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Recovery of facial expressions using functional electrical stimulation after full-face transplantation
BACKGROUND: We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840782/ https://www.ncbi.nlm.nih.gov/pubmed/29510722 http://dx.doi.org/10.1186/s12984-018-0356-0 |
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author | Topçu, Çağdaş Uysal, Hilmi Özkan, Ömer Özkan, Özlenen Polat, Övünç Bedeloğlu, Merve Akgül, Arzu Döğer, Ela Naz Sever, Refik Çolak, Ömer Halil |
author_facet | Topçu, Çağdaş Uysal, Hilmi Özkan, Ömer Özkan, Özlenen Polat, Övünç Bedeloğlu, Merve Akgül, Arzu Döğer, Ela Naz Sever, Refik Çolak, Ömer Halil |
author_sort | Topçu, Çağdaş |
collection | PubMed |
description | BACKGROUND: We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. METHODS: Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. RESULTS: At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. CONCLUSIONS: The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting synkinesis after full-face transplantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12984-018-0356-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5840782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58407822018-03-14 Recovery of facial expressions using functional electrical stimulation after full-face transplantation Topçu, Çağdaş Uysal, Hilmi Özkan, Ömer Özkan, Özlenen Polat, Övünç Bedeloğlu, Merve Akgül, Arzu Döğer, Ela Naz Sever, Refik Çolak, Ömer Halil J Neuroeng Rehabil Research BACKGROUND: We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals. METHODS: Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects. RESULTS: At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement. CONCLUSIONS: The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting synkinesis after full-face transplantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12984-018-0356-0) contains supplementary material, which is available to authorized users. BioMed Central 2018-03-06 /pmc/articles/PMC5840782/ /pubmed/29510722 http://dx.doi.org/10.1186/s12984-018-0356-0 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Topçu, Çağdaş Uysal, Hilmi Özkan, Ömer Özkan, Özlenen Polat, Övünç Bedeloğlu, Merve Akgül, Arzu Döğer, Ela Naz Sever, Refik Çolak, Ömer Halil Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title | Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title_full | Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title_fullStr | Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title_full_unstemmed | Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title_short | Recovery of facial expressions using functional electrical stimulation after full-face transplantation |
title_sort | recovery of facial expressions using functional electrical stimulation after full-face transplantation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840782/ https://www.ncbi.nlm.nih.gov/pubmed/29510722 http://dx.doi.org/10.1186/s12984-018-0356-0 |
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