Puckering and blowing facial expressions in people with facial movement disorders.

BACKGROUND AND PURPOSE People with facial movement disorders are instructed to perform various facial movements as part of their physical therapy rehabilitation. A difference in the movement of the orbicularis oris muscle has been demonstrated among people without facial nerve impairments when instructed to "pucker your lips" and to "blow, as if blowing out a candle." The objective of this study was to determine whether the within-subject difference between "pucker your lips" and "blow, as if blowing out a candle" found in people without facial nerve impairments is present in people with facial movement disorders. SUBJECTS AND METHODS People (N=68) with unilateral facial movement disorders were observed as they produced puckering and blowing movements. Automated facial image analysis of both puckering and blowing was used to determine the difference between facial actions for the following movement variables: maximum speed, amplitude, duration, and corresponding asymmetry. RESULTS There was a difference between the amplitudes of movement for puckering and blowing. "Blow, as if blowing out a candle" produced a larger amplitude of movement. DISCUSSION AND CONCLUSION The findings demonstrate that puckering and blowing movements in people with facial movement disorders differ in a manner that is consistent with differences found in people who are healthy. This information may be useful in the assessment of and intervention for facial movement disorders affecting the lower face.