Emotional Training via Telerehabilitation After Surgical Treatment for Facial Palsy: Prospective, Assessor-Blinded, 2-Arm Pilot Cohort Study
Bibliographic record
Abstract
Background: Peripheral facial nerve palsy is a debilitating condition that may necessitate surgical intervention. Although motor rehabilitation is considered essential, the most effective approach has not yet been determined. Objective: This study aimed to evaluate the feasibility and effectiveness of emotional training, a novel telerehabilitation-based treatment, on motor, functional, and psychological outcomes in patients with unilateral facial palsy following triple innervation surgery. Methods: A prospective, assessor-blinded, 2-arm pilot cohort study was conducted at the rehabilitation unit at University Hospital San Paolo, Milan, Italy, from January to October 2024. Participants (N=16) received 1 treatment session every 2 weeks over 20 weeks, each lasting 45 minutes, according to standard clinical procedures in place at the rehabilitation unit. Participants were nonrandomly assigned to either an in-person group (n=8) or an online group (ie, telerehabilitation; n=8) based on their ability to attend in-person sessions. The primary outcomes assessed at baseline (T0) and after treatment (T1) included facial symmetry (Sunnybrook Facial Grading System; SFGS), facial disability (Facial Disability Index; FDI), and anxiety levels (Beck Anxiety Inventory). Results: Statistical analysis revealed significant improvements at T1 for both groups in the FDI social and well-being function subscale, Beck Anxiety Inventory, SFGS resting symmetry score, SFGS symmetry of voluntary movement score, SFGS composite score, SFGS with bilateral masseter contraction symmetry of voluntary movement score, and SFGS with bilateral masseter contraction composite score (P<.001 for all). Only the FDI physical function subscale showed a differential improvement at T1 for the in-person group treatment (ANOVA for time × treatment: F1=14.356; P=.002; Holm-Bonferroni post hoc test: P<.001). Finally, a strong positive correlation was observed between the time elapsed from surgery to rehabilitation and SFGS composite score improvement at T1 (r=0.94; P=.005). Conclusions: These results suggest that the online emotional training protocol is as feasible and effective as the in-person emotional training protocol in improving facial motor function, reducing anxiety, and enhancing facial expression spontaneity in patients who had undergone surgery for peripheral facial palsy. These findings support the validity of telerehabilitation approaches as a feasible, accessible, and sustainable alternative to conventional in-person therapy for facial nerve recovery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".