Martineau Sarah, Rahal Akram, Piette Éric, Chouinard Anne-Marie, Marcotte Karine
Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada.
Centre de recherche du Centre intégré universitaire de santé et services sociaux du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.
Acta Otolaryngol. 2021 Feb;141(2):203-208. doi: 10.1080/00016489.2020.1842905. Epub 2020 Nov 20.
Small but interesting evidences suggest that facial rehabilitation for acute Bell Palsy (BP) could improve facial outcomes in patients who benefited from optimal medication, but whose symptoms are still severe two weeks after BP's onset.
This study aimed to provide preliminary evidence of the long-term effects of a new facial retraining based on motor imagery and mirror therapy, the Mirror Effect Plus Protocol (MEPP).
Twenty BP patients received the standard medication for acute BP and were then randomly allocated to the treatment (MEPP) or control group, if their palsy was still at least moderate-to-severe at 14 days post onset. Three blind independent assessors graded the patients' evolution until 6 months after onset.
Significant differences between the groups were not found for any measured variable; however, a trend toward better recovery was found in the treatment group for every measured variable. This trend grew bigger for patients with severe or total BP.
This study suggests a promising effect of the MEPP on acute severe to total BP but requires further investigation with a larger number of participants.
Facial rehabilitation should be considered as an adjunct to medication for acute and most severe degrees of BP.
虽有少量但颇为有趣的证据表明，对于急性贝尔面瘫（BP）患者，若其从最佳药物治疗中获益，但在BP发病两周后症状仍很严重，面部康复治疗可能改善面部预后。
本研究旨在为基于运动想象和镜像疗法的新型面部再训练方法——镜像效应增强方案（MEPP）的长期效果提供初步证据。
20例BP患者接受急性BP的标准药物治疗，若其面瘫在发病14天后仍至少为中重度，则随机分配至治疗组（MEPP）或对照组。3名独立的盲法评估者对患者直至发病后6个月的病情进展进行评分。
各测量变量在两组间均未发现显著差异；然而，治疗组的每个测量变量均呈现出更好恢复的趋势。对于重度或完全性BP患者，这种趋势更为明显。
本研究提示MEPP对急性重度至完全性BP有潜在疗效，但需要更多参与者进行进一步研究。
面部康复应被视为急性和最严重程度BP药物治疗的辅助手段。
