Remote Measurement, Management & Analysis for Facial Movement

It’s good that it has a mask feature because my face doesn’t look the same since my stroke and I’m still unsure about looking at my reflection.

PW, patient treated by Mark Chalmers
Speech and Language Therapist
Adult Conversations Speech and Language Therapy

With one patient, who had a left-sided facial weakness, and as they were doing mouth smile on the left and right (looking at) some of the measures that come up on the app, I said to them “Is there anything that you think you can do aside from these exercises that might bring the lines (on the app) closer together?” And just by looking at it they were able to do just that. I don’t know how but they could bring the lines closer. There was still a gap and you could still see that there was some weakness, but actually seeing that feedback on (the app) was really good. I said to the patient, “Well, remember how you did that, and try to do that again.” The patient then used this as their own sort of therapy exercise and took that forward.

Patient treated by Mark Chalmers
Speech and Language Therapist
Adult Conversations Speech and Language Therapy

Each week I’m keen to see if the recordings show whether there is more movement.

PL, patient treated by Mark Chalmers
Speech and Language Therapist
Adult Conversations Speech and Language Therapy

The real-time measures give you immediate feedback and that keeps me motivated.

IS, patient treated by Mark Chalmers
Speech and Language Therapist
Adult Conversations Speech and Language Therapy

So I had a 5AM start this morning, and nobody likes those. So that flight was to get me from Belfast to Gatwick and then Gatwick onto Queen Victoria Hospital in East Grinstead. And the reason for that is I attend a facial palsy clinic here with specialists who know everything there is to know about facial palsy. This clinic allows me ability to be able to blink, be able to eat, speak, and deal with the nerve pain and the spasms that I have because of my facial palsy. There’s 62 reasons why you can come to this condition, however in Northern Ireland there is no services for facial palsy whatsoever. This was a half hour appointment, and over 18 hours it will take me from door to door. I will continue to push for services for people with this condition, and that we get this sooner than later.

Janet Robb
Facial palsy sufferer

This is a very interesting tool, and I can definitely see its potential. As a speech-language therapist working primarily with children, I’m intrigued by its possibilities.

I can imagine how it could be adapted to support children with oral motor delays or childhood apraxia of speech. For example, incorporating elements like animated characters or avatars could make speech exercises more engaging and motivating for young clients.

My current assessments include evaluating children’s oral motor skills. I believe your app could be particularly useful in helping children practice tongue movements outside of the mouth, such as tongue elevation.

I’m also interested in the potential of adding an audio component to the app. This would allow clients to reflect on the sounds they produce in relation to their visual feedback, enhancing their self-awareness and self-correction skills.

I’ve been working as a speech-language therapist for 30 years, balancing my time between individual and school-based therapy.

Thank you for your time spent developing this promising tool. I wish you all the best in its continued development.

Rachel Barton
Independent Speech and Language Therapist
Professional Supervisor

I’m very excited about the app because there has been a huge void in the assessment of patients with facial palsy.  More specifically, there has been no ready means of objectively quantifying impaired facial movements to date.  The solutions that have been developed previously have all been unobtainable, due to high cost, for even our supra-specialist NHS-based facial nerve service.

The lack of a widely accepted and widely-used tool for objectively quantifying facial movements has meant that services like ours have been unable to get an accurate baseline profile of patients’ facial impairments and unable to gauge subtle gains secondary to treatment.  Patients probably think it is unacceptable that, in our high-tech world, assessments of facial function have remained highly subjective and of poor resolution.  Moreover, research into treatments (both conservative and surgical) for facial palsy has no doubt been stunted and/or stilted by the lack of measurement objectification.

I could see the app, [and the platform you are developing] if validated, being used routinely alongside patient-reported and clinician-rated outcome measures already in use, allowing for a clear picture of facial function to be gained.  In our service, we would use the app during almost all appointments in the Facial Nerve Clinic, the multi-disciplinary front-end clinic of our facial nerve service.  We have long waiting lists for both new and returning patients, so we would probably recommend to a large number of them that they download the app to monitor their progress during the ~5-month periods in-between successive clinic appointments.

My physiotherapy team sees about 140 patients with facial palsy per year, about 60% of the total number who pass through the front-end Facial Nerve Clinic each year.  I could envisage that a platform like yours might be developed to facilitate patients’ rehabilitation programmes as well as their assessments.  The fact that the app can produce a mirror-symmetric on-screen face, both sides of which move in tandem with the movements of only the unaffected side of a patient’s face, could be very helpful in the acute phase of facial palsy, as has been indicated by the research of Sarah Martineau in Canada.  If her research continues to yield positive results, it’s possible that an app like yours might be part of the recommended measures given to patients attending Emergency Departments very soon after the onset of their palsies.

Dr Jeremy Corcoran BSc MSc PhD
Clinical Specialist Physiotherapist – Vestibular and Facial Therapy
Physiotherapy Department
Guy’s and St Thomas’ NHS Foundation Trust