Functional Training in the Management of Chronic Facial Paralysis

Abstract

Disability in patients with facial paralysis is the result of impairment or loss of complex and multidimensional functions of the face, including expression of emotions, facial identity, and communication. However, the majority of interventions for facial paralysis are unidimensional and impairment oriented. Thus, a functional training program intended to address various dimensions of disability caused by facial paralysis was devised. This patient-centered, multidimensional approach to the rehabilitation of people with facial paralysis consists of patient education, functional training, and complementary exercises. This approach is focused on various dimensions of disability, including the physical, emotional, and social dimensions, by encouraging context-specific facial functions, positive coping strategies, and social interaction skills. The patient was a 25-year-old woman with chronic complete right facial paralysis caused by a postoperative complication of ear surgery. The patient's problems were evaluated with the Facial Disability Index (physical function subscale score=45/100, social/well-being function subscale score=28/100) and an informal interview exploring her experiences and priorities. After 8 weeks of functional training, the patient showed considerable improvement in facial functions (physical function subscale score=95/100, social/well-being function subscale score=100/100) and reported positive changes in social interactions and interpersonal relationships. The use of a functional training program was associated with positive changes in emotional expression, psychosocial function, and social integration, thus contributing to reduced disability of a person with chronic facial paralysis.