A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies

Objective. To perform a preliminary test of a new rehabilitation treatment (FIT-SAT), based on mirror mechanisms, for gracile muscles after smile surgery. Method. A pre- and postsurgery longitudinal design was adopted to study the efficacy of FIT-SAT. Four patients with bilateral facial nerve paraly...

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Main Authors: Elisa De Stefani, Anna Barbot, Chiara Bertolini, Mauro Belluardo, Gioacchino Garofalo, Nicola Bruno, Bernardo Bianchi, Andrea Ferri, Pier Francesco Ferrari
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Neural Plasticity
Online Access:http://dx.doi.org/10.1155/2021/8890541
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author Elisa De Stefani
Anna Barbot
Chiara Bertolini
Mauro Belluardo
Gioacchino Garofalo
Nicola Bruno
Bernardo Bianchi
Andrea Ferri
Pier Francesco Ferrari
author_facet Elisa De Stefani
Anna Barbot
Chiara Bertolini
Mauro Belluardo
Gioacchino Garofalo
Nicola Bruno
Bernardo Bianchi
Andrea Ferri
Pier Francesco Ferrari
author_sort Elisa De Stefani
collection DOAJ
description Objective. To perform a preliminary test of a new rehabilitation treatment (FIT-SAT), based on mirror mechanisms, for gracile muscles after smile surgery. Method. A pre- and postsurgery longitudinal design was adopted to study the efficacy of FIT-SAT. Four patients with bilateral facial nerve paralysis (Moebius syndrome) were included. They underwent two surgeries with free muscle transfers, one year apart from each other. The side of the face first operated on was rehabilitated with the traditional treatment, while the second side was rehabilitated with FIT-SAT. The FIT-SAT treatment includes video clips of an actor performing a unilateral or a bilateral smile to be imitated (FIT condition). In addition to this, while smiling, the participants close their hand in order to exploit the overlapped cortical motor representation of the hand and the mouth, which may facilitate the synergistic activity of the two effectors during the early phases of recruitment of the transplanted muscles (SAT). The treatment was also aimed at avoiding undesired movements such as teeth grinding. Discussion. Results support FIT-SAT as a viable alternative for smile rehabilitation after free muscle transfer. We propose that the treatment potentiates the effect of smile observation by activating the same neural structures responsible for the execution of the smile and therefore by facilitating its production. Closing of the hand induces cortical recruitment of hand motor neurons, recruiting the transplanted muscles, and reducing the risk of associating other unwanted movements such as teeth clenching to the smile movements.
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spelling doaj-art-dbb7923b0c864034af3a998f2cd9217e2025-08-20T02:21:30ZengWileyNeural Plasticity2090-59041687-54432021-01-01202110.1155/2021/88905418890541A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor SynergiesElisa De Stefani0Anna Barbot1Chiara Bertolini2Mauro Belluardo3Gioacchino Garofalo4Nicola Bruno5Bernardo Bianchi6Andrea Ferri7Pier Francesco Ferrari8Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, ItalyUnit of Audiology and Pediatric Otorhinolaryngology, University Hospital of Parma, ItalyUnit of Audiology and Pediatric Otorhinolaryngology, University Hospital of Parma, ItalyUnit of Neuroscience, Department of Medicine and Surgery, University of Parma, ItalyDepartment of Humanities, Social Sciences and Cultural Industries, University of Parma, ItalyUnit of Neuroscience, Department of Medicine and Surgery, University of Parma, ItalyMaxillo-Facial Surgery Operative Unit, Head and Neck Department, University of Parma, ItalyMaxillo-Facial Surgery Operative Unit, Head and Neck Department, University of Parma, ItalyUnit of Neuroscience, Department of Medicine and Surgery, University of Parma, ItalyObjective. To perform a preliminary test of a new rehabilitation treatment (FIT-SAT), based on mirror mechanisms, for gracile muscles after smile surgery. Method. A pre- and postsurgery longitudinal design was adopted to study the efficacy of FIT-SAT. Four patients with bilateral facial nerve paralysis (Moebius syndrome) were included. They underwent two surgeries with free muscle transfers, one year apart from each other. The side of the face first operated on was rehabilitated with the traditional treatment, while the second side was rehabilitated with FIT-SAT. The FIT-SAT treatment includes video clips of an actor performing a unilateral or a bilateral smile to be imitated (FIT condition). In addition to this, while smiling, the participants close their hand in order to exploit the overlapped cortical motor representation of the hand and the mouth, which may facilitate the synergistic activity of the two effectors during the early phases of recruitment of the transplanted muscles (SAT). The treatment was also aimed at avoiding undesired movements such as teeth grinding. Discussion. Results support FIT-SAT as a viable alternative for smile rehabilitation after free muscle transfer. We propose that the treatment potentiates the effect of smile observation by activating the same neural structures responsible for the execution of the smile and therefore by facilitating its production. Closing of the hand induces cortical recruitment of hand motor neurons, recruiting the transplanted muscles, and reducing the risk of associating other unwanted movements such as teeth clenching to the smile movements.http://dx.doi.org/10.1155/2021/8890541
spellingShingle Elisa De Stefani
Anna Barbot
Chiara Bertolini
Mauro Belluardo
Gioacchino Garofalo
Nicola Bruno
Bernardo Bianchi
Andrea Ferri
Pier Francesco Ferrari
A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
Neural Plasticity
title A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
title_full A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
title_fullStr A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
title_full_unstemmed A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
title_short A New Neurorehabilitative Postsurgery Intervention for Facial Palsy Based on Smile Observation and Hand-Mouth Motor Synergies
title_sort new neurorehabilitative postsurgery intervention for facial palsy based on smile observation and hand mouth motor synergies
url http://dx.doi.org/10.1155/2021/8890541
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