{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T12:29:14Z","timestamp":1754396954484,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lymphedema after treatment for head and neck cancer negatively impacts the quality of life and can produce neck tissue stiffness, dysphagia, pain, and swelling. One form of treatment for lymphedema is machine\u2010delivered sequential lymphedema massage, which is home based and self administered. This study was undertaken to determine economic and system access to home\u2010based lymphedema therapy and to measure patient\u2010reported outcomes among those able to access therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is a retrospective cohort study of 84 head and neck cancer patients who met the criteria for referral for home\u2010based lymphedema treatment. Patients who were able to access lymphedema therapy were surveyed prior to initiation of therapy and again after therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010five out of 84 patients were approved for home\u2010based therapy and received the equipment. Medicare denial of coverage (21\/84) was the most common cause of the inability to access therapy. Of the 35 patients who accessed therapy, presenting complaints included: stiffness (31), pain (29), dysphagia (20), and swelling (19). The average time from completion of cancer treatment to initiation of lymphedema therapy was 9\u00a0months. Thirty\u2010four (97%) reported compliance with prescribed therapy, 33 (94%) reported reduced fibrosis, and 30 (89%) reported improvement in activities of daily living. All reported symptoms improved with therapy in 30 (86%) patients. Thirty\u2010two (91%) reported overall satisfaction with home\u2010based lymphedema treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Stiffness and pain were the most common complaints of our patients with head and neck lymphedema. Forty\u2010two percent of patients who were recommended home lymphedema machine use were able to obtain this with cost coverage by their insurance company or by donation from the company. We found a high compliance rate and a highly reported improvement in symptoms with the machine. The only identifiable factor for the patients with less improvement in symptoms was a greater time gap between treatment and initiation of use of home lymphedema machine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>2 Retrospective cohort analysis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.810","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T11:05:00Z","timestamp":1652094300000},"page":"774-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility of machine\u2010delivered sequential massage for the management of lymphedema in the head and neck cancer survivor"],"prefix":"10.1002","volume":"7","author":[{"given":"Courtney Brooke","family":"Shires","sequence":"first","affiliation":[{"name":"West Cancer Center  Germantown Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Harris","sequence":"additional","affiliation":[{"name":"West Cancer Center  Germantown Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0033-2040","authenticated-orcid":false,"given":"Karuna","family":"Dewan","sequence":"additional","affiliation":[{"name":"Louisiana State University  Shreveport Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"volume-title":"Cancer Facts & Figures 2015","year":"2015","author":"American Cancer Society","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21269"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0001"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.04.013"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200104000-00006"},{"key":"e_1_2_11_7_1","first-page":"128","volume-title":"Lymphedema Management: the Comprehensive Guide for Practitioners","author":"Zuther J","year":"2013"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814558402"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1632401"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24995"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1876504101002020012"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.810","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.810","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.810","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:05:38Z","timestamp":1692835538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.810"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,9]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1002\/lio2.810"],"URL":"https:\/\/doi.org\/10.1002\/lio2.810","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"type":"print","value":"2378-8038"},{"type":"electronic","value":"2378-8038"}],"subject":[],"published":{"date-parts":[[2022,5,9]]},"assertion":[{"value":"2021-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}