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Reliability test of measurements of lower limb volume and local tissue water in healthy subjects

Jönsson, Charlotta LU ; Bjurberg, Maria LU ; Brogårdh, Christina LU and Johansson, Karin LU (2019) In European Journal of Lymphology and Related Problems 30(79). p.34-34
Abstract
Background:The assessment of lower limb volume by circumferential measurements every 4th cm along the limb is common in
lymphedema management. In recent years, also measurements of local tissue water by Tissue Dielectric Constant (TDC) of the skin
using a MoistureMeterD have been applied more frequently. There are very few studies assessing the reliability of these methods.
Aim of the work: To evaluate the test-retest reliability of lower limb volume and local tissue water by TDC values in healthy women
and men, and to define limits that indicate real changes over time.
Material & methods: In total, 33 women and 28 men completed the measurements. Inclusion criteria was 18 years or older, with a
stratified... (More)
Background:The assessment of lower limb volume by circumferential measurements every 4th cm along the limb is common in
lymphedema management. In recent years, also measurements of local tissue water by Tissue Dielectric Constant (TDC) of the skin
using a MoistureMeterD have been applied more frequently. There are very few studies assessing the reliability of these methods.
Aim of the work: To evaluate the test-retest reliability of lower limb volume and local tissue water by TDC values in healthy women
and men, and to define limits that indicate real changes over time.
Material & methods: In total, 33 women and 28 men completed the measurements. Inclusion criteria was 18 years or older, with a
stratified variety in age, and with no previous lower limb swelling. Both legs were measured by the same rater (CJ), at two occasions, 2
weeks apart, preferable in the morning. Circumferential measurements every 4th cm along the limb were used to calculate the volume,
and measurements of local tissue water were taken at 14 predefined points, using TDC.
Statistical methods: To evaluate the reliability agreements between measurements (ICC2,1), systematic changes in the mean, the
standard of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%) were used. The SEM% gives the
measurement variability in relative values and represents the limit for the smallest change that indicates a real change for a group of
subjects. The SRD% represents the limit for the smallest change that indicates a real change for a single subject.
Results: For the volume, the reliability was excellent (ICC2,1 0.99) and the mean difference was low for both women and men. A
systematic difference was seen only in the left limb in men. The SEM% was 1.3% and the SRD% was 3.6%. For the TDC
measurements, the ICC2,1 ranged from 0.63 to 0.93 in women and from 0.21 to 0.89 in men. The mean difference was low. Some
small systematic differences in the mean were found in a few points. The SEM% ranged from 3.9% to 10.2% in women and from 3.9%
to 14.5% in men. The SRD% ranged from 10.8% to 28.2% in women and from 10.9% to 40.1% in men.
Conclusions: Lower limb volume and TDC measurements can be reliable measured in healthy subjects. Small changes in volume will
indicate real clinical changes for a group of subjects as well as for single subjects. Relatively small changes in TDC values in all points
in women and in all but 3 points in men, will indicate real clinical changes for a group of subjects as well as for single subjects. (Less)
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Contribution to journal
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in
European Journal of Lymphology and Related Problems
volume
30
issue
79
pages
34 - 34
publisher
European Group of Lymphology
ISSN
0778-5569
language
English
LU publication?
yes
id
013a36f5-c9ba-48d4-bd33-2c5a5922e4b1
alternative location
https://www.eurolymphology.org/JOURNAL/VOL30-N79-2019.pdf
date added to LUP
2022-04-06 09:07:44
date last changed
2022-04-06 09:07:44
@misc{013a36f5-c9ba-48d4-bd33-2c5a5922e4b1,
  abstract     = {{Background:The assessment of lower limb volume by circumferential measurements every 4th cm along the limb is common in<br/>lymphedema management. In recent years, also measurements of local tissue water by Tissue Dielectric Constant (TDC) of the skin<br/>using a MoistureMeterD have been applied more frequently. There are very few studies assessing the reliability of these methods.<br/>Aim of the work: To evaluate the test-retest reliability of lower limb volume and local tissue water by TDC values in healthy women<br/>and men, and to define limits that indicate real changes over time.<br/>Material &amp; methods: In total, 33 women and 28 men completed the measurements. Inclusion criteria was 18 years or older, with a<br/>stratified variety in age, and with no previous lower limb swelling. Both legs were measured by the same rater (CJ), at two occasions, 2<br/>weeks apart, preferable in the morning. Circumferential measurements every 4th cm along the limb were used to calculate the volume,<br/>and measurements of local tissue water were taken at 14 predefined points, using TDC.<br/>Statistical methods: To evaluate the reliability agreements between measurements (ICC2,1), systematic changes in the mean, the<br/>standard of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%) were used. The SEM% gives the<br/>measurement variability in relative values and represents the limit for the smallest change that indicates a real change for a group of<br/>subjects. The SRD% represents the limit for the smallest change that indicates a real change for a single subject.<br/>Results: For the volume, the reliability was excellent (ICC2,1 0.99) and the mean difference was low for both women and men. A<br/>systematic difference was seen only in the left limb in men. The SEM% was 1.3% and the SRD% was 3.6%. For the TDC<br/>measurements, the ICC2,1 ranged from 0.63 to 0.93 in women and from 0.21 to 0.89 in men. The mean difference was low. Some<br/>small systematic differences in the mean were found in a few points. The SEM% ranged from 3.9% to 10.2% in women and from 3.9%<br/>to 14.5% in men. The SRD% ranged from 10.8% to 28.2% in women and from 10.9% to 40.1% in men.<br/>Conclusions: Lower limb volume and TDC measurements can be reliable measured in healthy subjects. Small changes in volume will<br/>indicate real clinical changes for a group of subjects as well as for single subjects. Relatively small changes in TDC values in all points<br/>in women and in all but 3 points in men, will indicate real clinical changes for a group of subjects as well as for single subjects.}},
  author       = {{Jönsson, Charlotta and Bjurberg, Maria and Brogårdh, Christina and Johansson, Karin}},
  issn         = {{0778-5569}},
  language     = {{eng}},
  note         = {{Conference Abstract}},
  number       = {{79}},
  pages        = {{34--34}},
  publisher    = {{European Group of Lymphology}},
  series       = {{European Journal of Lymphology and Related Problems}},
  title        = {{Reliability test of measurements of lower limb volume and local tissue water in healthy subjects}},
  url          = {{https://www.eurolymphology.org/JOURNAL/VOL30-N79-2019.pdf}},
  volume       = {{30}},
  year         = {{2019}},
}