Physiotherapy in the first three months after allograft face transplantation – case report

Abstract

AbstractObjective: The aim of the study was to present physiotherapy procedures of the patient with von Recklinhausen’s disease in the first three months after allograft face transplantation (PT).Methods: During hospitalization lasting 2.5 months intensive functional rehabilitation was conducted. It ran in two stages: early (up to 30 days after surgery) and recovery (1 to 3 months). In physiotherapy the method with elements of PNF (Prioprioceptywne Neuromuscular Facilitation) was used. During 2 months from PT an electrostimulation of orbicularis oris muscles was included. Physiotherapists did not focus only on rehabilitation of the face transplant, but also paid attention to functional problems caused by von Recklinhausen’s disease. When planning therapy, they took into consideration personal, physical and emotional features. In therapy we used exercises in different starting positions, such as rollers, elastic bands, balls and sensory rings were employed. Lymphatic drainage of the face and neck was performed.Results: During three months of the rehabilitation an improvement of upper and lower limbs′ muscle strength was achieved; cervical spine range of motion increased, pain and discomfort caused by scar restrictions were reduced. There was also an improvement of the overall functionality of the patient. However, due to short time after PT no improvement in the functioning of facial expressions and sensory feeling was noticed, nevertheless the patient accepted the new face. In our opinion, rehabilitation is an inevitable element after face transplant (PT). The use of an individual and comprehensive program of physiotherapy, and it’s early and systematic implementation allow to achieve an improvement of the patient’s physical function after PT. Continuing rehabilitation is necessary to achieve full facial functionality and maintain physical capacity.