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

Research output: Contribution to journalPublished meeting abstractpeer-review

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 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.
Original languageEnglish
Pages (from-to)34
JournalEuropean Journal of Lymphology and Related Problems
Volume30
Issue number79
Publication statusPublished - 2019

Subject classification (UKÄ)

  • Physiotherapy

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