Morishima Naohito, Kamiya Takeshi, Naito Yoshinori, Morisaka Ayako, Ishikawa Tomoji, Tachibana Keita, Murakami Shingo
Department of Rehabilitation, Toyohashi Municipal Hospital.
Department of Central Rehabilitation Medicine, Osaka Rosai Hospital.
Phys Ther Res. 2020 Feb 25;23(1):59-65. doi: 10.1298/ptr.E10000. eCollection 2020.
To evaluate the effect of muscle strengthening intervention in peripheral facial palsy (PFP).
A randomized controlled trial was conducted at five hospitals. Fifty-one subjects with PFP who showed a response of less than 20% on electroneurography (ENoG) were enrolled. Subjects in a muscle-strengthening-intervention group (MS Group) underwent a selective muscle contraction intervention (SMCI). Subjects in another group not receiving muscle strengthening intervention (Non-MS Group). Both groups underwent three interventions: Prohibition of maximum effort movements, Stretching of the affected facial muscles, and Mirror biofeedback therapy. The outcomes were measured by the Sunnybrook Facial Grading System (FGS) at 6 months after onset (primary endpoint) and at 12 months after onset (secondary endpoint). The subjects in the MS Group and Non-MS Group were further divided into subgroups showing ENoG responses of 10% or less and ENoG responses of over 10%, as a sub-analysis.
No significant differences between the MS Group and Non-MS Group at either the primary endpoint or secondary endpoint. Among the subjects in the treatment group with an ENoG response of over 10% at the primary endpoint, the FGS Composite Score and FGS Voluntary Movement score were both significantly higher in the MS Group than in Non-MS Group. Although the MS Group had a significantly lower FGS Resting Symmetry Score, there was no significant difference between the two groups in the FGS Synkinesis Score.
SMCI improved paralysis in subjects exhibiting an ENoG response of over 10% within the 6 months from onset without any deterioration of synkinesis.
评估肌肉强化干预在外周性面瘫（PFP）中的效果。
在五家医院进行了一项随机对照试验。纳入了51例在神经电图（ENoG）上显示反应低于20%的PFP患者。肌肉强化干预组（MS组）的受试者接受了选择性肌肉收缩干预（SMCI）。另一组未接受肌肉强化干预的受试者（非MS组）。两组均接受了三种干预：禁止最大努力运动、患侧面部肌肉拉伸和镜像生物反馈疗法。在发病后6个月（主要终点）和发病后12个月（次要终点）通过阳光布鲁克面部分级系统（FGS）测量结果。作为亚分析，将MS组和非MS组的受试者进一步分为ENoG反应低于10%和ENoG反应超过10%的亚组。
在主要终点或次要终点，MS组和非MS组之间均无显著差异。在主要终点时ENoG反应超过10%的治疗组受试者中，MS组的FGS综合评分和FGS自主运动评分均显著高于非MS组。虽然MS组的FGS静息对称评分显著较低，但两组在FGS联带运动评分上无显著差异。
SMCI改善了发病后6个月内ENoG反应超过10%的受试者的瘫痪情况，且联带运动无任何恶化。
