Photobiomodulation in the Treatment of Bell's Palsy: An Integrative Review / Fotobiomodulación en el Tratamiento de la Parálisis de Bell: una Revisión Integradora

Bell's palsy is defined as a lower motor neuron palsy that develops from a non-suppurative inflammation of the facial nerve at the stylomastoid foramen. The objective of this integrative review was to determine the effects of photobiomodulation as a therapeutic method for Bell's palsy. This qualitative study provided a broader understanding of the subject studied. Searches for articles were carried out in PubMed databases via Medline, LILACS, IBES, Scopus, Web of Science, Embase, and CENTRAL using MeSH and DeCS descriptors to determine the search terms. A total of 143 articles were found. After applying the inclusion and exclusion criteria, 7 articles were included. Therefore, it can be concluded that the application of low-level laser in the treatment of Bell's palsy is effective since the studies indicated significant and relevant improvements for the recovery of these patients when associating the laser with other types of treatments.

La parálisis de Bell se define como una parálisis de la neurona motora inferior que se desarrolla a partir de una inflamación no supurativa del nervio facial en el agujero estilomastoideo. El objetivo de esta revisión integradora fue determinar los efectos de la fotobiomodulación como método terapéutico para la parálisis de Bell. Este estudio cualitativo proporcionó una comprensión más amplia del tema estudiado. Las búsquedas de artículos se realizaron en las bases de datos PubMed a través de Medline, LILACS, IBES, Scopus, Web of Science, Embase y CENTRAL utilizando los descriptores MeSH y DeCS para determinar los términos de búsqueda. Se encontraron un total de 143 artículos. Después de aplicar los criterios de inclusión y exclusión, se incluyeron 7 artículos. Por tanto, se puede concluir que la aplicación de láser de baja intensidad en el tratamiento de la parálisis de Bell es eficaz debido a que los estudios indicaron mejoras significativas y relevantes para la recuperación de estos pacientes al asociar el láser a otro tipo de tratamientos.

Psychometric properties of the Brazilian version of the Sunnybrook Facial Grading System / Propriedades psicométricas da versão brasileira do Sunnybrook Facial Grading System

Abstract Introduction: The Sunnybrook Facial Grading System (SFGS) is a scale to evaluate facial function in three domains, namely resting symmetry, voluntary move-ments, and synkinesis. It is commonly used in scientific research and clinical practice to assess and monitor people with facial paralysis. Objective: To translate and cross-culturally adapt the SFGS, develop a version for the Brazilian population (SFGS - Brazil) and analyze its psychometric properties, including validity, interrater reliability and responsiveness. Methods: A multidisciplinary panel translated and adapted the SFGS into Brazilian Portuguese, creating the SFGS-Brazil version. Next, content validation was carried out by a panel of four physical therapists with clinical experience in caring for people with facial paralysis, in addition to interrater reliability and scale responsiveness after physical therapy intervention. Results: For SFGD validation, committee agreement rate and the content validity index were greater than 90%. Agreement (interrater reliability) was excellent for most items and overall (intraclass correlation coefficient = 0.99; p < 0.000) and the scale proved to be responsive, indicating post-intervention improvement (t = 10.66; p = 0.000). Conclusion: The domains and items of the SFGS-Brazil are conceptually equivalent to those of the original version, and the instrument displays adequate psychometric properties, including validity, agreement and responsiveness. The SFGS-Brazil is suitable for the Brazilian population and can be used in scientific studies and clinical practice.

Resumo Introdução: O Sunnybrook Facial Grading System (SFGS) é uma escala para avaliar a função facial em três domínios, incluindo simetria em repouso, movimentos voluntários e sincinesias. Essa escala é comumente utilizada em pesquisas científicas e na prática clínica para a avaliação e acompanhamento de pessoas com paralisia facial. Objetivo: Traduzir e adaptar transculturalmente o SFGS, elaborar a versão para a população brasileira (SFGS-Brasil) e analisar suas propriedades psicométricas, incluindo validade, confiabilidade interexaminadores e responsividade. Métodos: Um comitê multidisciplinar traduziu e adaptou o SFGS para o português do Brasil, gerando a versão SFGS-Brasil. Após esta fase, realizou-se a validação de conteúdo por um comitê de quatro fisioterapeutas com experiência clínica em atendimento de pessoas com paralisia facial, além da confiabilidade interexaminadores e a responsividade da escala após intervenção fisioterapêutica. Resultados: Para a validação do SFGS, a taxa de concordância do comitê total e o índice de validade do conteúdo mostraram-se maiores que 90%. A concordância (confiabilidade interexaminadores) mostrou-se excelente para maioria dos itens e para o total (coeficiente de correlação intraclasse = 0,99; p < 0,000), e o instrumento mostrou-se responsível, podendo-se identitificar melhora segundo o SFGS-Brasil após a intervenção (t = 10,66; p = 0,000). Conclusão: O SFGS-Brasil possui equivalência conceitual dos domínios e itens à versão original, possui propriedades psicométricas adequadas, incluindo validade, concordância e responsividade. O SFGS-Brasil é adequado para a população brasileira, podendo ser usado em estudos científicos e na prática clínica.

Facial Nerve Palsy: A Report on the Prevalence, Intervention and Outcome in a Tertiary Hospital in the South- South Region of Nigeria

Background: The facial nerve is an important and complex nerve whose course predisposes to various affectations. Most work has been focused mainly on Bell’s palsy and not much has been done on other aspects of the nerve affectation.Aim:To determine the prevalence of facial nerve palsy, possible aetiology and the treatment outcome in our environment.Patients and Methods: This isa retrospective study of all patients diagnosed with facial nerve palsy seen in the ENT Surgery department and the Physiotherapy department of Teaching hospital university of Port Harcourt within the period of January 2015 to January 2018. The patients` case files, clinic and ward registers were the source of data. The patients` demographics, presenting complaints, side affected, type of lesion, aetiology, intervention and outcome, were sought from these records. Data was analyzed with IBM SPSS version 20 and results presented in statistical tables.Results:There were altogether 76 patients seen within the period under study. There were more females than males 57.9% and 42.1% with a ratio of 1.4:1. Age ranged from 20-83 years with a mean age of 48.9+/-14.1 years. Highest incidence was among the age range 50-59 years Commonest presenting complaint was facial weakness-80.3% outright facial deviation was seen in 17.1%. The left side was more affected and upper motor neuron lesion was the commonest type of facial nerve palsy encountered 80.3%. Hypertension was the commonest aetiology. About 69.7% had a good response to management. The outcome of treatment in relation to the type was statistically significant.Conclusion:Facial nerve paralysis is not rare in this region and hypertension is a common aetiology with UMNL as the commonest type. Majority recover after the paralysis with steroid treatment.

Evaluación clínica y funcional de pacientes con parálisis de Bell tratados con láser / Clinical and functional evaluation of patients with Bell´s palsy treated with laser

Se realizó una intervención terapéutica, multicéntrica, de 88 pacientes con parálisis de Bell tratados con láser en los servicios de rehabilitación de los policlínicos "Julián Grimau", "Ramón López Peña" y "28 de Septiembre" de Santiago de Cuba, desde enero de 2013 hasta diciembre 2014, para determinar la eficacia de este proceder según la evolución clínica y funcional de los afectados. La muestra aleatoria fue dividida en 2 grupos con 44 integrantes cada uno: los del grupo control recibieron magnetoterapia; los del grupo de estudio, láser en puntos locales y a distancia, para lo cual se empleó la estadística descriptiva, así como las pruebas T de Student, Mann Whitney, Ji al cuadrado de homogeneidad y de Pearson. Predominaron las féminas vinculadas laboralmente (76,1%) y las edades comprendidas entre 25 y 34 años (46,6%). En los tratados con láser prevalecieron los tiempos rápidos de respuesta con evolución satisfactoria y no hubo complicaciones. Se concluye que el láser de baja potencia es una modalidad no invasiva y eficaz, capaz de modificar parámetros clínicos y funcionales en corto tiempo, de modo que constituye una opción terapéutica válida.

A multicenter therapeutical intervention of 88 patients with Bell´s palsy treated with laser in the rehabilitation services of "Julián Grimau", "Ramón López Peña" and "28 de Septiembre" polyclinics in Santiago de Cuba, was carried out from January, 2013 to December, 2014, to determine the effectiveness of this procedure according to the functional and clinical course from those affected. The random sample was divided in 2 groups with 44 members each: those from the control group received magnetotherapy; those from the study group, laser in local points and laser at distance, for which the descriptive statistic was used, as well as Student´s t, Mann Whitney, homogeneity chi-squared and Pearson tests. There was a prevalence of working women (76.1%) and the ages between 25 and 34 (46.6%). In those treated with laser the response quick times prevailed, with satisfactory clinical course and there were no complications. As a conclusion: low power laser is a non invasive and effective modality, able to modify clinical and functional parameters in short time, so it constitutes a valid therapeutic option.