A comparison of conceptions concerning rehabilitation following facial nerve injuries in children

Wojciech Kiebzak, Czesław Szmigiel, Zbigniew Śliwiński, Marek Zięba

Wojciech Kiebzak, Czesław Szmigiel, Zbigniew Śliwiński, Marek Zięba – A comparison of conceptions concerning rehabilitation following facial nerve injuries in children. Fizjoterapia Polska 2006; 6(1); 22-26

Abstract

Background. The authors studied the dynamics of the improvement of facial muscle motor function in children with peripheral facial nerve paresis. The objective of the present investigations is the comparison of the therapeutic effect achieved in children with peripheral facial nerve paresis using neurophysiological stimulation with the effects obtained with laser biostimulation and electrostimulation. Material and methods. 51 children with peripheral damage of the facial nerve symptoms were examined. To assess the function of the above muscles, a „0” to „3” score scale developed by Pietruski was used. The children were divided into three groups: Group 1 (N=17) received laser biostimulation (4-6 J/cm2, 3-4 procedures per week, 20 procedures per series, a CTL-1106 MX 830 nm, 400 mW laser manufactured by Laser Instruments); Group 2 children (N=17) were subjected to a therapy that combined elements of three neurophysiological methods: the reflex therapy developed by Vojta, method PNF and elements of the Castillo-Morales method; Group 3 patients (N=17) were subjected to impulse electrostimulation (an Pulsotronic ST-5D electrostimulator manufactured, with impulse duration of 80 – 180 ms, frequency of 1 – 4 Hz and amplitude of 20 – 60 mA). All the children were subjected to passive, passive-active and active motor exercises of the facial muscles and delicate massage. Results. In the first examination at the beginning of therapy, mimical muscle function was poor and the score low: in Group 1 – 4.2, Group 2 – 4.8 and in Group 3 – 6.2. In consequence of various types of stimulatory treatment, the mean time of muscle function restoration in the investigated patients was as follows: Group 1 – 33.4 days, Group 2 – 22,9 days and Group 3 – 41.7 days. Conclusion. Reflex forms of therapy using the methods of PNF, Castillo-Morales and Vojta constitute an effective and commonly available rehabilitative treatment modality in peripheral damage to the facial nerve. Effectiveness of electrostimulation turn out to be very low that is why using this method in peripheral facial nerve paralysis treatment isn’t crucial.

Key words:
paresis nervi facialis, methods of physiotherapy, facial muscle
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