Abstract
PurposeTo evaluate the continued rehabilitation motivation in patients with postparalytic facial synkinesis (PFS).MethodsIn this single-center cross-sectional survey, the multidimensional patient questionnaire for assessment of rehabilitation motivation (PAREMO-20) was used to assess the rehabilitation motivation. Associations Sunnybrook and Stennert index grading, Facial Clinimetric Evaluation (FaCE) survey, general quality of life (SF-36), Liebowitz Social Anxiety Scale (LSAS), Patient Health Questionnaire (PHQ)-9, technology commitment and affinity, and interest in further therapy were analyzed.Results69 adults with PFS (73% women; median age: 54 years) answered the survey. In comparison to prior treatment forms, there was a significant higher future interest in computer-based home facial training (p < 0.0001). For PAREMO Psychological burden subscore, SF36 Emotional role was the highest negative correlative factor (p < 0.0001). For PAREMO Physical burden subscore, SF-36 General health was the highest negative correlative factor (p = 0.018). Working (p = 0.033) and permanent relationship (p = 0.029) were the only independent factors correlated to PAREMO Social Support Subscore. Higher positive impacts of technology affinity was inversely correlated to PAREMO Knowledge subscore (p = 0.017). Lower SF-36 Role physical subscore p = 0.045) and a lower SF-36 General health (p = 0.013) were correlated to a higher PAREMO Skepticism subscore.ConclusionsPatients with PFS seem to have a high facial motor and non-motor psychosocial impairment even after several facial therapies. Rehabilitation-related motivation increases with both, higher facial motor and non-motor dysfunction. Social and emotional dysfunction are drivers to be interested in innovative digital therapy forms.
Highlights
Severe facial nerve paralysis can lead in the chronic phase to altered patterns of muscle contraction and postparetic facial synkinesis (PFS)
Investigation of a selection bias: comparison of study participants with the patients not responding to the survey
The reported values for Liebowitz Social Anxiety Scale (LSAS) and Patient Health Questionnaire (PHQ)-9 are much higher in patients with PFS than in the normal population [19, 27,28,29,30]
Summary
Severe facial nerve paralysis can lead in the chronic phase to altered patterns of muscle contraction and postparetic facial synkinesis (PFS). PFS is a disfiguring condition characterized by involuntary contraction of one or more facial muscles during voluntary movement of other muscles [1, 2]. Diminished facial expression, especially the inability to smile and affected face-to-face communication are the major non-motoric disabilities [3]. Altered facial motor function and the non-motor psychosocial problems can severely decrease quality of life in facial palsy patients [4]. Many patients with PFS are never referred to a specialist or with a too long delay to receive a treatment [5]. The patient’s perspective on the demand of and access to therapy for PFS has be considered.
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