Development of an open-source and free facial rehabilitation website for severe bell’s palsy: a within-subject study on user experience and patient’s compliance with the MEPP-website

Abstract

Purpose

An open source and free website called Mirror Effect Plus Protocol (MEPP)-website was developed with features to diminish cognitive load and support motor learning during facial exercises. Assessing patient’s perceptions is crucial when developing rehabilitation tools because patients’ willingness to use the tools strongly affect engagement in the rehabilitation process. This study compared clinicians’ and patients’ user experience with the MEPP-website versus a hobby-designed website.

Materials and Methods

Ten patients with acute severe Bell’s palsy and five clinicians were enrolled in a within-subject and crossover design. User experience was assessed with the Modular evaluation of Components of User Experience questionnaire. Wilcoxon-Signed-Rank test analysed user experience, and descriptive analyses explored the order effect. Therapeutic compliance was verified for the MEPP-website by an integrated feature. Clinicians’ descriptive statistics and subjective observations were also reported.

Results

Both patients and clinicians demonstrated a preference for the MEPP-website, whether they used it first or second. Despite this preference, compliance with the MEPP-website was reduced, although it tended to be better when used first.

Conclusions

MEPP- website during facial rehabilitation improved user experience. Better user experience likely optimizes how patients perform and facilitate their exercises. Factors affecting compliance with facial rehabilitation remain to be addressed.

Implications for rehabilitation

• Recent data suggests that mirror effect therapy combined with drug therapy supports the recovery of severe Bell’s Palsy.

• The specialized Mirror Effect Plus Protocol (MEPP)- website is a clinical computer-based tool developed to promote patients’ motor learning and diminish cognitive load during mirror therapy.

• The MEPP-website increase clinicians’ accessibility to a specialized facial rehabilitation tool for mirror therapy.

• Clinicians using the MEPP-website can also objectively and easily measure compliance to facial therapy with the MEPP-website.

Keywords:

• Bell’s palsy
• facial nerve
• facial rehabilitation
• mirror therapy
• peripheral facial palsy

Acknowledgments

The authors are deeply grateful to those who participated in this study and to their families. This work was supported by the FRQS under 266532 and REPAR-OOAQ under 5080.

Ethical Approval

Centre de recherche du Centre intégré universitaire de santé et services sociaux du Nord-de-l’île-de-Montréal (MP-32-2017-1365). No URL associated. Link to the ethics comitee: https://www.ciusssnordmtl.ca/recherche-enseignement-et-innovation/ethique-de-la-recherche/

Disclosure statement

The authors report no conflicts of interest. The MEPP-website is free and open-source, thus no financial gains are possible.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Additional information

Funding

This work was supported by a partnership between Réseau Provincial de Recherche en Adaptation-Réadaptation and Ordre des orthophonistes et audiologist du Québec (REPAR-OOAQ).