title: Facial motor function monitored by hand held calipers versus computer-assisted photography.
abstract: BACKGROUND
  It is essential to have easy to use, reliable tools to assess and compare facial function for clinical records, audit and research purposes. In this study, two different techniques were examined, Hand held calipers (HHC, as described by Burres), and computerised analysis of digital photographs (CAOP) using Adobe Photoshop 7. The aim of this study was to determine the level of agreement between two operators (physiotherapist) using HHC to measure the distance between facial landmarks, and the level of agreement between two operators (photographers) using CAOP to measure the same distance between facial landmarks and explore whether these two techniques can be used interchangeably.
  
  
  METHODS
  The distance between facial landmarks was measured, with the face at rest and following four standard facial expressions. All measurements were repeated one week later to permit inter/intra-rater reliability over time to be assessed. Nine female volunteers with normal facial function were included in the study.
  
  
  RESULTS
  The intra- and inter-rater agreement using CAOP was high whereas the agreement was low when using HHC.
  
  
  CONCLUSIONS
  Hand held calipers proved to be an unreliable technique for monitoring facial function. However digital photography when combined with Adobe Photoshop 7 provides a highly reliable objective measurement tool. It was simple to use, low cost and suitable for use in a clinical environment.
authors.affiliation: Department of Physiotherapy, Wessex Neurological Centre, Southampton, UK. Lorraine.Clapham@suht.swest.nhs.uk
authors.forename: L
authors.initials: L
authors.lastname: Clapham
authors.forename: S
authors.initials: S
authors.lastname: Bottoms
authors.forename: R
authors.initials: R
authors.lastname: Mehta
authors.forename: A
authors.initials: A
authors.lastname: Davis
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000295:instrumentation / Q000379:methods*; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods*; D004185:Disability Evaluation; D005152:Facial Muscles / Q000294:innervation* / Q000503:physiopathology*; D005155:Facial Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods; D015588:Observer Variation; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010291:Paresis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010781:Photography / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D012984:Software