TY - JOUR

T1 - Assessment and rehabilitation interventions for central facial palsy in patients with acquired brain injury: A systematic review

AU - Fabricius, Jesper

AU - Kothari, Simple F.

AU - Kothari, Mohit

PY - 2021/4

Y1 - 2021/4

N2 - Objectives: A systematic review covering assessments and interventions for central facial palsy (CFP) in patients with acquired brain injury.Methods: PubMed, Embase, Cinahl, PsycInfo, and Web of Science were screened until April 2019. Assessments were defined as clinical- and instrumental tools and rating scales. Interventions were defined as rehabilitation interventions alleviating CFP. Results: 690 articles were screened based on the title and abstract. Interrater agreement was 98.12% (kappa=-0.0081). 16 articles were included: six clinical trials and ten observational studies. Assessment: Commonest scale for assessing CFP was the House-Brackmann facial nerve Grading System. Strain gauges for measuring lip and cheek strength were applied in five studies and neurophysiological methods of assessing motor neuron pathways was applied in three studies. Interventions: An oral screen for improving lip strength was reported in three studies. Other interventions reported were neuromuscular electrical stimulation, Castillo Morales therapy, mirror therapy, exercises with electromyography feedback, and acupuncture. Conclusions: Scales for assessing peripheral facial palsy was applied for assessing CFP. Based on neurophysiological differences between peripheral facial palsy and CFP, these scales should be validated in patients with CFP. More studies on interventions for CFP are required before conclusions may be drawn about their effectiveness.

AB - Objectives: A systematic review covering assessments and interventions for central facial palsy (CFP) in patients with acquired brain injury.Methods: PubMed, Embase, Cinahl, PsycInfo, and Web of Science were screened until April 2019. Assessments were defined as clinical- and instrumental tools and rating scales. Interventions were defined as rehabilitation interventions alleviating CFP. Results: 690 articles were screened based on the title and abstract. Interrater agreement was 98.12% (kappa=-0.0081). 16 articles were included: six clinical trials and ten observational studies. Assessment: Commonest scale for assessing CFP was the House-Brackmann facial nerve Grading System. Strain gauges for measuring lip and cheek strength were applied in five studies and neurophysiological methods of assessing motor neuron pathways was applied in three studies. Interventions: An oral screen for improving lip strength was reported in three studies. Other interventions reported were neuromuscular electrical stimulation, Castillo Morales therapy, mirror therapy, exercises with electromyography feedback, and acupuncture. Conclusions: Scales for assessing peripheral facial palsy was applied for assessing CFP. Based on neurophysiological differences between peripheral facial palsy and CFP, these scales should be validated in patients with CFP. More studies on interventions for CFP are required before conclusions may be drawn about their effectiveness.

KW - facial palsy

KW - brain injury

KW - rehabilitation

KW - assessment

KW - intervention

KW - stroke

U2 - 10.1080/02699052.2021.1890218

DO - 10.1080/02699052.2021.1890218

M3 - Journal article

C2 - 33645363

VL - 35

SP - 511

EP - 519

JO - Brain Injury

JF - Brain Injury

SN - 0269-9052

IS - 5

ER -