Katsikitis M, Pilowsky I
Department of Psychiatry, University of Adelaide, South Australia, Australia.
J Psychosom Res. 1996 Apr;40(4):387-96. doi: 10.1016/0022-3999(95)00611-7.
The aim of this study was to evaluate the effects of orofacial physiotherapeutic treatment (OPT) on the facial mobility of Parkinson's disease (PD) sufferers. Sixteen participants with PD were allocated randomly to either the Treatment group or the Control group. A short interview between the physiotherapist and each subject was videotaped, and 10 random frames of the videotape were selected to be used in the facial expression assessment. The quantification of facial expressions was achieved by using an objective microcomputer-based measurement system, based on a mathematical model of the face (FACEM). A facial outline is obtained, as well as 12 facial measures, which represent distances between key facial landmarks. The facial assessment was performed on 3 separate occasions, that is, baseline (pretreatment), posttreatment, and follow-up (4 weeks later). A repeated measures analysis of variance (MANOVA) revealed a significant main effect of Time and a significant interaction effect between Time and Group for the Mouth-Opening Measure, suggesting that after treatment, members of the Treatment group opened their mouths to a greater degree than members of the Control group. Within the Treatment group, significant differences between pretreatment and posttreatment scores (MANOVA) were found for Mouth-Opening Measure and Mid-Top-Lip Measure. Similarly, Mouth-Opening Measure, Mid-Top-Lip Measure, Lower-Lip Thickness Measure, Top Eyelid/Iris Intersect Measure and Lower Eyelid/Iris Intersect Measure were significant across time from baseline to follow-up in the Treatment group only. No significant differences were found on any of the facial measures during the same period for members of the Control group. These findings suggest that OPT can improve facial movement and that this benefit extends in time, beyond the period of OPT itself. Such an increase in facial mobility can be expected to modify the "Parkinsonian facies" and facilitate the display of facial expressions.
本研究的目的是评估口面部物理治疗（OPT）对帕金森病（PD）患者面部活动度的影响。16名PD患者被随机分配到治疗组或对照组。物理治疗师与每位受试者之间的简短访谈被录像，并从录像带中随机选取10帧用于面部表情评估。面部表情的量化是通过使用基于计算机的客观测量系统实现的，该系统基于面部的数学模型（FACEM）。获得面部轮廓以及12项面部测量指标，这些指标代表关键面部标志之间的距离。面部评估在3个不同时间进行，即基线（治疗前）、治疗后和随访（4周后）。重复测量方差分析（MANOVA）显示，对于张口测量，时间有显著的主效应，时间和组之间有显著的交互效应，这表明治疗后，治疗组成员的张口程度比对照组成员更大。在治疗组内，发现张口测量和上唇中部测量的治疗前和治疗后分数之间存在显著差异（MANOVA）。同样，仅在治疗组中，从基线到随访期间，张口测量、上唇中部测量、下唇厚度测量、上眼睑/虹膜相交测量和下眼睑/虹膜相交测量均有显著变化。在同一时期，对照组成员的任何面部测量指标均未发现显著差异。这些发现表明，OPT可以改善面部运动，并且这种益处会随着时间延续，超出OPT治疗本身的时间段。面部活动度的这种增加有望改变“帕金森面容”并促进面部表情的展现。
