Effect of an Intensified Combined Electromyography and Visual Feedback Training on Facial Grading in Patients With Post-paralytic Facial Synkinesis.
Gerd F Volk, Benjamin Roediger, Katharina Geißler and 4 others
PMID 36188835WHAT IT FOUND
Ten days of intensive EMG and visual feedback training improved facial symmetry and reduced synkinesis in 54 patients.
Gains held stable at six-month follow-up, but the lack of a control group means natural recovery cannot be ruled out.
Key findings
01Facial grading did not change significantly during the waiting period before training started.
02The 10-day training significantly improved facial symmetry and decreased synkinetic activity, with strong effect sizes on the Sunnybrook and FNGS 2.0 scales.
03Improvements remained stable at the six-month follow-up, with no further deterioration or gain.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was observational with no control group, so it is impossible to distinguish the training effect from natural recovery or regression to the mean, although the waiting period analysis showed no change prior to training. Facial grading was performed by a single rater, introducing potential subjectivity and lack of inter-rater reliability. The study relied on retrospective chart reviews and did not include patient-reported outcome measures regarding quality of life. The specific contribution of the EMG biofeedback versus the visual mirror feedback or the constraint-induced elements cannot be separated due to the combined nature of the intervention.
Declared interests
The authors declare no conflicts of interest. Funding was provided by a Deutsche Forschungsgemeinschaft (DFG) grant to one of the authors.
The easy way to misread this
Do not interpret the 85% improvement rate as proof of efficacy against a control. Without a randomized comparison group, these gains could reflect natural history, placebo effect, or other concurrent factors, and the study design cannot rule these out.