Facial nerve paralysis is a common condition with multiple potential causes. The most common cause of facial nerve paralysis is Bell's palsy. Facial retraining exercises are designed to retrain facial muscles for movement. They act to normalise facial muscular tone, inhibit undesired movements and increase symmetrical movement patterns of the face. These exercises are based on the idea that neurons are in a constant state of growth and regression. Facial training can be very successful for patients suffering from facial paralysis, resulting in an average 60 to 70 per cent decrease in synkinesis after seven months.
Mirror Visual Feedback
Visual feedback with the use of a mirror is the most common type of facial retraining exercise that can be completed both at home and at a clinic. This exercise uses a mirror to change the patient's motor facial pattern and reinforce proper facial responses. A patient, using a mirror, will assist facial movement or expression with his fingers, such as moving his mouth into a smile. Then the patient will slowly release his finger pressure and attempt to hold the smile. Another common mirror visual feedback exercise is speaking, especially using words that include the letters M and B, while keeping your eyes open.
Electromyograph Training Exercises
An electromyograph (EMG) instrument converts electrical activity associated with skeletal or muscle movement into a visual or auditory record. Surface EMG training begins by attaching electrodes to the patient's skin over the monitored muscles. The patient has the opportunity to hear or see the feedback immediately and can adjust her facial movement until the desired facial pattern is achieved. This teaches patients to control muscle tension in their face. These exercises can including smiling, eyebrow raising and lip puckering.
Exercises in symmetry assist facial paralysis patients in producing appropriate facial expressions. In symmetry exercises, patients are taught about the symmetry of movements to reinforce normal physiological responses. Generally, these exercises entail limiting the movement on the dominant, less-affected side of the face. If that side of the face is allowed to dominate, movement on the paralysed side may diminish and not recover. One such exercise is to raise both eyebrows at the same time and to hold them in that position for at least 15 seconds. Smiling exercises also focus on symmetry.
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