Main prognostic factors and physical therapy modalities associated with functional recovery in patients with peripheral facial paralysis

ABSTRACT Patients with peripheral facial paralysis (PFP) have some degree of recovery. The aim of this study was to evaluate prognostic factors and physical therapy modalities associated with functional recovery in patients with PFP. This is a cohort study with 33 patients. We collected the following variables of patients who underwent treatment at the rehabilitation center: age, sex, risk factors, affected side, degree of facial paralysis (House-Brackmann scale), start of rehabilitation, and therapy modality (kinesiotherapy only; kinesiotherapy with excitomotor electrotherapy; and kinesiotherapy with excitomotor electrotherapy and photobiomodulation therapy). The outcomes were: degree of facial movement (House-Brackmann) and face scale applied 90 days after treatment. Degree of PFP was associated with functional recovery (RR=0.51, 95% CI: 0.51-0.98; p=0.036). The facial movement was associated with the time to start rehabilitation (r=−0.37; p=0.033). Lower facial comfort was observed among women, worse ocular comfort was associated with diabetes mellitus, worse tear control with prior PFP, and worse social function with the degree of PFP. Our results indicate that the all modalities present in this study showed the same result in PFP. Recovery of PFP was associated with degree of nerve dysfunction, the length of time to onset of rehabilitation, female sex, hypertension, diabetes mellitus, and previous PFP, all of which were associated with worse outcomes on the face scale.

摘要：周围性面神经麻痹（peripheral facial paralysis, PFP）患者存在不同程度的功能恢复。本研究旨在评估与PFP患者功能恢复相关的预后因素及物理治疗方式。本研究为一项纳入33例患者的队列研究。我们收集了在康复中心接受治疗的患者的以下变量：年龄、性别、危险因素、受累侧、面神经麻痹程度（House-Brackmann量表（House-Brackmann scale））、康复启动时间以及治疗方式（单纯运动疗法（kinesiotherapy）；运动疗法联合兴奋运动电疗法（excitomotor electrotherapy）；运动疗法联合兴奋运动电疗法与光生物调节疗法（photobiomodulation therapy））。本研究的结局指标为：治疗后90天时的面部运动功能程度（House-Brackmann量表）及面部量表评分。面神经麻痹程度与功能恢复相关（相对危险度RR=0.51，95%置信区间CI：0.51~0.98；p=0.036）。面部运动功能与康复启动时间呈负相关（相关系数r=−0.37；p=0.033）。女性患者的面部舒适度更低，糖尿病患者的眼部舒适度更差，既往有PFP病史者的泪液控制能力不佳，而PFP程度越高则社会功能越差。本研究结果显示，纳入的所有治疗方式对PFP的治疗效果均无显著差异。PFP的功能恢复与神经功能障碍程度、康复启动时长、女性性别、高血压、糖尿病及既往PFP病史相关，上述因素均与面部量表评分更差的结局相关。