Dataset Information

A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?

ABSTRACT: There is a lack of data on patient and diagnostic factors for prognostication of complete recovery in patients with peripheral facial palsy. Thus, the aim of this study was to evaluate the role of a telerehabilitave enhancement through the description of a case report with the use of short-wave diathermy and neuromuscular electrical stimulation combined to facial proprioceptive neuromuscular facilitation (PNF) rehabilitation in unrecovered facial palsy, in a COVID-19 pandemic scenario describing a paradigmatic telerehabilitation report. A 43-year-old woman underwent a facial rehabilitation plan consisting of a synergistic treatment with facial PNF rehabilitation, short-wave diathermy, and neuromuscular electrical stimulation (12 sessions lasting 45 min, three sessions/week for 4 weeks). Concerning the surface electromyography evaluation of frontal and orbicularis oris muscles, the calculated ratio between amplitude of the palsy side and normal side showed an improvement in terms of movement symmetry. At the end of the outpatient treatment, a daily telerehabilitation protocol with video and teleconsultation was provided, showing a further improvement in the functioning of a woman suffering from unresolved facial paralysis. Therefore, an adequate telerehabilitation follow-up seems to play a fundamental role in the management of patients with facial palsy.

SUBMITTER: de Sire A

PROVIDER: S-EPMC8949994 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?

de Sire Alessandro A Marotta Nicola N Agostini Francesco F Drago Ferrante Vera V Demeco Andrea A Ferrillo Martina M Inzitari Maria Teresa MT Pellegrino Raffaello R Russo Ilaria I Ozyemisci Taskiran Ozden O Bernetti Andrea A Ammendolia Antonio A

Journal of personalized medicine 20220319 3

There is a lack of data on patient and diagnostic factors for prognostication of complete recovery in patients with peripheral facial palsy. Thus, the aim of this study was to evaluate the role of a telerehabilitave enhancement through the description of a case report with the use of short-wave diathermy and neuromuscular electrical stimulation combined to facial proprioceptive neuromuscular facilitation (PNF) rehabilitation in unrecovered facial palsy, in a COVID-19 pandemic scenario describing ...[more]

PMID: 35330496

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Project description:Eliminating facial electromyographic (EMG) signal from the electroencephalogram (EEG) is crucial for the accuracy of applications such as brain computer interfaces (BCIs) and brain functionality measurement. Facial electromyography typically corrupts the electroencephalogram. Although it is possible to find in the literature a number of multi-channel approaches for filtering corrupted EEG, studies employing single-channel approaches are scarce. In this context, this study proposed a single-channel method for attenuating facial EMG noise from contaminated EEG. The architecture of the method allows for the evaluation and incorporation of multiple decomposition and adaptive filtering techniques. The decomposition method was responsible for generating EEG or EMG reference signals for the adaptive filtering stage. In this study, the decomposition techniques CiSSA, EMD, EEMD, EMD-PCA, SSA, and Wavelet were evaluated. The adaptive filtering methods RLS, Wiener, LMS, and NLMS were investigated. A time and frequency domain set of features were estimated from experimental signals to evaluate the performance of the single channel method. This set of characteristics permitted the characterization of the contamination of distinct facial muscles, namely Masseter, Frontalis, Zygomatic, Orbicularis Oris, and Orbicularis Oculi. Data were collected from ten healthy subjects executing an experimental protocol that introduced the necessary variability to evaluate the filtering performance. The largest level of contamination was produced by the Masseter muscle, as determined by statistical analysis of the set of features and visualization of topological maps. Regarding the decomposition method, the SSA method allowed for the generation of more suitable reference signals, whereas the RLS and NLMS methods were more suitable when the reference signal was derived from the EEG. In addition, the LMS and RLS methods were more appropriate when the reference signal was the EMG. This study has a number of practical implications, including the use of filtering techniques to reduce EEG contamination caused by the activation of facial muscles required by distinct types of studies. All the developed code, including examples, is available to facilitate a more accurate reproduction and improvement of the results of this study.

Project description:BACKGROUND:Patients with facial nerve paralysis (FNP) experience challenges in accessing health care that could potentially be overcome by telemedicine. However, the reliability of telemedicine has yet to be established in this field. OBJECTIVE:This study aimed to investigate the consistency between face-to-face and video assessments of patients with FNP by experienced clinicians. METHODS:A repeated-measures design was used. A total of 7 clinicians assessed the FNP of 28 patients in a face-to-face clinic using standardized grading systems (the House-Brackmann, Sydney, and Sunnybrook facial grading systems). After 3 months, the same grading systems were used to assess facial palsy in video recordings of the same patients. RESULTS:The House-Brackmann system in video assessment had excellent reliability and agreement (intraclass correlation coefficient [ICC]=0.780; principal component analysis [PCA]=87.5%), similar to face-to-face assessment (ICC=0.686; PCA=79.2%). Reliability of the Sydney system was good to excellent, with excellent agreement face-to-face (ICC=0.633 to 0.834; PCA=81.0%-95.2%). However, video assessment of the cervical branch and synkinesis had fair reliability and good agreement (ICC=0.437 to 0.597; PCA=71.4%), whereas that of other branches had good to excellent reliability and excellent agreement (ICC=0.625 to 0.862; PCA=85.7%-100.0%). Reliability of the Sunnybrook system was poor to fair for resting symmetry (ICC=0.195 to 0.498; PCA=91.3%-100.0%) and synkinesis (ICC=-0.037 to 0.637; PCA=69.6%-87.0%) but was good to excellent for voluntary movement (ICC=0.601 to 0.906; PCA=56.5%-91.3%) in face-to-face and video assessments. Bland-Altman plots indicated normal limits of agreement within ±1 between face-to-face and video-assessed scores only for the temporal and buccal branches of the Sydney system and for resting symmetry in the Sunnybrook system. CONCLUSIONS:Video assessment of FNP with the House-Brackmann and Sunnybrook systems was as reliable as face-to-face but with insufficient agreement, especially in the assessment of synkinesis. However, video assessment does not account for the impact of real-time interactions that occur during tele-assessment sessions.

Project description:Background and objectiveAfter vestibular schwannoma (VS) surgery, some patients exhibit different degrees of peripheral facial paralysis, which can seriously affect their quality of life. The recovery of facial nerve function after surgery typically takes a considerable amount of time; therefore, the recovery of facial nerve function depends mainly on the rehabilitation treatment and nursing after discharge. In the past, we implemented conventional paralysis rehabilitation nursing program for patients with facial paralysis due to VS surgery. However, several patients with facial paralysis have bad compliance and do not achieve ideal facial nerve function recovery. Therefore, this study aimed to investigate whether modified facial paralysis rehabilitation nursing improves the effectiveness of rehabilitation of facial paralysis after VS surgery by analysing the clinical data of patients.MethodsWe screened the patients with facial paralysis after VS surgery from December 2019 to May 2023. The patients were divided into the conventional and modified groups based on the different nursing programs (conventional vs. modified facial paralysis rehabilitation nursing program) to compare the differences in facial nerve function, quality of life of patients, and compliance of rehabilitation between the two groups.ResultsWe analysed 128 patients with facial paralysis after VS surgery who met the inclusion and exclusion criteria; 65 and 63 patients in the conventional and modified group, respectively. The number of patients in the modified group with House-Brackmann grade changes >0 in facial nerve function was significantly higher than that in the conventional group 3 months after surgery (82.5 % vs 63.1 %, p = 0.01). Except for the lacrimal control score, the mean scores of the Chinese version of the FaCE scale were significantly higher in the modified group than those in the conventional group at 1 and 3 months postoperatively.ConclusionsThe modified facial paralysis rehabilitation nursing, i.e., integrated use of facial expressive muscle exercises and facial massage with video-assisted education, substantially improved the facial nerve function, quality of life, and compliance of rehabilitation nursing of patients with facial paralysis after VS surgery.

Dataset Information

A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?

Publications

A Telerehabilitation Approach to Chronic Facial Paralysis in the COVID-19 Pandemic Scenario: What Role for Electromyography Assessment?

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