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  • Normative Interlimb Impedance Ratios: Implications for Early Diagnosis of Uni- and Bilateral, Upper and Lower Limb Lymphedema

    Author(s)
    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
    Hayes, Sandra C
    Griffith University Author(s)
    Hayes, Sandi C.
    Reul-Hirche, Hildegard M.
    Year published
    2018
    Metadata
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    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) ...
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    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.
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    Journal Title
    Lymphatic Research and Biology
    Volume
    16
    Issue
    6
    DOI
    https://doi.org/10.1089/lrb.2017.0082
    Subject
    Oncology and carcinogenesis not elsewhere classified
    Clinical sciences not elsewhere classified
    Science & Technology
    Life Sciences & Biomedicine
    Medicine, Research & Experimental
    Physiology
    Research & Experimental Medicine
    Publication URI
    http://hdl.handle.net/10072/388060
    Collection
    • Journal articles

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