Effectiveness of orofacial myofunctional intervention to mitigate facial aging signs: a clinical trial

Frazão, Yasmin Salles; Manzi, Silvia Bertacci; Krakauer, Lilian; Berretin-Felix, Giédre

doi:10.1590/2317-1782/20242023016en

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ORIGINAL ARTICLE • CoDAS 36 (5) • 2024 • https://doi.org/10.1590/2317-1782/20242023016en copy

Effectiveness of orofacial myofunctional intervention to mitigate facial aging signs: a clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

Propose and verify the efficiency of myofunctional intervention program to attenuate facial aging signs and balance the orofacial functions.

Methods

Thirty women, aged 50 to 60 years, randomly divided into: therapy group (TG) submitted to Orofacial Myofunctional Therapy and electromyographic biofeedback group (EBG), submitted to the same program associated with electromyographic biofeedback for chewing, swallowing, and smiling functions training. Aesthetic and oromyofunctional aspects were assessed from photographs, videos, MBGR Protocol and scales for assessing facial aging signs, described in the literature. 50-minute sessions were held weekly for nine weeks and monthly for six months after washout period. Three assessments, identical to the initial one, were performed in the tenth week, eighth week after washout and conclusion of the research. The participants responded to the Satisfaction Questionnaire on the tenth week.

Results

The statistical analysis using the ANOVA, Tukey and Mann Whitney tests, for inter and intragroup comparison, showed that: intervention promoted attenuation of facial aging signs mainly in TG group, balance of chewing and swallowing functions in both groups; there was an impact of electromyographic biofeedback on the degree of participants’ satisfaction, greater for EBG; interruption of the program for eight weeks resulted in aesthetic losses, mainly in TG, yet not functional losses, in both groups; the six monthly sessions had a limited impact on overcoming the esthetic losses that occurred after washout.

Conclusion

The proposed program resulted in attenuation of aging signs, mainly in the TG group and improvement in orofacial functions, in both groups.

Keywords
Esthetics; Speech, Language and Hearing; Sciences; Myofunctional Therapy; Electromyography; Rejuvenation; Aging

	Minimum		Maximum		Median		Mean		SD
	TG	EBG	TG	EBG	TG	EBG	TG	EBG	TG	EBG
T1	14	14	28	33	22	22	20.80	21.87	4.60	5.01
T2	10	11	36	33	17	19	18.33	20.33	6.58	6.13
T3	15	12	36	32	23	20	23.87	20.93	6.09	5.36
T4	15	11	38	31	23	21	23.20	21.20	6.18	5.39

	SS	Degr. of	MS	F	p
Intercept	54528.03	1	54528.03	468.5641	0.000000
GROUP	6.53	1	6.53	0.0561	0.814427
Error	3258.43	28	116.37
TIME	176.63	3	58.88	12.8851	0.000001
TIME/GROUP	126.53	3	42.18	9.2304	0.000024
Error	383.83	84	4.57

Group	Time	Mean	SD	Significance ^* * Significance: different letters indicate a statistically significant difference
EBG	T1	21.87	5.01	a,b,c
EBG	T2	20.33	6.13	a,b,c
EBG	T3	20.93	5.36	a,b,c
EBG	T4	21.20	5.39	a,b,c
TG	T1	20.80	4.60	a
TG	T2	18.33	6.58	c
TG	T3	23.87	6.09	b
TG	T4	23.20	6.18	a,b

	Minimum		Maximum		Median		Mean		SD
	TG	EBG	TG	EBG	TG	EBG	TG	EBG	TG	EBG
T1	5	0	16	13	14	8	11.60	8.00	3.89	3.21
T2	2	0	14	12	7	4	6.67	4.27	3.42	3.28
T3	0	0	13	11	3	4	3.93	4.73	3.37	2.81
T4	0	0	8	12	3	5	3.27	4.67	2.05	2.97

	SS	Degr. of	MS	F	p
Intercept	4165.408	1	4165.408	193.4935	0.000000
GROUP	27.075	1	27.075	1.2577	0.27161
Error	602.767	28	21.527
TIME	647.692	3	215.897	34.9272	0.00000
TIME/GROUP	132.825	3	44.275	7.1627	0.00024
Error	519.233	84	6.181

Group	Time	Mean	SD	Significance^*
EBG	T 1	8.00	3.21	c,d
EBG	T2	4.27	3.28	a,b
EBG	T3	4.73	2.81	a,b
EBG	T4	4. 67	2.97	a,b
TG	T1	11.60	3.89	d
TG	T2	6.67	3.42	b,c
TG	T3	3.93	3.37	a,b
TG	T4	3.27	2.05	a

	n	Missing	Q1	Median	Q3
EBG	15	0	82.50	90.00	90.00
TG	15	0	73.50	76.00	80.00

Participants	Comments
1	"Excellent training. I learned how to eat and drink in a way that makes the tongue move correctly."
2	"This technique was essential. Perception with the naked eye without seeing the computer graph is subjective. Once I see the graph (on the screen), it becomes easier to correct improper movements."
3	"The biofeedback served as a parameter to remember and recall the movements that produce oral-aesthetic health."
4	"It was extremely helpful. It provides parameters whether I am working the muscles that were necessary or not."
5	"It greatly helps in the awareness of movement and rhythm."
6	"It helps in confirming that the exercises are being done correctly."
7	"Despite the discomfort from the electrodes, seeing the response to movement in real-time on the screen was spectacular. Understanding the involved muscles and their linked responses was impactful."
8	"It is important to re-educate the brain in new ways to use facial expressions and facial muscle movements. It gave me a new self-awareness about automatic actions that we perform erroneously and unknowingly."
9	"Excellent method because it greatly helped integrate automatic movements in relation to chewing, and the perception of lips and tongue at the time of swallowing."
10	"The training helped me to fix the movements of the tongue and bite. When I saw these movements on the screen, I found it easier to perform them at home."
11	"Visual memory enhances the repetition of exercises at home."
12	"This training helps us to see the act of chewing and swallowing and how it can be improved."
13	"Very interesting. I had difficulty performing some movements and also controlling the facial muscles, but I believe that over time I will overcome all difficulties."
14	"Biofeedback is very helpful in disassociating movements and also in seeing the correct performance."
15	“The training helped me to see how exactly the exercise/movement should be done; it’s imprinted in my memory to use during the routines of my meals and movements.”

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[1] Conflict of interests: nothing to declare.