OBJECTIVE: To investigate factors affecting the effect of physical 
rehabilitation therapy for synkinesis as a sequela to facial nerve palsy.
METHODS: A total of 37 patients with peripheral facial nerve palsy in 
Teine-Keijinkai Hospital were enrolled in this study. All patients showed 
synkinesis at 6 months after the onset of facial nerve palsy and were instructed 
in physical rehabilitation by expert staff from their first visit. The degree of 
synkinesis was evaluated at 6, 9 and 12 months after the onset of facial nerve 
palsy based on Sunnybrook facial grading system score and asymmetry in eye 
opening width. The patients were divided into two groups by age, gender, cause 
of palsy, electroneurography (ENoG) value, onset of synkinesis, initial 
treatment and timing of the start of physical rehabilitation.
RESULTS: Female patients and younger patients did not show any deterioration in 
synkinesis. Patients in the lower ENoG group and the later onset of synkinesis 
group showed significant deterioration in synkinesis after the 6th month from 
onset of facial palsy.
CONCLUSION: Physical rehabilitation was shown to prevent significant 
deterioration in synkinesis in female and younger patients with facial nerve 
palsy. Careful follow-up with regard to synkinesis is required in cases in which 
the facial nerve damage is thought to be severe.