title: Rehabilitation of hypomimia in Parkinson's disease: a feasibility study of two different approaches.
abstract: Parkinson's disease (PD) patients frequently have an impairment of facial expression both in voluntary and spontaneous emotional expression. Aim of this study was to evaluate the feasibility of a rehabilitation program for hypomimia in patients with PD, comparing two different approaches. Thirty-six patients with PD were included: 20 patients received a rehabilitative intervention for hypomimia either with a DVD showing exercises focused on facial muscles (PD-group-A) or with a therapist-guided facial rehabilitation with a proprioceptive/recognition approach (PD-group-B). Sixteen patients (PD-Ctrl group) did not receive any treatment and served as control group. The feasibility of the proposed rehabilitation techniques was the main focus of this evaluation. We also evaluate the efficacy of the treatments by means of the sub-item 19 of the Unified Parkinson's disease Rating Scale motor score (UPDRS-III) and by a computerized analysis of facial expression (E-Motion), which was assessed prior to (T0) and after therapy (T1). The proposed rehabilitative program for the treatment of hypomimia was shown to be feasible. Our data show a significant improvement in UPDRS-III sub-item 19 in PD-group-B compared to PD-group-A, (p = 0.005) and to PD-Ctrl (p = 0.003) and in expressivity of fear in PD-group-B compared to PD-Ctrl (p = 0.01). The proposed rehabilitative program showed to be feasible. A larger multi-center trial is now warranted to establish its efficacy to improve facial expression over long time period.
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom.
authors.forename: Lucia
authors.initials: L
authors.lastname: Ricciardi
authors.affiliation: Department of Neurorehabilitation, Casa di Cura Villa Margherita, via Costacolonna n.1, Arcugnano, Vicenza, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Baggio
authors.affiliation: Department of Geriatry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ricciardi
authors.affiliation: Department of Geriatry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Morabito
authors.affiliation: Department of Neurology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Pomponi
authors.affiliation: Department of Neurology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Bentivoglio
authors.affiliation: Department of Geriatry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Department of Biomedical Engineering, Scientific Institute of Montescano, Montescano, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Maestri
authors.affiliation: Department of Parkinson Disease Rehabilitation, 'Moriggia-Pelascini' Hospital, Gravedona ed Uniti, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
authors.affiliation: Department of Neurorehabilitation, Casa di Cura Villa Margherita, via Costacolonna n.1, Arcugnano, Vicenza, Italy. dott.dvolpe@libero.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Volpe
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D005149:Facial Expression; D005152:Facial Muscles / Q000503:physiopathology; D000066499:Facial Recognition; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D011434:Proprioception; D021641:Recognition, Psychology; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Facial expression; Geriatrics; Hypomimia; Parkinson’s disease; Randomized controlled trial; Rehabilitation