This page summarizes the questionnaires available in the FaceRehab Provider Portal. Each questionnaire includes its intended use and the wording of questions with answer options.

Functionality Questionnaire

Assesses basic motor functions such as eye closure, smiling, and forehead movement.

• • How easily can you close your affected eye? (0–5)
    → 0 Cannot close at all / 1 Very difficult / 2 Moderately difficult / 3 Slightly difficult / 4 Almost no limitation / 5 Fully easy, no limitation
  • Can you smile so that both corners of your mouth lift equally?
    → Yes / Partially / No
  • Can you raise your eyebrows to create wrinkles on your forehead?
    → Yes / No

Symmetry Questionnaire

Captures perception of resting facial symmetry and differences between affected and healthy side.

• • When your face is at rest, does it look symmetrical to you?
    → Completely symmetrical / Mildly asymmetrical / Moderately asymmetrical / Very asymmetrical
  • Do you notice visible differences between the affected and the healthy side of your face at rest?
    → Yes / No / Unsure

Communication & Social Impact Questionnaire

Evaluates speech clarity, self-consciousness, and ability to show emotions in social situations.

• How easily can you speak clearly? (0–5)
  → 0 Not understandable at all / 1 Very difficult / 2 Moderately difficult / 3 Somewhat understandable / 4 Almost fully understandable / 5 Fully understandable
• Do you feel self-conscious when talking to others because of your facial problem? (0–5)
  → 0 Not at all / 1 Slightly / 2 Moderately / 3 Considerably / 4 Very much / 5 Extremely
• Do you have difficulties showing emotions (smiling, laughing) in social situations?
  → Never / Sometimes / Often / Always

Emotions & Self-confidence Questionnaire

Explores satisfaction with facial appearance, stress frequency, and social limitations.

• How satisfied are you with the appearance of your face? (0–10)
  → 0 Not satisfied at all / 1 Very dissatisfied / 2 Dissatisfied / 3 Slightly dissatisfied / 4 Somewhat satisfied / 5 Moderately satisfied / 6 Mostly satisfied / 7 Satisfied / 8 Very satisfied / 9 Almost fully satisfied / 10 Fully satisfied
• How often does your facial problem cause you stress?
  → Never / Rarely / Sometimes / Often / Always
• Do you feel limited in making new social contacts because of your facial problem?
  → Not at all / Slightly / Moderately / Very much

Quality of Life Questionnaire

Screens daily-life impact, including eating, activities, and pain/discomfort levels.

• Do you have difficulties eating or drinking (e.g., keeping fluids in your mouth)?
  → Yes / No / Sometimes
• To what extent does your facial problem interfere with your daily activities? (0–10)
  → 0 Not at all / 1 Very little / 2 Slightly / 3 Somewhat / 4 Moderately / 5 Noticeably / 6 Considerably / 7 Strongly / 8 Very much / 9 Almost completely / 10 Fully, severely interfering
• Do you feel facial pain or discomfort in everyday life? (0–10)
  → 0 No discomfort / 1 Very mild discomfort / 2 Mild discomfort / 3 Slight discomfort / 4 Some discomfort / 5 Moderate discomfort / 6 Considerable discomfort / 7 Strong discomfort / 8 Very strong discomfort / 9 Almost severe discomfort / 10 Severe discomfort

Specific Symptoms Questionnaire (Hemifacial spasm)

Targets symptom severity and frequency, focusing on involuntary eye closure and spasms.

• How much are you bothered by involuntary eye closure? (0–5)
  → 0 Not at all / 1 Slightly / 2 Moderately / 3 Considerably / 4 Very much / 5 Extremely
• How often do you experience involuntary facial spasms?
  → Never / Sometimes / Often / Always

Custom Questionnaires

If you would like to suggest or add your own questionnaire or a specific question to the database, please contact us at info@facerehab.eu.

At the moment, we process such requests manually, but in the future we are preparing a more interactive option directly through the Provider Portal.