Department of Economics, 119703Institute of Business Administration, Karachi, Pakistan.
Centre for Healthcare Research, 2706Coventry University, Coventry, UK.
Clin Rehabil. 2022 Nov;36(11):1424-1449. doi: 10.1177/02692155221110727. Epub 2022 Jul 5.
To conduct a systematic review of the effectiveness of facial exercise therapy for facial palsy patients, updating an earlier broader Cochrane review; and to provide evidence to inform the development of telerehabilitation for these patients.
MEDLINE, EMBASE, CINAHL, Cochrane Library, PEDro and AMED for relevant studies published between 01 January 2011 and 30 September 2020.
Predetermined inclusion/exclusion criteria were utilised to shortlist abstracts. Two reviewers independently appraised articles, systematically extracted data and assessed the quality of individual studies and reviews (using GRADE and AMSTAR-2, respectively). Thematic analysis used for evidence synthesis; no quantitative meta-analysis conducted. The review was registered with PROSPERO (CRD42017073067).
Seven new randomised controlled trials, nine observational studies, and three quasi-experimental or pilot studies were identified ( = 854 participants). 75% utilised validated measures to record changes in facial function and/or patient-rated outcomes. High-quality trials (4/7) all reported positive impacts; as did observational studies rated as high/moderate quality (3/9). The benefit of therapy at different time points post-onset and for cases of varying clinical severity is discussed. Differences in study design prevented data pooling to strengthen estimates of therapy effects. Six new review articles identified were all rated critically low quality.
The findings of this targeted review reinforce those of the earlier more general Cochrane review. New research studies strengthen previous conclusions about the benefits of facial exercise therapy early in recovery and add to evidence of the value in chronic cases. Further standardisation of study design/outcome measures and evaluation of cost-effectiveness are recommended.
对颜面肌运动疗法治疗面瘫患者的效果进行系统评价，更新早期更广泛的 Cochrane 综述；并为这些患者的远程康复提供证据。
在 2011 年 1 月 1 日至 2020 年 9 月 30 日期间，在 MEDLINE、EMBASE、CINAHL、Cochrane 图书馆、PEDro 和 AMED 中检索相关研究。
使用预定的纳入/排除标准筛选摘要。两位审查员独立评估文章，系统地提取数据，并评估单个研究和综述的质量（分别使用 GRADE 和 AMSTAR-2）。使用主题分析进行证据综合；未进行定量荟萃分析。该综述在 PROSPERO（CRD42017073067）中进行了注册。
共确定了 7 项新的随机对照试验、9 项观察性研究和 3 项准实验或试点研究（ = 854 名参与者）。75%的研究使用经过验证的措施来记录面部功能和/或患者评定结果的变化。高质量的试验（4/7）均报告了积极的影响；高/中质量评定的观察性研究（3/9）也是如此。讨论了发病后不同时间点和不同临床严重程度的治疗益处。研究设计的差异阻止了数据汇总，以加强对治疗效果的估计。确定的 6 篇新的综述文章均被评为批判性低质量。
本次针对性综述的结果强化了早期更广泛的 Cochrane 综述的结果。新的研究加强了早期恢复中颜面肌运动疗法的益处的先前结论，并增加了慢性病例中该疗法价值的证据。建议进一步标准化研究设计/结果测量并评估成本效益。
