ArticleFrontiers in neurology2026
Short-term clinical outcomes associated with a standardized multicomponent facial rehabilitation program in acute or early-subacute peripheral facial nerve palsy: a prospective controlled cohort study.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Peripheral facial nerve palsy can impair facial symmetry, eye closure, oral competence, communication, and quality of life. Although spontaneous recovery is common, some patients experience persistent functional and psychosocial impairment. Evidence for structured adjunctive rehabilitation during the acute and early-subacute phases remains limited. We examined whether a standardized multicomponent facial rehabilitation program, added to usual care, was associated with more favorable short-term outcomes than usual care alone. Methods: This prospective controlled cohort study included 160 adults with acute or early-subacute unilateral peripheral facial nerve palsy. Eighty-four participants received usual care plus a standardized program comprising facial acupuncture, therapist-assisted facial massage, supervised facial movement training, and daily home exercises over 12 supervised sessions during 6 weeks; 76 received usual care alone. Allocation was non-randomized and based on clinician recommendation and patient preference, and outcome assessors were not blinded. The primary outcome was Week 12 Sunnybrook Facial Grading System (SFGS) total score. Secondary outcomes included SFGS subscales, House-Brackmann outcomes, Facial Disability Index (FDI), Facial Clinimetric Evaluation (FaCE), pain, and stiffness. Adjusted between-group differences were estimated using multivariable regression controlling for baseline values and prespecified clinical covariates. Results: SFGS scores improved in both groups, with greater observed improvement in participants receiving the multicomponent program. At Week 12, mean SFGS scores were 82.5 ± 11.8 versus 69.5 ± 11.5, with mean improvements of 46.7 ± 12.6 versus 33.2 ± 12.5 points. The adjusted between-group difference was 12.7 points (95% CI, 8.8-16.7; Conclusion: The multicomponent rehabilitation program was associated with more favorable short-term clinician-rated and patient-reported outcomes. Given the non-randomized allocation and unblinded assessment, these findings are hypothesis-generating and require confirmation in randomized, blinded, attention-matched trials.
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