Vaughan Annabelle, Gardner Danielle, Miles Anna, Copley Anna, Wenke Rachel, Coulson Susan
Speech Pathology Service, Gold Coast University Hospital, Gold Coast, QLD, Australia.
School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia.
Front Neurol. 2020 Mar 31;11:222. doi: 10.3389/fneur.2020.00222. eCollection 2020.
Facial palsy is a frequent and debilitating sequela of stroke and brain injury, causing functional and aesthetic deficits as well as significant adverse effects on quality of life and well-being. Current literature reports many cases of acquired facial palsy that do not recover spontaneously, and more information is needed regarding the efficacy of physical therapies used in this population. A systematic search of eight electronic databases was performed from database inception to December 2018. Gray literature searches were then performed to identify additional articles. Studies were included if they addressed physical rehabilitation interventions for adults with acquired facial palsy. Reasons for exclusion were documented. Independent data extraction, quality assessment, and risk of bias assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Following abstract screening, a total of 13 full-text articles were identified for independent screening by two reviewers. This included four randomized control trials, two non-randomized control trials, one cohort study, and six prospective case series studies. Twelve out of the 13 included studies reported on facial palsy as a sequela of stroke. A total of 539 participants received intervention for facial palsy across the 13 included studies. Therapy design, length and frequency of intervention varied across the studies, and a wide range of outcome measures were used. Improvement on various outcome measures was reported across all 13 studies. The quality of the evidence was low overall, and most studies were found to have high risk of bias. All the studies in this review report improvement of facial movement or function following application of various methods of physical rehabilitation for facial palsy. Methodological limitations and heterogeneity of design affect the strength of the evidence and prevent reliable comparison between intervention methods. Strong evidence supporting physical rehabilitation was not found; well-designed rigorous research is required.
面瘫是中风和脑损伤常见且使人衰弱的后遗症，会导致功能和美观缺陷，以及对生活质量和幸福感产生重大不利影响。当前文献报道了许多后天性面瘫无法自发恢复的病例，对于该人群所采用物理治疗的疗效，还需要更多信息。从数据库建立至2018年12月，对八个电子数据库进行了系统检索。随后进行了灰色文献检索以识别其他文章。纳入的研究需涉及针对后天性面瘫成人的物理康复干预措施。记录排除原因。独立数据提取、质量评估和偏倚风险评估遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。经过摘要筛选，共确定了13篇全文文章供两名评审员独立筛选。其中包括四项随机对照试验、两项非随机对照试验、一项队列研究和六项前瞻性病例系列研究。13项纳入研究中有12项报告面瘫为中风后遗症。13项纳入研究中共有539名参与者接受了面瘫干预。各研究的治疗设计、干预时长和频率各不相同，且使用了广泛的结局指标。所有13项研究均报告了在各种结局指标上的改善情况。总体证据质量较低，且大多数研究被发现存在高偏倚风险。本综述中的所有研究均报告了对面瘫应用各种物理康复方法后面部运动或功能有所改善。方法学局限性和设计的异质性影响了证据的强度，阻碍了干预方法之间的可靠比较。未发现支持物理康复的有力证据；需要精心设计的严谨研究。
