{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:42:57Z","timestamp":1770745377883,"version":"3.49.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic non-flaccid peripheral facial palsy is frequently associated with synkinesis, residual motor deficits, and reduced quality of life. Evidence-based, standardized rehabilitation protocols remain limited. This study examined the effect of an intensive two-week electromyography (EMG) and video-based biofeedback program on changes in physical and psychosocial patient-reported outcomes in patients with chronic facial palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients with chronic non-flaccid facial palsy, either with synkinesis or residual hypotonia, who completed a two-week EMG and video-biofeedback program between 2020 and 2023. The intervention targeted synkinetic co-activation and improved voluntary motor control in hypotonia. Data consisted of routine documentation and patient-reported outcome measures (PROMs) collected at baseline 6\u202fmonths before therapy (T1), therapy initiation (T2), therapy conclusion (T3), and six-month follow-up (T4). PROMs included the Facial Disability Index (FDI), Facial Clinimetric Evaluation Scale (FaCE), Short Form-36 Health Survey (SF-36), and Beck Depression Inventory (BDI). Analyses used repeated-measures ANOVA and segmented regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 175 patients were included. Significant improvements were observed across all PROMs. From T2 to T3, FDI total score increased by 5.24 points (95% CI 3.90 to 6.60) and FaCE total score by 9.86 points (95% CI 7.80 to 11.92). SF-36 showed improvements in social functioning (+4.67 points, 95% CI 2.19 to 7.15) and emotional well-being (+4.32 points, 95% CI 2.60 to 6.00). BDI decreased by 3.29 points (95% CI \u20134.63 to \u22121.96). Segmented regression indicated small but significant pre-therapy improvements from T1 to T2. At follow-up, outcomes remained above baseline, with FDI total score rising from 65.64\u202f\u00b1\u202f14.88 at T1 to 75.31\u202f\u00b1\u202f13.83 at T4 and FaCE total score from 53.89\u202f\u00b1\u202f16.54 to 63.72\u202f\u00b1\u202f17.10 (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Older age was associated with lower FDI values; male gender was associated with higher FDI and FaCE and lower BDI scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participation in an intensive EMG- and video-based biofeedback program was associated with clinically relevant and sustained improvements in facial function, quality of life, and psychosocial well-being in patients with chronic non-flaccid facial palsy. Age- and gender-related differences highlight the importance of individualized rehabilitation approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1759106","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T05:21:54Z","timestamp":1770700914000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective cohort study evaluating patient-reported outcomes following intensive electromyography and video-biofeedback training in chronic non-flaccid facial palsy"],"prefix":"10.3389","volume":"17","author":[{"given":"Annika","family":"Kunzler","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Hesse","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Gei\u00dfler","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]},{"name":"Center for Rare Diseases, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Ballmaier","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]},{"name":"Center for Rare Diseases, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene","family":"Kreysa","sequence":"additional","affiliation":[{"name":"Department for General Psychology and Cognitive Neuroscience, Friedrich Schiller University","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Dobel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]},{"name":"Center for Rare Diseases, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Saal","sequence":"additional","affiliation":[{"name":"Department of Health and Nursing, Ernst Abbe University of Applied Sciences Jena","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orlando","family":"Guntinas-Lichius","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]},{"name":"Center for Rare Diseases, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd Fabian","family":"Volk","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital","place":["Jena, Germany"]},{"name":"Facial-Nerve-Center, Jena University Hospital","place":["Jena, Germany"]},{"name":"Center for Rare Diseases, Jena University Hospital","place":["Jena, 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