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She enthusiastically embraced the exercise recommendations. Intervention C O O R D I N AT I O N , C O M M U N I C AT I O N , A N D D O C U M E N TAT I O N As part of a multidisciplinary approach, the patient was given a binder in which to place lecture notes and exercise recommendations, as well as any questions that arose during the class times, to maintain a record of what she learned and to help her review material after returning home. The exercise prescription was practiced throughout the educational program, and was provided to the patient in both audiotape and written formats on the last day of the program.

For example, a history of cardiac arrhythmias may preclude the use of electric stimulation devices as an intervention. The therapist uses the information obtained from the history and systems review to screen for undiagnosed problems that may require further evaluation by the referring physician or other health care practitioner. For a patient with Bell’s palsy, the therapist should conduct a detailed examination of facial musculature and cranial nerve VII function. This examination might include the following components: muscle strength, power, and endurance during functional activities; electroneuromyography; strengthduration testing; and reaction to degeneration testing.

Ross B, Nedzelski JM, McLean A: Efficacy of feedback training in long-standing facial nerve paresis, Laryngoscope 101:744, 1991. 5. Ysunza A, Inigo F, Oritz-Monasterio F, et al: Recovery of congenital facial palsy in patients with hemifacial mocrosomia subjected to sural to facial nerve grafts is enhanced by electric field stimulation. Arch Med Res 27:7, 1996. 6. Targan RS, Alon G, Kay SL: Effect of long-term electrical stimulation on motor recovery and improvement of clinical residuals in patients with unresolved facial nerve palsy, Otolaryngol Head Neck Surg 122:246, 2000.

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