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Neuro-Proprioceptive Rehabilitation Method

About the NPR method

The Neuro-Proprioceptive Rehabilitation (NPR) method addresses aesthetic issues that arise from complications of long-standing Bell’s palsy.

It was created by Crystal Touch Clinic’s co-founder, Elena PashovaThe NPR method is based on 25 years of experience and 8 years of private scientific research. This method was presented in 2014 at the World Congress for NeuroRehabilitation in Istanbul.

Neuro-Proprioceptive Rehabilitation method can successfully reduce, and in certain cases completely eliminate, most of the complications of long-standing Bell’s palsy.

Application of the Neuro-Proprioceptive Rehabilitation method for the treatment of patients with long-standing Bell’s palsy produces a measurable and lasting reduction of Bell’s palsy sequelae, and improves the quality of life, irrespective of the patient’s age, sex or time that had passed since the onset.

Efficacy of Neuro-Proprioceptive facial Rehabilitation method
Efficacy of Neuro-Proprioceptive facial Rehabilitation method - Click to read

What the Neuro-Proprioceptive Rehabilitation method achieves

The NPR method improves the quality and symmetry of facial movements, general facial appearance and optimizes the functioning of facial muscles. Besides working on physical improvements, the method also addresses psychological recovery from experiencing life changes that long-term recovery and residuals may cause.

The systematic application of this method substantially improves the quality of life of our patients.

The entire Neuro-Proprioceptive Rehabilitation method for Bell’s palsy is aimed at:

  • neuronal regeneration of the facial nerve
  • restoration of the symmetry of brain signals to both sides of the face
  • developing skills of conscious relaxation of the facial muscles
  • training of a finely differentiated control of facial muscles, which is essential for overcoming synkinesis
  • forming the correct coordination patterns of facial muscles in order to restore the symmetry of the facial movements
  • restoration of normal symmetrical tone of facial muscles

How the NPR method works

The Neuro-Proprioceptive Rehabilitation consists of regular working sessions every 4-5 weeks and the patient’s own daily work at home in between. Special NPR techniques that the patients use at home, they learn gradually during the working sessions.

For our overseas patients, we compose specially structured programs that allow increasing the interval between regular visits to the clinic to 10-12 weeks. With some patients, we can also work online.

Each NPR working session takes 1,5 hours and includes several modules, one of which is the treatment using a working apparatus. The treatment is painless and feels comfortable. Other modules of the working session are carried out without the use of special equipment.

For patients following their rehabilitation online, we cannot provide assistance with the help of the apparatus. Nonetheless, this does not reduce the efficacy of the NPR method.

Crystal Touch Neuro-Proprioceptive Rehabilitation stimulates several aspects:

  • regeneration of facial nerve fibres
  • normalization of facial muscles’ tonus on the affected side
  • symmetrization of the tonic signals from the brain to both sides of the face
  • a proper balance between relaxation and contraction of muscle fibres on the affected side of the face
  • blood and lymph circulation in the face tissues
  • improves the sense of facial proprioception

Based on our experience, some improvements can already be felt and observed after the first working session.

As we move through the program and learn new rehabilitation techniques for self-application, the improvements become more visible and lasting.

Measuring the efficiency of NPR

At Crystal Touch Clinic, we measure objectively the progress of facial nerve recovery and the level of synkinesis. We do these measurements before the start of rehabilitation program in the clinic with each of our patients (this is not possible when following the rehabilitation online).

With these measurements we can see with better clarity the current level of recovery of your facial nerve as well as the level of synkinetic correlation. In the process of rehabilitation, we repeat these measurements to observe your recovery and make any necessary adjustments to your rehabilitation program.

Measuring the progress of facial nerve recovery

We measure the level of facial nerve recovery with the Nerve Conduction Study (NCS). With it, we measure the ability of each facial nerve branch to conduct the signals from the brain to the facial muscles. By analyzing the response of the facial muscles to electrical stimuli, we can objectively measure to what extent each branch of the facial nerve has regenerated. This enables us to “see” the functionality level of the facial nerve.

Nerve conduction study, affected side, zygomatic muscles
Results of Nerve Conduction Study on Zygomatic muscles

Measuring the level of synkinesis

Synkinetic Correlation Analysis helps us to measure the level of synkinesis objectively. With this test, we can clearly see and analyse the difference in facial movements on the affected side versus the normal movements of a healthy side. It also shows us the level of synkinesis – the correlation of synkinetic co-contraction between involved muscles.

Synkinetic Correlation Analysis
Synkinetic Correlation Analysis
You can find more details and explanation about Nerve Conduction Study and Synkinetic Correlation Analysis in a dedicated article – “What we can measure, we can manage!”.

FAQs about Neuro-Proprioceptive Rehabilitation Method

The Neuro-Proprioceptive Rehabilitation method approaches synkinesis as manifestations of pathological facial movement patterns that the patient gradually develops during the first 4-9 months after the onset. We have written an extensive article on what is synkinesis, as well as presented our point of view of synkinesis at several NeuroRehabiliation congresses around the world.In short, we see synkinesis as a conditioned reflex, that develops during the long Bell’s palsy recovery. As a conditioned reflex, it can be reversed using negative feedback. During our working sessions and at home, our patients learn and apply the techniques of negative feedback to reduce the manifestations of their synkinesis.

The method addresses the root causes of facial tensions and contractures. Its application helps to normalize the brain signal levels for facial muscles’ tone, “teaches” the contractured facial muscles to relax, and facilitates neuronal regeneration of the facial nerve. As a result, the contractures and pains are gradually reduced, eventually eliminated, and the face becomes more symmetrical.

  • We do not use any injections of botulinum toxin (Botox), hyaluronic acid nor any other fillers or neurotoxins.
  • We do not use any tools of plastic surgery. Face-lifting, thread, implants, etc. are not used in NPR method.
  • We do not use electromyostimulation that includes electric shocks, currents of high intensity and painful treatments.

All our Bell’s palsy and congenital facial palsy patients who completed their Neuro-Proprioceptive Rehabilitation program have achieved ​​satisfactory improvements. By the end of the rehabilitation program, they had learned how to maintain the achieved results on their own.

After the completion of the program, there is no need for repeated sessions. Some of our patients prefer to follow the “maintenance” sessions once or twice per year.

To revert it all back and achieve 100% recovery “as it used to be” can hardly be expected. In theory, this is possible, but to achieve these results, the duration of the rehabilitation program will be excessively long (it would take a few years).

The results will vary from person to person. To find out what you can realistically expect (we do not give false hopes) in your condition, please register for an online consultation, so we can analyse your condition in detail and explain to you in-depth what is possible.

One can expect the following improvements from the application of the Neuro-Proprioceptive Rehabilitation method:

  • decreased or resolved contractures and facial tightness on the affected side
  • symmetrization of the facial movements to the aesthetically acceptable (from the patient’s point of view) level
  • reduction in manifestation of synkinesis to aesthetically acceptable level
  • significant reduction or elimination of pains on the affected side of the face
  • overall improvements in the appearance, skin color, face contour and facial expression