and rehabilitation medicine. Eura medicophys 2006; 42:41-7.
Coulson S, O’Dwyer N, Adams R, Croxson G. Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy. Exp Brain Res 2006; 173:153-8.
Pérez E, Gámez C, Guzmán JM, Escobar D, López, VM, Montes de Oca RD, et al. Guía clínica para la rehabilitación del paciente con parálisis facial periférica. Rev Med Inst Mex Seguro Soc 1994; 42 (5): 425-36.
Batista R, Barbosa Y, Borges G, Ramina R. Long-term facial nerve clinical evaluation following vestibular schwannoma surgery. Arq Neuropsiquiatr 2008; 66(2-A):194-8.
Padua G, Guarderas J, Rodríguez D, Zaldivar I, Espinoza E. Procedimiento para la rehabilitación de Sinkinesis mediante la técnica de retroalimentación Biológica electromiográfica. Rev Mex Psicol 1994;11(1):19-23.
Nakamura K, Toda N, Sakamaki K, Kashima K, Takeda N. Biofeedback rehabilitation for prevention of synkinesis after facial palsy. Otolaryngol Head Neck Surg 2003; 128: 539-43.
Segal B, Hunter T, Danys I, Freedman C, Black M. Minimizing synkinesis during rehabilitation of the paralyzed face: preliminary assessment of a new small-movement therapy. J Otolaryngol 1995; 24:149-53.
Ross B, Nedzelski JM, McLean JA. Efficacy of feedback training in long-standing facial nerve paresis. Laryngoscope 1991; 101 (7 Pt 1): 744-50.
Schwartz M, Andrasik F. Biofeedback: a practitioner’s guide. 3a. edición. U.S.A.: Editorial Guilford, 1994.
Cacioppo J, Tassinari L, Berntson G. Handbook of Psychophysiology. 3a. edición. New York, USA. Cambridge University Press; 2007.
Dalla E, Bossi D, Buonocore M, Montomoli C, Petrucci L, Alfonsi, E. Usefulness of BFB/EMG in facial palsy rehabilitation. Disabil Rehabil 2005; 27(14): 809-15.
Carrobles JA, Godoy J. Biofeedback. Autocontrol de funciones biológicas y trastornos psicosomáticos. Barcelona. Editorial Martínez Roca 1987.
Yagiz A, Pelin H, Kirazli Y. Agreement between clinical and electromyographic assessments during the course of peripheric facial paralysis. Clin Rehabil 2007; 21: 344-50.
Manikandan N. Effect of facial neuromuscular re-education on facial symmetry in patients with Bell’s palsy: a randomized controlled trial. Clin Rehabil 2007; 21: 338-43.
Beurskens CH, Heymans PG. Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial. Aust J Physiother 2006; 52: 177-83.
Aboytes-Meléndez C, Torres-Valenzuela A. Perfil clínico y epidemiológico de la parálisis facial. Rev Med Hosp Gen Mex 2006; 69 (2): 70-7.
González L, Sánchez A, Pérez M. Estandarización de la onda F del nervio facial y su valor pronóstico en la parálisis facial. Rev Mex Med Fis Rehab 2001; 13 (4): 113-5.