Managing Facial Palsy After Stroke: Results From an Online Survey of Health Professionals

Background
Post-stroke facial palsy significantly impacts patients' communication, eating and overall quality of life. Despite its prevalence, standardised management guidelines are lacking and evidence for assessment and treatment approaches remains limited.

Aim
To describe UK clinical practice for assessing and treating post-stroke facial palsy and which healthcare professionals play a role.

Methods
A cross-sectional online survey was conducted using Qualtrics to collect data on participants' professional lives, assessment and treatment practices. UK healthcare professionals in stroke or facial palsy care were recruited through social media, conferences and professional networks.

Results
Ninety-six out of 150 professionals completed the survey, mainly speech and language therapists (40%) and physiotherapists (43%), including 17 others (occupational therapists, nurses, doctors and orthoptists). Speech and language therapists and physiotherapists were the most likely professions involved in the collaborative management of post-stroke facial palsy. The most common assessment was clinical observation (84%). Some assessments were more favoured by certain professions, for example, 71% of nurses and doctors used the National Institutes of Health Stroke Scale; speech and language therapists and physiotherapists used the Sunnybrook Facial Grading System and clinical observational methods more than the ‘Other group’. The most commonly used treatments were orofacial exercises (60%) and facial massage (52%).

Conclusion
The study describes current UK practice for managing post-stroke facial palsy and underscores the critical roles of speech and language therapists and physiotherapists. Now that we know what is used and by whom, we should explore the evidence underpinning this practice to guide assessment and treatment and improve outcomes for stroke survivors.