Rankin Physiotherapy

Facial Palsy and Vestibular Treatment


Facial Neuromuscular Retraining

BC Section of the Neurosciences Division


Facial Neuromuscular Retraining

One-day Introductory Course
Susan Rankin, Instructor

Facial palsy can affect every aspect of a person’s life. More than just an absence of movement, it often changes the way people think about themselves and how others perceive them. Treatment techniques for peripheral nerve injuries of the extremities do not work on the face. The facial muscles are different physiologically and so is the treatment of peripheral facial palsies.

This lecture-based course will introduce therapists to an effective and validated method for treating lower motor neuron facial palsies. Typical diagnoses include Bell’s Palsy, Ramsay Hunt syndrome, Acoustic Neuroma, Cholesteatoma, parotid cancer, trauma to the facial nerve, Guillain Barre and congenital among others. This technique is not effective for upper motor neuron facial palsy e.g. stroke.

The cost for this one-day course will be $135 for NSD members and $160 for non-NSD members, plus GST. The cost will include a catered lunch and printed lecture materials. This course is open to PTs, OTs, and SLPs.


GF Strong Rehabilitation Centre – 4255 Laurel Street. Lecture Hall. Vancouver, BC

Further Information and Registration

Facial Nerve Clinic Referrals

The second Facial Nerve Clinic at St. Paul’s hospital was held on November 25th and was fully booked. If you’re interested in attending the next clinic, it will be held in February 2016.

In order to book into the clinic, your doctor needs to refer you to Dr. Van Laeken’s office at 604-669-1633. Dr. Van Laeken is a plastic surgeon who specializes in the facial nerve and heads the Facial Nerve Clinic.

This clinic is a teaching clinic so there will be medical students, interns, residents and physiotherapy students attending at different times.

Balance Course

I recently attended a week-end workshop on balance. It was taught by Dr. Faye Horak from Oregon, a Physical Therapist who does research in the area of balance and has done so for most of her career. She suggested a systems approach to balance which is divided into 6 sections.

  • Biomechanical constraints, which include things like deformities in the feet, weakness, decreased ROM and pain
  • Stability limits which are assessed by leaning in sitting and functional reach measurements
  • Anticipatory postural adjustments that are tested by sit to stand, toe raises, standing on one leg and arm raises
  • Reactive postural responses done by giving and removing resistance to see what reactions occur (i.e. ankle strategy or stepping responses)
  • Sensory orientation which is checked by varying the amount of input from one of three systems: visual, proprioceptive or vestibular
  • Stability in gait which includes components of the Dynamic Gait assessment and the timed up and go tests

Dr. Horak has devised a balance assessment to include all 6 components called the BESTest. There is also a mini-BESTest. I’m looking forward to integrating these aspects of testing and treatment into my practice.

Facial Nerve Clinic Update

Vancouver Facial Nerve Clinic

The first Facial Nerve clinic at St. Paul’s hospital was held on August 26, 2015. 11 patients were seen by Dr. Van Laeken, an ENT fellow, 2 medical students and myself.

At the clinic facial patients have the opportunity to be assessed and then have the best course of action recommended for their facial palsies.

The next clinic will be held on November 25, from 8am to 12 pm.