Impact of disability on quality of life and activities of daily living in peripheral facial paralysis.

OBJECTIVE

To investigate the relationships between patient-reported physical and social facial disability, health-related quality of life (HRQoL), and instrumental activities of daily living (IADLs) in individuals with peripheral facial paralysis (PFP) compared with healthy controls.

METHODS

This cross-sectional study included 100 PFP patients and 116 age- and sex-matched controls. Facial disability, IADLs, and HRQoL were assessed using the Facial Disability Index (FDI), Nottingham Extended Activities of Daily Living Index (NEADL), and EuroQol-5 Dimensions (EQ-5D). Between-group comparisons and partial correlations controlling for demographics were performed.

RESULTS

Patients with PFP had significantly lower physical and social scores on the FDI than controls (p < .001). Scores for HRQoL were significantly reduced across all dimensions (p ≤ .002). Total and subdomain scores of the NEADL Index were also significantly lower in the PFP group. Partial correlation analyses showed that the social subscale of the FDI was significantly associated with multiple NEADL items and EQ-5D dimensions (r = 0.197-0.410, p < .050), whereas physical scores had limited correlations. Mediation analysis confirmed that psychological distress (EQ-5D Anxiety/Depression) fully mediated the relationship between social disability and IADL performance (Path c' p = .108). Paralysis duration showed limited association with functional outcomes.

CONCLUSION

Patients with PFP exhibited significant impairments in social facial function, HRQoL, and NEADL performance. Social facial disability, rather than physical impairment, is the primary driver of limitations in daily activities, a relationship that is fully mediated by psychological distress. These findings underscore the need for psychosocial interventions alongside motor rehabilitation to optimize functional independence in PFP patients.