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. ... Case Report
Case Report  |   June 22, 2017
The Effects of Lip-Closure Exercise on Lip Strength and Function Following Full Facial Transplantation: A Case Report
 
Author Affiliations & Notes
  • Bridget J. Perry
    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
  • Brian D. Richburg
    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
  • Bohdan Pomahac
    Center for Reconstructive and Restorative Surgery, Brigham and Women's Hospital, Boston, MA
  • Ericka M. Bueno
    Center for Reconstructive and Restorative Surgery, Brigham and Women's Hospital, Boston, MA
  • Jordan R. Green
    Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Jordan R. Green: jgreen2@mghihp.edu
  • Editor: Nancy Solomon
    Editor: Nancy Solomon×
  • Associate Editor: Angela Dietsch
    Associate Editor: Angela Dietsch×
Article Information
Speech, Voice & Prosodic Disorders / Swallowing, Dysphagia & Feeding Disorders / Special Populations / Speech, Voice & Prosody / Special Issue: Selected Papers From the 2016 Conference on Motor Speech—Clinical Science and Implications / Case Report
Case Report   |   June 22, 2017
The Effects of Lip-Closure Exercise on Lip Strength and Function Following Full Facial Transplantation: A Case Report
American Journal of Speech-Language Pathology, June 2017, Vol. 26, 682-686. doi:10.1044/2017_AJSLP-16-0101
History: Received June 14, 2016 , Revised September 13, 2016 , Accepted November 23, 2016
 
American Journal of Speech-Language Pathology, June 2017, Vol. 26, 682-686. doi:10.1044/2017_AJSLP-16-0101
History: Received June 14, 2016; Revised September 13, 2016; Accepted November 23, 2016

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.

Acknowledgments
This work was supported by research funds provided by the MGH Institute of Health Professions to the corresponding author.
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