The Effects of Lip-Closure Exercise on Lip Strength and Function Following Full Facial Transplantation: A Case Report.

Purpose Facial transplantation is a relatively new option for individuals with severe facial disfigurements. Clinical case studies on existing patients indicate many instances of persistent facial motor impairment for facial expression, speech, and swallowing. These preliminary findings motivate additional research on the impact of lip-strengthening exercises following facial transplantation. Method In this study, we assessed the efficacy of an 8-week, biofeedback-driven, lip closure-strengthening exercise program in a single patient 1-year status post-full facial transplantation. Exercise was at 60% of peak strength. Outcome measures included instrumental measures of lip strength and mobility, clinical measures of speech, and patient-reported outcomes in feeding and facial expression. Results Results revealed improvements in labial strength, speed of lip movement, and range of motion during speech. A 3-point improvement in sentence speech intelligibility was also observed following strength-training exercise. The patient reported improvements in her ability to drink from a straw and communicate via facial expression. Conclusion These preliminary findings motivate additional research on the efficacy of lip-strengthening exercises following facial transplantation.

[1]  Raymond D. Kent,et al.  Maximum performance tests of speech production. , 1987, The Journal of speech and hearing disorders.

[2]  JoAnne Robbins,et al.  The Effects of Lingual Exercise on Swallowing in Older Adults , 2005, Journal of the American Geriatrics Society.

[3]  M. ButlerPeterE,et al.  Facial transplantation , 2006 .

[4]  Gary Weismer,et al.  Philosophy of research in motor speech disorders , 2006, Clinical linguistics & phonetics.

[5]  Jordan R Green,et al.  Estimating mandibular motion based on chin surface targets during speech. , 2007, Journal of speech, language, and hearing research : JSLHR.

[6]  C. Steele,et al.  Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports , 2008, Clinical interventions in aging.

[7]  Shuzhong Guo,et al.  Human facial allotransplantation: a 2-year follow-up study , 2008, The Lancet.

[8]  M. Hägg,et al.  Lip muscle training in stroke patients with dysphagia , 2008, Acta oto-laryngologica.

[9]  S. Corrie,et al.  Effects of directional exercise on lingual strength. , 2009, Journal of speech, language, and hearing research : JSLHR.

[10]  G. Lof,et al.  Evidence-based systematic review: effects of nonspeech oral motor exercises on speech. , 2009, American journal of speech-language pathology.

[11]  A. Lohmander,et al.  The effect of lip strengthening exercises in children and adolescents with myotonic dystrophy type 1. , 2010, International journal of pediatric otorhinolaryngology.

[12]  F. Bellivier,et al.  Feasibility, Reproducibility, Risks and Benefits of Face Transplantation: A Prospective Study of Outcomes , 2011, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[13]  Nancy Pearl Solomon,et al.  Age and Sex Differences in Orofacial Strength , 2012, Dysphagia.

[14]  X. Nuvials,et al.  Full Face Transplant: The First Case Report , 2011, Annals of surgery.

[15]  Facial transplantation , 2012, Current opinion in otolaryngology & head and neck surgery.

[16]  Joe Reichle,et al.  Single-subject experimental design for evidence-based practice. , 2012, American journal of speech-language pathology.

[17]  H. Clark.  Specificity of training in the lingual musculature. , 2012, Journal of speech, language, and hearing research : JSLHR.

[18]  S. Testelin,et al.  First Human Face Transplantation: 5 Years Outcomes , 2012, Transplantation.

[19]  Effects of functional movement strength training on strength, muscle size, kinematics, and motor function in cerebral palsy: a 3-month follow-up. , 2013, NeuroRehabilitation.

[20]  Jun Wang,et al.  SMASH: a tool for articulatory data processing and analysis , 2013, INTERSPEECH.

[21]  M. Heiland,et al.  Face Transplantation: On the Verge of Becoming Clinical Routine? , 2014, BioMed research international.

[22]  R. Newton,et al.  Transfer Effect of Strength and Power Training to the Sprinting Kinematics of International Rugby Players , 2014, Journal of strength and conditioning research.

[23]  Gigliola Sica,et al.  Local Overexpression of V1a-Vasopressin Receptor Enhances Regeneration in Tumor Necrosis Factor-Induced Muscle Atrophy , 2014, BioMed research international.

[24]  C. Lian,et al.  The Management of Antibody‐Mediated Rejection in the First Presensitized Recipient of a Full‐Face Allotransplant , 2014, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[25]  Paul Corthals,et al.  Speech characteristics one year after first Belgian facial transplantation , 2014, The Laryngoscope.

[26]  Jordan R. Green,et al.  Characteristics of speech following facial transplantation , 2015, ICPhS.

[27]  Jordan R. Green,et al.  Mouth Matters: Scientific and Clinical Applications of Speech Movement Analysis , 2015 .