Tedeschi Roberto, Donati Danilo, Giorgi Federica
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Via Zamboni 33, 40126, Bologna, Italy.
Physical Therapy and Rehabilitation Unit, Policlinico di Modena, Modena, Italy.
Acta Neurol Belg. 2024 Dec;124(6):1805-1822. doi: 10.1007/s13760-024-02630-w. Epub 2024 Aug 29.
Effective rehabilitation of peripheral facial paralysis (PFP) requires reliable assessment tools. This systematic review aimed to identify and validate instruments used in PFP rehabilitation, categorizing them according to the ICF framework.
A comprehensive search was conducted across PubMed, Cinahl, Web of Science, and Scopus up to April 2024. Observational analytical studies and one non-randomized controlled trial that validated tools for assessing PFP were included.
Thirty-three studies were included, covering twenty different tools. Seventeen tools were related to the "Structure and Function" domain, while three addressed "Activity and Participation." The Sunnybrook and House-Brackmann scales were the most extensively studied. The Sunnybrook scale exhibited excellent intra- and inter-rater reproducibility and internal validity, making it suitable for clinical use. The House-Brackmann scale was user-friendly but had limitations in reproducibility and sensitivity to subtle differences, which newer versions like the FNGS 2.0 aimed to address. The FAME scale showed promise by reducing subjective scoring. Computerized tools, such as eFACE and A-FPG, and instruments for lip asymmetry and ocular involvement demonstrated potential but require further validation. The Facial Disability Index and the FaCE Scale were validated for assessing disability and participation restrictions.
This review identified several validated tools for PFP assessment, with the Sunnybrook and House-Brackmann scales being the most reliable. While emerging tools and computerized programs show promise, they need further validation for routine clinical use. Integrating validated tools into clinical practice is essential for comprehensive assessment and effective rehabilitation of PFP.
周围性面瘫（PFP）的有效康复需要可靠的评估工具。本系统评价旨在识别和验证PFP康复中使用的工具，并根据国际功能、残疾和健康分类（ICF）框架对其进行分类。
截至2024年4月，在PubMed、CINAHL、科学引文索引和Scopus数据库中进行了全面检索。纳入了观察性分析研究和一项验证PFP评估工具的非随机对照试验。
共纳入33项研究，涵盖20种不同工具。17种工具与“结构和功能”领域相关，3种涉及“活动和参与”。阳光布鲁克量表和House-Brackmann量表是研究最广泛的。阳光布鲁克量表在评分者内和评分者间具有出色的可重复性和内部效度，适合临床使用。House-Brackmann量表使用方便，但在可重复性和对细微差异的敏感性方面存在局限性，像FNGS 2.0这样的新版本旨在解决这些问题。FAME量表通过减少主观评分显示出前景。电子面部评估（eFACE）和自动面部麻痹分级（A-FPG）等计算机化工具以及用于评估唇不对称和眼部受累的工具显示出潜力，但需要进一步验证。面部残疾指数和面部评估量表（FaCE Scale）已被验证可用于评估残疾和参与限制。
本评价确定了几种经过验证的PFP评估工具，其中阳光布鲁克量表和House-Brackmann量表最为可靠。虽然新兴工具和计算机化程序显示出前景，但它们需要进一步验证才能用于常规临床实践。将经过验证的工具整合到临床实践中对于PFP的全面评估和有效康复至关重要。
