The Effects of Clinical and Home-based Physiotherapy Programs in Secondary Head and Neck Lymphedema

Laryngoscope. 2021 May;131(5):E1550-E1557. doi: 10.1002/lary.29205. Epub 2020 Oct 28.


Objectives/hypothesis: To determine the effects of complex decongestive physiotherapy (CDP) and home programs on external lymphedema, staging of lymphedema, fibrosis, and three-dimensional (3D) surface scanning and volume evaluation in head and neck lymphedema.

Study design: A prospective randomized controlled study.

Methods: Twenty-one patients were randomly divided into three groups: CDP (n:7), home program (n:7), and control (n:7). Assessment methods were applied at baseline and 4 weeks later for all groups. MD. Anderson Cancer Center Head and Neck Lymphedema Protocol was implemented to evaluate head and neck external lymphedema, staging of lymphedema, and fibrosis. A 3D scanner and a software were used to determine and calculate the volume of the head and neck region via 3D surface scanning. Head and neck external lymphedema and fibrosis assessment criteria were performed to evaluate visible soft tissue edema and the degree of stiffness.

Results: The severity and volume of lymphedema decreased in the CDP program group (P < .05). Besides, external lymphedema and fibrosis at submental region were decreased in both CDP program and home program groups (P < .05).

Conclusions: While the benefits of home program are limited, a CDP program may be more effective in the management of lymphedema and fibrosis in patients diagnosed with head and neck cancer. The clinical trial registration number: NCT04286698, date: 02/25/2020, retrospectively registered.

Level of evidence: 4 Laryngoscope, 131:E1550-E1557, 2021.

Keywords: 3D analysis; Complex decongestive physiotherapy; face mask; home program; manual lymph drainage.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Over Studies
  • Female
  • Head / diagnostic imaging
  • Head and Neck Neoplasms / complications*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Imaging, Three-Dimensional
  • Lymphedema / diagnosis
  • Lymphedema / etiology
  • Lymphedema / therapy*
  • Male
  • Middle Aged
  • Neck / diagnostic imaging
  • Physical Therapy Modalities*
  • Prospective Studies
  • Self Care / methods*
  • Severity of Illness Index
  • Treatment Outcome

Associated data