IMPROVING FUNCTIONAL OF FACIAL ABILITY FOR CHRONIC BELLS PALSY'S BY USING MODALITIES MASSAGE AND MIRROR EXERCISE: A CASE REPORT

Abstract

Introduction: Bell's palsy is a weakness or paralysis of the peripheral facial nerves, is acute, and the cause is unknown (idiopathic). In Indonesia, the exact incidence of Bell's palsy is difficult to determine. Data collected from 4 hospitals in Indonesia in 2010 found that the frequency of Bell's palsy was 19.55% of all neuropathy cases and the highest was at the age of 21-30 years. Problems that arise in right Bell's palsy are facial asymmetry, stiffness and thickness on the affected side of the face, decreased facial muscle strength on the injured side, the potential for tissue spasm and adhesions, and the potential for irritation of the eye on the injured side. Case Presentation: A 23-year-old woman with the status of a student was referred to medical rehabilitation with complaints of slurred speech during a speech, lack of right eyebrow movement, unconscious right eye blinking, inability to chew food, forehead wrinkles, and inability to whistle. Management and Outcome: The Exercise Program is given three times a week for two weeks according to a doctor's referral and each session lasts 30-45 minutes. A home program is recommended to be done every day with a dose of twice a day and each movement is repeated five times. Results were measured using the Ugo Fisch for facial function. After six treatment sessions, the patient showed the improvement are increase in the score on the frown expression by 4 points from 3 points to 7 points and the smiling expression increased by 12 points from 9 points to 21 points. Discussion: Physiotherapy measures in the form of massage and mirror exercise have been given to these patients. massage has a positive effect in improving muscle function and relaxation to improve blood circulation, thereby reducing tension, anxiety and stress. Mirror exercise is a therapeutic intervention in which a mirror is used to convey visual stimuli to the brain by observing the unaffected body part when the individual performs a series of movements. Conclusion: Through our research and previous research, we concluded that massage and mirror exercise can improve the functional ability of facial muscles.