Therapist-Guided Facial Proprioceptive Training for Early-Stage Peripheral Facial Palsy: A Protocol With...

This article describes a therapist-guided facial proprioceptive training protocol for early-stage peripheral facial palsy. The method uses therapist-applied tactile tapping, a brief facilitative quick stretch, and assisted voluntary contraction to train seven representative facial expressions involving the upper, middle, and lower face. These cues are intended to enhance the patient's perception of movement direction and to support selective activation of the affected-side facial muscles when voluntary output is weak. To illustrate routine clinical use of the method, we reviewed a retrospective cohort of 40 patients treated in the Department of Rehabilitation Medicine at The First Affiliated Hospital of Soochow University from January 2023 to June 2024. According to the rehabilitation approach documented in the medical records, 20 patients received the proprioceptive training protocol and 20 received conventional facial exercise training. Facial function was evaluated at baseline (T0) and at 4, 8, and 12 weeks (T1-T3) using the Sunnybrook Facial Grading System and the House-Brackmann (HB) scale. Both groups improved over time. In unadjusted exploratory comparisons, both groups showed improvement in Sunnybrook scores and a shift toward less severe HB grades over the 12-week follow-up period. Because group allocation was not randomized and the cohort was retrospective, these observations should be interpreted as descriptive rather than confirmatory. The protocol is presented with emphasis on cueing sequence, pacing, and task-specific assistance to facilitate standardized implementation and video-based demonstration.