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Published on: November 6, 2014
Classification of central facial paralysis: an agreement analysis
Nathallie Angel Conceição da Silva Andrade1, Raquel Karoline Gonçalves Amaral1, Laélia Cristina Caseiro Vicente1
1Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.
Codas
|May 7, 2025
Summary
The Sunnybrook Facial Grading System (SFGS) showed better agreement among raters for central facial paralysis. Experts preferred the SFGS for classifying facial paralysis severity, though the House & Brackmann (HB) scale also demonstrated good intrarater reliability.
Area of Science:
- Neurology
- Speech-Language Pathology
- Rehabilitation Medicine
Background:
- Central facial paralysis, often resulting from stroke, significantly impacts communication and quality of life.
- Accurate assessment of facial paralysis severity is crucial for treatment planning and outcome evaluation.
- Existing scales like the House & Brackmann (HB) and Sunnybrook Facial Grading System (SFGS) are used, but their comparative reliability needs further investigation.
Purpose of the Study:
- To compare the interrater and intrarater reliability of the House & Brackmann (HB) scale and the Sunnybrook Facial Grading System (SFGS) for classifying central facial paralysis.
- To determine which scale experts consider more appropriate for assessing facial expression severity in post-stroke patients.
Main Methods:
- An observational, prospective, cross-sectional study involving 30 adult stroke survivors with central facial paralysis.
- Five experienced speech-language-hearing pathologists evaluated facial expressions using both the HB and SFGS scales.
- Interrater agreement was assessed for all participants, while intrarater agreement was evaluated on a subset after a 10-day interval, using weighted kappa and intraclass correlation coefficients.
Main Results:
- The House & Brackmann (HB) scale demonstrated considerable interrater and excellent intrarater agreement.
- The Sunnybrook Facial Grading System (SFGS) exhibited good interrater and intrarater agreement.
- All participating speech-language-hearing pathologists favored the SFGS as the more appropriate scale for classifying central facial paralysis severity.
Conclusions:
- The Sunnybrook Facial Grading System (SFGS) showed superior performance in interrater agreement for central facial paralysis assessment.
- The House & Brackmann (HB) scale proved highly reliable for intrarater assessments.
- While both scales are valuable, expert opinion suggests the SFGS is the preferred tool for classifying the severity of central facial paralysis.
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