Feasibility of a Physiatry Assessment Clinic to Address Physical Impairment in Head and Neck Cancer Patients Following Neck Resection and Free Flap Reconstruction

Abstract

Individuals with head and neck cancers are living longer than ever before, yet many live with the long-term effects of their cancer and treatment. The purpose of this study was to assess the feasibility of a physiatry assessment clinic (PAC) following neck resection and free flap reconstruction, during which physical function was assessed.

Methods: Adult patients participating in a larger prehabilitation study were included. Attendance and the ability to complete the physical function assessment were examined. Exploratory analyses were completed to describe physical function, fitness, shoulder, and neck function among PAC attenders. To further understand PAC feasibility, patient-reported outcomes among PAC attenders and non-attenders were examined over 12 months (QuickDASH, NDII, EAT-10).

Results: A total of 36 eligible participants (78.2%) from the larger prehabilitation study were approached to participate in the PAC, and 19 of the 36 attended (52.8%). Participants attended on average 8.6 ± 3.6 weeks post surgery, and 100% were able to complete the functional measures. Exploratory data suggest that those who did not attend (17 of 36 approached) had more advanced disease compared to those who attended (p < 0.05). Patient-reported outcomes suggested better shoulder function and swallow function at 6 months among those who attended the clinic versus those who did not.

Conclusions: While recruitment to the PAC and assessment completion demonstrated feasibility, attendance posed challenges for patients. These findings highlight the need for innovative approaches to screening patients and tailoring rehabilitation services based on physical impairment.

Keywords: cancer physiatry; cancer rehabilitation; free flap reconstruction; head and neck cancer; impairment-driven screening; neck resection.

Figure 1

Physiatry clinic attendance.