Dalla Toffola Elena, Bossi Daniela, Buonocore Michelangelo, Montomoli Cristina, Petrucci Lucia, Alfonsi Enrico
Physical Medicine and Rehabilitation, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy.
Disabil Rehabil. 2005 Jul 22;27(14):809-15. doi: 10.1080/09638280400018650.
To analyze and to compare the recovery and the development of synkinesis in patients with idiopathic facial palsy (Bell's palsy) following treatment with two methods of rehabilitation, kinesitherapy (KT) and biofeedback/EMG (BFB/EMG).
Retrospective cases--series review.
Seventy-four patients with Bell' palsy were clinically evaluated within 1 month from onset of palsy and at 12 months after palsy (House scale and synkinesis evaluation). Electromyography (EMG) and Electroneurography (ENG) were performed about 4 weeks after palsy to better evaluate functional abnormalities due to facial nerve lesion. The patients followed two different protocols for rehabilitation: the first 32 patients were treated with therapeutic exercises performed by therapists (KT group), the latter 42 patients were treated using BFB/EMG methods (BFB group) with inhibition of synkinetic movement as the primary goal.
KT and BFB patients were evaluated for clinical and neurophysiological characteristics before rehabilitative treatment. BFB patients showed better clinical recovery and minor synkinesis than KT patients.
BFB/EMG seems to be more useful than KT in Bell's palsy treatment. This could be due to the fact that BFB/EMG gives more accurate information than KT on muscle activation with better modulation in voluntary recruitment of motor unit.
分析并比较特发性面神经麻痹(贝尔氏麻痹)患者采用两种康复方法,即运动疗法(KT)和生物反馈/肌电图(BFB/EMG)治疗后联带运动的恢复及发展情况。
回顾性病例系列研究。
74例贝尔氏麻痹患者在麻痹发作后1个月内及麻痹后12个月时接受临床评估(采用House量表和联带运动评估)。在麻痹后约4周进行肌电图(EMG)和神经电图(ENG)检查,以更好地评估面神经损伤导致的功能异常。患者遵循两种不同的康复方案:前32例患者接受治疗师进行的治疗性锻炼(KT组),后42例患者采用以抑制联带运动为主要目标的BFB/EMG方法治疗(BFB组)。
对KT组和BFB组患者在康复治疗前的临床和神经生理特征进行了评估。BFB组患者的临床恢复情况优于KT组,且联带运动较少。
在贝尔氏麻痹治疗中,BFB/EMG似乎比KT更有效。这可能是因为BFB/EMG在肌肉激活方面比KT能提供更准确的信息,在运动单位的自主募集方面具有更好的调节作用。