Feasibility and efficacy of home-based lymphedema exercises for head and neck cancer patients at a safety net hospital

Purpose: Lymphedema therapy is an effective tool in mitigating head and neck lymphedema morbidity and long-term fibrosis. Studies have shown the efficacy of facility-based therapy; however, access can be limited by sociodemographic factors, including socioeconomic status and transportation. This study evaluates the feasibility and effectiveness of home-based lymphedema therapy in a socially vulnerable patient population.

Materials and methods: A retrospective chart review analyzed patients who underwent home-based lymphedema exercise regimen after training with a lymphedema-trained speech language pathologist between 2019 and 2022 at a tertiary academic medical center. Patient and cancer demographics were collected. Primary outcomes measured were quality of life surveys and diet status.

Results: Of the 27 patients included, 85.1 % were in the two highest quintiles of neighborhood deprivation based on national Area Deprivation Index (ADI). Treatment breakdown included 78 % who were treated with surgery, 96 % completed radiation and 59.3 % chemotherapy. Six months after initiating lymphedema therapy, most patients (59.3 %) were compliant with exercises. Quality of life scores showed trends toward improvement, but only a decrease in condition-related anxiety at 3 months (p = 0.004) reached statistical significance. Improvement in diet was significant at 6 and 9 months after initiation of treatment (p = 0.020).

Conclusions: Patient compliance rate demonstrates feasibility of home exercises for lymphedema treatment in a tertiary care setting with a socially vulnerable patient population. Home-based head and neck lymphedema treatment showed improvements in patient diet over time.