Normative interlimb impedance ratios: implications for early diagnosis of uni- and bilateral, upper and lower limb lymphedema

Steele, Megan L., Janda, Monika, Vagenas, Dimitrios, Ward, Leigh C., Cornish, Bruce H., Box, Robyn, Gordon, Susan, Matthews, Melanie, Poppitt, Sally D., Plank, Lindsay D., Yip, Wilson, Rowan, Angela, Reul-Hirche, Hildegard, Obermair, Andreas, and Hayes, Sandra C. (2018) Normative interlimb impedance ratios: implications for early diagnosis of uni- and bilateral, upper and lower limb lymphedema. Lymphatic Research and Biology, 16 (6). pp. 559-566.

[img] PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: https://doi.org/10.1089/lrb.2017.0082
 
4
3


Abstract

Background: Bioimpedance spectroscopy detects unilateral lymphedema if the ratio of extracellular fluid (ECF) between arms or between legs is outside three standard deviations (SDs) of the normative mean. Detection of bilateral lymphedema, common after bilateral breast or gynecological cancer, is complicated by the unavailability of an unaffected contralateral limb. The objectives of this work were to (1) present normative values for interarm, interleg, and arm-to-leg impedance ratios of ECF and ECF normalized to intracellular fluid (ECF/ICF); (2) evaluate the influence of sex, age, and body mass index on ratios; and (3) describe the normal change in ratios within healthy individuals over time.

Methods: Data from five studies were combined to generate a normative data set (n=808) from which mean and SD were calculated for interarm, interleg, and arm-to-leg ratios of ECF and ECF/ICF. The influence of sex, age, and body mass index was evaluated using multiple linear regression, and normative change was calculated for participants with repeated measures by subtracting their lowest ratio from their highest ratio.

Results: Mean (SD) interarm, interleg, dominant arm-to-leg, and nondominant arm-to-leg ratios were 0.987 (0.067), 1.005 (0.072), 1.129 (0.160), and 1.165 (0.174) for ECF ratios; and 0.957 (0.188), 1.024 (0.183), 1.194 (0.453), and 1.117 (0.367) for ECF/ICF ratios, respectively. Arm-to-leg ratios were significantly affected by sex, age, and body mass index. Mean normative change ranged from 7.2% to 14.7% for ECF ratios and from 14.7% to 67.1% for ECF/ICF ratios.

Conclusion: These findings provide the necessary platform for extending bioimpedance-based screening beyond unilateral lymphedema.

Item ID: 55872
Item Type: Article (Research - C1)
ISSN: 1557-8585
Keywords: lymphedema, bilateral, lower limb, diagnostic criteria, bioimpedance
Date Deposited: 17 Oct 2018 08:06
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified @ 100%
Downloads: Total: 3
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page