The Facial Neuromuscular Rehabilitation Program
St. John's Mercy Facial Neuromuscular Rehabilitation Program assists individuals with one-sided facial paralysis or weakness in normalizing facial resting tone and achieving more symmetrical voluntary movement and facial expression.

Treatment Eligibility
Individuals who are eligible for treatment are those who have lost facial muscle control as a result of:

• Bell's palsy
• Post-surgical facial nerve damage
• Traumatic facial nerve injury
• Cranial nerve VII-XII anastomosis
• Any other condition resulting in impaired function of the facial nerve.

Evaluation Process
A physical therapist with specialized training in facial neuromuscular rehabilitation will perform an extensive evaluation of each patient to determine needs and appropriate treatment. The evaluation will include visual and photographic assessment of facial resting tone, voluntary movement, and synkinesis (extraneous or unwanted facial movement).

Treatment Plan
Facial rehabilitation typically begins six months after injury or onset of weakness, although some treatment goals may be addressed during the acute phase of rehabilitation. Treatment during the acute phase (up to six months after onset of facial weakness) will consist of:

• Patient education
  
• Increasing awareness of movement
• Assessing recovery of movement
• Eye closure exercises and education in eye care
• Promoting relaxed movement of the non-impaired side.
  
  

During the post-acute phase of rehabilitation (weakness or asymmetry lasting longer than
six months), treatment will emphasize:

• Administration of and education in facial massage and stretching
  
• Increasing control of movement as healing occurs
  
• Normalizing facial resting tone
• Designing and periodically modifying a home exercise program
• Minimizing the effects of synkinesis with the help of mirror and computerized surface EMG biofeedback
• Providing the physician with regular progress assessments
• Assisting patients and physicians with decisions about the management of chronic impairment.

Patients whose facial nerve injury occurred several years ago have also shown improvement with the program. Although treatment frequency varies, individuals are typically seen one to two times per week initially then reassessed with revision of home exercise program monthly to bi-monthly, as needed.

A physician's referral is required for evaluation and treatment. To schedule an appointment, please call 314-881-4200.