Comparison on the Effectiveness of “Face-it” Application versus Mirror Therapy as part of Home Exercise Program in Addressing Facial Paresis for People with Acute Stroke: A Pilot Study

There are currently few available strategies available to address facial disability, including mirror therapy (MT). MT lacks a definite protocol, has limited interactivity, and poses risk of injury. Digital games have been used successfully in limb rehabilitation due to their interactiveness and sufficient feedback information. “Face-it” (FI) is a novel mobile application developed to provide interactive theory-based rehabilitation. This pilot study compared the effectiveness of FI and MT in improving facial paresis and physical and social function among community-dwelling people with acute stroke, and the adherence of participants in both programs. House-Brackmann facial nerve grading system (HB) and Facial disability index (FDI) were used to assess functional improvement. Ten people from Region IV-A were randomly placed in either MT or FI group after baseline measurement, and were repeatedly assessed after receiving the assigned treatments. Pearson correlation and Chi-square statistic were used to compare baseline measurements, T-test for within- and between-group measurements, and the tally of completed sessions for participant adherence. Within-group t-test results showed that both MT and FI groups have significantly reduced facial paresis and improved physical (HB p=.03 and .03, PF p=.03 and .01 respectively) function after 14 days. Between-group t-test showed no significant difference for both groups, except for social function where FI group improved significantly after 5 days (p=.00) and 10 days (p=.01). All participants completed the assigned interventions without adverse effects. More research involving larger sample size is recommended as FI is potentially a safe, engaging alternative for improving facial function.

Keywords – Stroke, Facial paresis, Mirror therapy, Face it, mobile application