Facial paralysis, defined by the inability to move one or both sides of the face, has an incidence of 20 to 30 cases per 100,000 people annually. This condition often causes facial weakness, difficulties in eating and drinking, and asymmetry that disrupts an individual’s identity, hinders effective communication and emotional expression. This can result in significant emotional, social, and professional repercussions, including decreased self-esteem and potential self-isolation. The complexity of facial paralysis arises from its diverse range of underlying causes, such as viral infections, trauma, tumors/neoplasms, acute events such as a stroke, or even unknown origins, complicating diagnosis and treatment.
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Home / Publications / Publication
REHABILITATION OF FACIAL PARALYSIS THROUGH VIRTUAL ASSISTANTS
Publication type: Article Summary
Original title: FaceRehab – Facial Paralysis Rehabilitation at home
Article publication date: September 2022
Source: Repositório Científico da Universidade de Coimbra
Author: Marina Salomão
Supervisors: Rui Cortesão & João Quintas
What is the goal, target audience, and areas of digital health it addresses?
FaceRehab intends to improve the facial rehabilitation process of patients with facial paralysis, targeting both affected individuals and healthcare professionals involved in their recovery. The areas of digital health that FaceRehab addresses encompass telemedicine, digital therapeutics and telerehabilitation technologies.
What is the context?
Facial paralysis, defined by the inability to move one or both sides of the face, has an incidence of 20 to 30 cases per 100,000 people annually. This condition often causes facial weakness, difficulties in eating and drinking, and asymmetry that disrupts an individual’s identity, hinders effective communication and emotional expression. This can result in significant emotional, social, and professional repercussions, including decreased self-esteem and potential self-isolation. The complexity of facial paralysis arises from its diverse range of underlying causes, such as viral infections, trauma, tumors/neoplasms, acute events such as a stroke, or even unknown origins, complicating diagnosis and treatment.
The rehabilitation process often necessitates frequent visits to specialized medical facilities, which can be burdensome, especially for individuals with mobility issues or reduced transportation options. Regular rehabilitation exercises are essential for recovery, however incorrect exercises can lead to complications such as synkinesis – unwanted contractions of the muscles of the face during attempted movement.
Digital therapeutics are evidence-based software interventions designed to diagnose, monitor, and treat health conditions, providing patients with tools to manage their symptoms independently and enhance their quality of life. By leveraging technologies such as smartphones, applications, and sensors, digital therapeutics facilitate behavioral changes and improve patient engagement in their treatment processes.
What are the current approaches?
Current approaches to treating facial paralysis include therapist supervised facial exercises designed to strengthen facial muscles and promote coordinated movement. However, these exercises lack standardization, leading to inconsistencies in patient care, and require in-person visits, which poses accessibility challenges, particularly in rural areas. Other treatments, such as steroids and antivirals, acupuncture, surgery, biofeedback, electromyography (EMG), and electrostimulation, often lack robust studies, may have associated risks, and/or demonstrate limited effectiveness.
Current digital therapeutic solutions encompass academic works that leverage tele-rehabilitation technologies, machine learning and image processing techniques for the diagnosis and evaluation of facial paralysis. However, many of these solutions lack validation in real-world contexts, limiting their practical applicability. In contrast, some non-academic solutions offer detailed information on the causes, symptoms, and treatment options for facial paralysis, while others concentrate specifically on rehabilitation exercises, monitoring facial movements and assessing the stages of facial paralysis. Despite their diverse functionalities, these commercially available solutions do not offer a holistic approach to rehabilitation.
What does FaceRehab consist of? How was the impact of FaceRehab assessed?
FaceRehab innovatively addresses facial paralysis rehabilitation through a comprehensive digital approach. It combines a user-friendly hardware device with an interactive software platform that enables patients to perform rehabilitation exercises at home while receiving real-time feedback to adjust their movements. Key features include facial expression and muscle movement recognition, a virtual assistant to guide patients, and data analytics for monitoring progress.
For healthcare professionals, FaceRehab offers a Health Management tool that allows therapists to remotely monitor patient progress, facilitating timely interventions and adjustments. It also offers video conferences that allow virtual consultations and guidance during rehabilitation sessions, reinforcing therapeutic relationships and ensuring exercise adherence.
In the prototype, patients perform key tasks such as logging in with a username and password for authentication, following calibration instructions for accurate facial recognition, initiating prescribed exercise plans, and returning to the main menu upon completion. Therapist interactions encompass secure login, managing patient scheduling, recording facial metrics, assessing progress, tailoring exercise plans, updating patient records and treatment notes, and evaluating the effectiveness of prescribed exercises. To support these interactions, the system integrates a secure data management server to protect sensitive information, complemented by a hardware architecture that includes a VPN and Proxy Server to ensure secure data flow and prevent cyberattacks.
The impact of FaceRehab was assessed through a usability validation process for medical devices, following the international standard IEC 62366-1, which emphasizes safety and user interaction. The evaluation involved 20 participants without facial paralysis, equally divided into those who represented the patient’s perspective during domestic use and those who acted as therapists for the first clinical evaluation of facial paralysis. These participants interacted with the prototype to identify usability issues and provide feedback. The evaluation included observational studies and questionnaires designed to measure perceived Usefulness, Satisfaction, and Ease of use (USE).
What are the main results? What is the impact of these results? What is the future of this technology?
The evaluation of FaceRehab revealed that participants viewed the device as a helpful and intuitive rehabilitation tool, demonstrating good acceptance across various usability dimensions. “Patient participants” achieved an average total score of 5.64 out of 7 on the USE questionnaire. This score reflected high scores in categories such as “It is useful” and “I would recommend it to a friend”. For “therapists participants” the average total USE score was 5.27 out of 7, indicating that their tasks were more complex and required greater familiarity with the device’s functionalities. Despite challenges, participant feedback indicates effective navigation on the FaceRehab system and task completion with sufficient information for achieving expected results, suggesting strong potential for its use independently and frequently.
The impact of the usability results for FaceRehab is significant, indicating its potential as a viable alternative to traditional rehabilitation methods, particularly in the context of growing telemedicine adoption. Positive feedback highlights the device’s ability to enhance patient autonomy and facilitate personalized care, reinforcing the value of digital health solutions. Economically, FaceRehab could reduce healthcare costs by approximately 10% by decreasing the need for in-person interventions, thus optimizing resource allocation. Additionally, it streamlines care delivery through improved data exchange between patients and healthcare professionals, lightening physician workloads.
Future plans include evaluations with actual facial paralysis patients and therapists, enhancements to visual elements and technical features, as well as the integration of advanced functionalities like machine learning and artificial intelligence to improve usability and the overall effectiveness of FaceRehab in treating facial paralysis.
Would you like to know all the details?
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Home / Publications / Publication
REHABILITATION OF FACIAL PARALYSIS THROUGH VIRTUAL ASSISTANTS
Publication type: Article Summary
Original title: FaceRehab – Facial Paralysis Rehabilitation at home
Article publication date: September 2022
Source: Repositório Científico da Universidade de Coimbra
Author: Marina Salomão
Supervisors: Rui Cortesão & João Quintas
What is the goal, target audience, and areas of digital health it addresses?
FaceRehab intends to improve the facial rehabilitation process of patients with facial paralysis, targeting both affected individuals and healthcare professionals involved in their recovery. The areas of digital health that FaceRehab addresses encompass telemedicine, digital therapeutics and telerehabilitation technologies.
What is the context?
Facial paralysis, defined by the inability to move one or both sides of the face, has an incidence of 20 to 30 cases per 100,000 people annually. This condition often causes facial weakness, difficulties in eating and drinking, and asymmetry that disrupts an individual’s identity, hinders effective communication and emotional expression. This can result in significant emotional, social, and professional repercussions, including decreased self-esteem and potential self-isolation. The complexity of facial paralysis arises from its diverse range of underlying causes, such as viral infections, trauma, tumors/neoplasms, acute events such as a stroke, or even unknown origins, complicating diagnosis and treatment.
The rehabilitation process often necessitates frequent visits to specialized medical facilities, which can be burdensome, especially for individuals with mobility issues or reduced transportation options. Regular rehabilitation exercises are essential for recovery, however incorrect exercises can lead to complications such as synkinesis – unwanted contractions of the muscles of the face during attempted movement.
Digital therapeutics are evidence-based software interventions designed to diagnose, monitor, and treat health conditions, providing patients with tools to manage their symptoms independently and enhance their quality of life. By leveraging technologies such as smartphones, applications, and sensors, digital therapeutics facilitate behavioral changes and improve patient engagement in their treatment processes.
What are the current approaches?
Current approaches to treating facial paralysis include therapist supervised facial exercises designed to strengthen facial muscles and promote coordinated movement. However, these exercises lack standardization, leading to inconsistencies in patient care, and require in-person visits, which poses accessibility challenges, particularly in rural areas. Other treatments, such as steroids and antivirals, acupuncture, surgery, biofeedback, electromyography (EMG), and electrostimulation, often lack robust studies, may have associated risks, and/or demonstrate limited effectiveness.
Current digital therapeutic solutions encompass academic works that leverage tele-rehabilitation technologies, machine learning and image processing techniques for the diagnosis and evaluation of facial paralysis. However, many of these solutions lack validation in real-world contexts, limiting their practical applicability. In contrast, some non-academic solutions offer detailed information on the causes, symptoms, and treatment options for facial paralysis, while others concentrate specifically on rehabilitation exercises, monitoring facial movements and assessing the stages of facial paralysis. Despite their diverse functionalities, these commercially available solutions do not offer a holistic approach to rehabilitation.
What does FaceRehab consist of? How was the impact of FaceRehab assessed?
FaceRehab innovatively addresses facial paralysis rehabilitation through a comprehensive digital approach. It combines a user-friendly hardware device with an interactive software platform that enables patients to perform rehabilitation exercises at home while receiving real-time feedback to adjust their movements. Key features include facial expression and muscle movement recognition, a virtual assistant to guide patients, and data analytics for monitoring progress.
For healthcare professionals, FaceRehab offers a Health Management tool that allows therapists to remotely monitor patient progress, facilitating timely interventions and adjustments. It also offers video conferences that allow virtual consultations and guidance during rehabilitation sessions, reinforcing therapeutic relationships and ensuring exercise adherence.
In the prototype, patients perform key tasks such as logging in with a username and password for authentication, following calibration instructions for accurate facial recognition, initiating prescribed exercise plans, and returning to the main menu upon completion. Therapist interactions encompass secure login, managing patient scheduling, recording facial metrics, assessing progress, tailoring exercise plans, updating patient records and treatment notes, and evaluating the effectiveness of prescribed exercises. To support these interactions, the system integrates a secure data management server to protect sensitive information, complemented by a hardware architecture that includes a VPN and Proxy Server to ensure secure data flow and prevent cyberattacks.
The impact of FaceRehab was assessed through a usability validation process for medical devices, following the international standard IEC 62366-1, which emphasizes safety and user interaction. The evaluation involved 20 participants without facial paralysis, equally divided into those who represented the patient’s perspective during domestic use and those who acted as therapists for the first clinical evaluation of facial paralysis. These participants interacted with the prototype to identify usability issues and provide feedback. The evaluation included observational studies and questionnaires designed to measure perceived Usefulness, Satisfaction, and Ease of use (USE).
What are the main results? What is the impact of these results? What is the future of this technology?
The evaluation of FaceRehab revealed that participants viewed the device as a helpful and intuitive rehabilitation tool, demonstrating good acceptance across various usability dimensions. “Patient participants” achieved an average total score of 5.64 out of 7 on the USE questionnaire. This score reflected high scores in categories such as “It is useful” and “I would recommend it to a friend”. For “therapists participants” the average total USE score was 5.27 out of 7, indicating that their tasks were more complex and required greater familiarity with the device’s functionalities. Despite challenges, participant feedback indicates effective navigation on the FaceRehab system and task completion with sufficient information for achieving expected results, suggesting strong potential for its use independently and frequently.
The impact of the usability results for FaceRehab is significant, indicating its potential as a viable alternative to traditional rehabilitation methods, particularly in the context of growing telemedicine adoption. Positive feedback highlights the device’s ability to enhance patient autonomy and facilitate personalized care, reinforcing the value of digital health solutions. Economically, FaceRehab could reduce healthcare costs by approximately 10% by decreasing the need for in-person interventions, thus optimizing resource allocation. Additionally, it streamlines care delivery through improved data exchange between patients and healthcare professionals, lightening physician workloads.
Future plans include evaluations with actual facial paralysis patients and therapists, enhancements to visual elements and technical features, as well as the integration of advanced functionalities like machine learning and artificial intelligence to improve usability and the overall effectiveness of FaceRehab in treating facial paralysis.
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