Efficacy of Neuro-Proprioceptive facial Rehabilitation method (NPR

Efficacy of Neuro-Proprioceptive facial Rehabilitation method (NPR) for the
lasting reduction of Bell’s palsy sequelae in the later stages of the recovery
Authors: Alex Pashov, Elena Pashova
Crystal Touch Bell’s Palsy clinic, Rotterdam, The Netherlands
Background.
If a complete spontaneous recovery from Bell’s palsy (BP) does not occur within 6-9
months, the patients are confronted with sustained BP sequelae: facial weakness
and asymmetry, synkineses, facial muscle contractures and chronic facial pains.
Patient M. (38 years) from Enschede, The Netherlands
Congenital facial palsy due to birth injury.
difficulty with articulation, permanent facial
Intake-meeting (Nov 2013).
Bell’s phenomenon, deep paresis of the
pains above the eyebrow.
facial muscles on the affected side (see
pictures of the neurological tests), heavy
Result after 3 months of NPR program
(4 treatments).
These manifestations have a dramatic effect on patient’s psycho-emotional state and
considerably reduce the quality of life.
Objective.
Research the efficacy of non-invasive Neuro-Proprioceptive facial Rehabilitation
method (NPR) for achieving a lasting reduction of BP sequelae in the later stages
asymmetry of the facial movements,
of recovery (more than 2 years).
Patients and method.
A group of 21 patients with BP sequelae (15 female and 6 male). Mean age: 47.1
years (range 19-66), mean number of years since BP: 9.9 (range 2-25). Initial
condition according to House-Brackman Scale: grade IV – 6 patients, grade III - 15
patients. 12 patients reported chronic facial pain. Depending on the severity of BP
sequelae, all patients had been treated during 4 to 6 months using NPR method.
Number of treatments: 4-6. Rehabilitation programs consisted of regular treatment
sessions at Crystal Touch clinic every 4-5 weeks, and included daily application of
special NPR techni`ques by the patients themselves. During each treatment in the
The only
specialized
Bell’s palsy clinic
in Europe
clinic patients gradually learned NPR techniques for daily use at home between the
sessions. Upon completion of the rehabilitation program, House-Brackman Grades
improved from IV to III in 6 patients, from III to II in 15 patients. None reported
facial pain. Check-up visits after 6 months showed no decrease in achieved
improvements.
Conclusions.
Application of the neuro-proprioceptive facial rehabilitation method (NPR) for the
PATIENT M. (38 YEARS). CONGENITAL FACIAL PALSY DUE
TO BIRTH INJURY. NEUROLOGICAL TESTS DURING THE
INTAKE-MEETING.
treatment of BP patients produces measurable and lasting reduction of BP sequelae
and improves the quality of life, irrespective of patient’s age, sex or time passed
since Bell’s palsy.
Brings back
your smile!
EXAMPLES OF SYNKINESES
(BELL’S PALSY SEQUELAE)
Patient R. (47 years) from Rotterdam, The Netherlands
Non-recovered Bel’s pasly since 2005.
Intake-meeting (June 2012).
Multiple synkineses, rigidity of facial
muscles, facial asymmetry. Lack of selfconfidence
Result after 9 weeks of NPR
program (2 treatments).
Denis (3 years) from Moscow, Russia
Congenital ptosis of the left upper eyelid
and left mouth corner.
As a participant in our humanitarian project
“Crystal Fridays”, Denis was treated in
2012-2013 in Moscow.
Result after 7 months on NPR program
(5 treatments): a substantial reduction of the
eyelid ptosis, elimination of the mouth
corner ptosis, the left eyesight improved
from +0.4 to +0.8. The planned operation of
the left eyelid correction had been cancelled
as unnecessary.
Crystal Touch
Bell’s Palsy clinic
SYNKINESES CAN BE PERMANENTLY ELIMINATED
1
WHAT IS NEW IN THE CRYSTAL TOUCH
APPROACH TO THE CAUSES AND
FORMING MECHANISMS OF BELL’S
PALSY SEQUELAE?
Synkineses are usually not addressed at all. They are
believed to develop as a result of an aberrant regeneration
(wrong regrowth) of the nerve fibers during the regeneration
process.
Usual complications (sequelae) of Bell’s palsy are:
contractures of the facial muscles, pathological synkineses,
weakness of facial muscles and facial asymmetry.
Crystal Touch NPR method approaches pathological
synkineses as manifestations of pathological facial
movement stereotypes that patient gradually develops
Contractures are often accompanied by chronic pains of
facial muscles and headaches.
during the first 4-9 months after the onset. From our point of
view, these manifestations are not related in any way to the
presumable aberrant regeneration of facial nerve which
usually receives all the blame for pathological synkineses.
The traditional remedy for facial contractures is Botox
injections. However, after several repeated injections the
efficiency of the therapy usually decreases.
Crystal Touch NPR method addresses the root causes of
contractures. Its application helps to normalize the brain
signal levels for facial muscles’ tone, “teaches” the
contractured facial muscles to relax, and induces neuronal
regeneration of the facial nerve. As a result, the contractures
and pains are gradually reduced, eventually eliminated and
the face becomes more symmetrical.
The entire NPR program is aimed at:
• Neuronal regeneration of the facial nerve;
• Restoration of the symmetry of brain signals to both sides
of the face;
• Developing skills of conscious relaxation of the facial
muscles;
• Training of a finely differentiated control of facial muscles,
which is essential for overcoming synkineses;
• Forming the correct movement stereotype of facial
muscles in order to restore the symmetry of the facial
movements;
• Training and restoration of normal symmetrical tone of
facial muscles.
3
WHAT IS THE EFFECT OF THE NEUROPROPRICEPTIVE REHABILITATION
TREATMENTS?
Crystal Touch Rehabilitation program consists of regular
working sessions in the clinic every 4-5 weeks and patient’s
own daily work at home in between. Special NPR techniques
for the self-progressing the patient learns gradually during
the working sessions.
Crystal Touch NPR treatment stimulates several aspects:
• regeneration of facial nerve fibers
• normalization of facial muscles’ tonus on the affected side
• symmetrization of the tonic signals from the brain to both
sides of the face
• proper balance between relaxation and contraction of
muscle fibers on the affected side of the face
• blood and lymph circulation in the face tissues
• improves the sense of facial proprioception
Each NPR working session takes 2 hours and includes several
modules, one of which is the treatment using a working
apparatus. The treatment is painless and feels comfortable.
Other modules of the working session are carried out without
the use of special equipment.
Based on our experience, some improvements the patient
can already feel after the first working session. As we move
through the program and learn new rehabilitation techniques
for self-application, the improvements become more visible
and lasting.
2
HOW DOES NPR PROGRAM LOOK LIKE?
www.Crystal-Touch.nl • [email protected]
Rotterdam, The Netherlands
4
IS THE POSITIVE RESULT GUARANTEED
AFTER THE COMPLETION OF THE
PROGRAM? DOES ONE NEED ANY
“SUPPORT” SESSIONS?
All our Bell’s palsy and congenital facial palsy patients who
followed the Crystal Touch NPR program have achieved
significant improvements.
Basically, after the completion of the program there is no
need for repeated courses. Some of our patients, however,
prefer to follow the “maintenance” sessions every 6 months.
5
DO YOU USE BOTULINUM TOXIN IN NPR
PROGRAMS?
• We do not use any injections of botulinum toxin,
hyaluronic acid or any other fillers or neurotoxins.
• We do not use any tools from the arsenal of plastic
surgery. Lifting, thread, implants, etc. are not used in NPR
method.
• We do not use electromyostimulation, with currents of
high intensity and painful treatments.
6
WHAT CAN AND WHAT CANNOT BE
EXPECTED FROM THE APPLICATION OF
NPR METHOD?
100% recovery “as it used to be” can hardly be expected. In
theory this is possible, but to achieve these results, the
duration of the rehabilitation program will be excessively
long (up to a year, sometimes more).
One can expect the following improvements from the
application of Crystal Touch NPR method:
• decreased or resolved contractures on the affected side;
• symmetrization of the facial movements to the
aesthetically acceptable level;
• reduction in manifestation degree of synkineses to the
aesthetically acceptable level;
• significant reduction or elimination of pains on the
affected side of the face (if applicable);
• overall improvements in the appearance, skin color, face
contour and facial expression.

Download Report