BIOELECTRICAL-IMPEDANCE FOR MONITORING THE EFFICACY OF LYMPHEDEMA TREATMENT PROGRAMS

The treatment of lymphoedema includes a combination of massage, compre ssion bandaging, and exercise. To date the most common technique of as sessing the efficacy of treatment has involved estimating the total li mb volume from circumferential measurements at fixed intervals along t he limb. This study investigated the application of multiple frequency bioelectrical impedance analysis, MFBIA, to monitor the volume of lym phoedema in the upper limb of patients who developed this disorder fol lowing surgery for cancer of the breast. Daily measurements of both ci rcumference and impedance of both the affected and unaffected limbs we re recorded for 20 patients throughout their 4 week treatment programm es. Twenty control subjects were also monitored daily over a similar 4 week period. Prior to the commencement of treatment the bioimpedance technique detected a significant (P < 0.01) asymmetry between the two limbs of the control subjects, associated with handedness (P < 0.001). Circumferential estimates of limb volumes in the control group detect ed no asymmetry. Impedance measures of extracellular fluid showed all of the patients to lie outside the 95% confidence interval determined from the data of the control group. The trends of the impedance measur es and the circumferential estimates of volume throughout the 4 week p rogram were found to be significantly different (P < 0.05); MFBIA exhi biting a greater sensitivity in the detection of lymphoedema. The resu lts demonstrate that MFBIA is significantly more sensitive than circum ferential measurement both in the early diagnosis of lymphoedema and i n monitoring change.