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Summary of the included studies
| Author, Year | Participants | Intervention | Outcome measures | Salient findings | PEDro score |
|---|---|---|---|---|---|
| De Vos MC et al., 2013 | Women, N=18 (9 experimental and 9 control), mean age of experimental group=47 years (range: 40-55 years), and mean age of control group=46 years (range: 39-60 years) | Four isometric exercises (targeted muscles: frontalis, orbicularis oris, zygomaticus minor, and sternocleidomastoid and mylohyoid muscles) conducted daily for 7 weeks | Photographs, visual analogue scale: comparison of facial areas (forehead, nasolabial folds, area above the upper lip, jawline and area under the chin) before and after intervention: whether it looks younger, has wrinkles, etc. | In comparison with the experimental group and the control group, only the upper lip appeared to look younger after the intervention | 7 |
| Kim et al., 2016 | Women, N=16, mean age=not reported (38-45 years) | Isometric resistance exercise, 3 sets twice a day for 8 weeks | Mechanical and elastic properties of skin: cutometer | The ability to return to the original position was improved by increasing the elasticity of the skin. No change in viscoelastic properties | 3 |
| Hwang UJ et al., 2018 | Women, N=50, mean age=40.0±10.0 years (range: 30-63 years) | Facial exercise using the Pao device, 6 days a week for 8 weeks, twice a day | Muscle thickness, cross-sectional area (ultrasound), facial surface distance, surface area, volumes: laser scanning system Wrinkles and jawline sagging: face visual scale |
Increased cross-sectional area of the zygomaticus major Increased muscle thickness in the levator labii superioris and orbicularis oris Midfacial surface distance decreased Facial visual scale improved |
3 |
| Alam M et al., 2018 | Women, N=16, mean age=53.7±5.8 years (range: 40-65 years) | Muscle resistance facial exercise performed every day for 8 weeks, and facial exercises performed every other day for 9 to 20 weeks | Facial aging: Merz-Carruthers Facial Aging photoscales | Reported satisfaction with all aspects of facial aging after the intervention (showed an increase in upper and lower cheek fullness) | 2 |
| Ibrahim F et al., 2013 | Women, N=13, mean age=44.7±3.4 years (range: 40 years and above) | Orofacial myofunctional exercise (using Patakara, an oral rehabilitation device) for 14 or 24 weeks, 4 times daily for 3 minutes | Lip De Cum ®/ LDC-110: labial closure strength (LCS), tongue elevation strength (TES) Skin elasticity: cutometer |
After the intervention, there were significant improvements in LCS, TES, and skin elasticity | 3 |
| Ohtsuka M et al., 2015 | Healthy volunteers (but with lip incompetence), N=18, mean age=25.0±2.5 years | Lip endurance training was conducted daily for 4 weeks using 20 repetitions using 50% of orbicularis oris 1RM | Sealed lip ratio: lip-contact sensor and electrical recording device Orbicularis oris endurance: the time from the start of the test to the plates escaping the mouth was recorded as a measure of the endurance of the orbicularis oris |
Lip-endurance training increased orbicularis oris endurance and the sealed lip ratio | 3 |
| Potter NL et al., 2015 | N=33 (16 experimental and 16 control, 1 with Bell's palsy), mean age of experimental group=28.7±17.4 years (range: 18-27 years), and mean age of control group=28.9±16.6 years | Comparison of differences in strength and endurance of lips, cheeks, and tongue between adult trumpet players and non-trumpet players practicing at least 6 hr/wk | Strength and endurance of lip, cheek, and tongue muscles: Iowa Oral Performance Instrument | The trumpet players had greater cheek strength and greater lip endurance than controls. There was no difference in tone strength and endurance | 4 |
| Kaede K et al., 2015 | N=20 (10 experimental and 10 control), mean age of experimental group=28.5±1.5 years, and mean age of control group=26.7±1.8 years | Lip-closing training (using Patakara). 3 tasks per day for 4 weeks |
Multidirectional lip-closing forces (MLCF): MLCF measurement system | The lip-closing force significantly increased in the experimental group in the upward and downward directions compared to the control group | 4 |
| Fujiwara A et al., 2016 | Women, N=66 (32 group A and 34 group B). Mean age of group A=20.5 years, and mean age of group B=20.2 years) | Intervention (lip training) 2 sets daily for 7 days | Lip-closing force (LCF): multidirectional LCF measurement device | LCP increased in the following order: pre-training, 5 days post-training, and 7 days post-training in every direction | 4 |
| Yoshizawa S et al., 2016 | Healthy volunteers, N=20, mean age=23.6±2.3 years | Hypoxic lip training performed daily for 4 weeks | Sealed lip ratio: lip contact sensor and electrical recording device The tensile strength of the orbicularis oris: measured at the force required for the plate to come out of the oral vestibule |
The sealed lip ratios in both the relaxation and concentration conditions significantly increased during the training period | 3 |
| Takamoto K et al., 2018 | Elderly people, N=20 (10 experimental and 10 control), mean age of experimental group=87.3±1.6 years, and mean age of control group=85.3±5.9 years | Performed lip closure training using an oral rehabilitation device 3 times daily for 4 weeks | Maximal lip closure force: A digital measurement device (Lip De Cum®), eating behavior: digital video cameras, rest-activity rhythm: three-axis accelerometer, cerebral hemodynamic activity during the lip closure movement: near-infrared spectroscopy | The experimental group showed improvement in maximal lip closure force, shortened eating time, decreased food spill rates, and decreased daytime sleeping. The experimental group also showed a significant increase in prefrontal cortical activity during lip closure | 7 |