MuIti‐frequency bioelectrical impedance augments the diagnosis and management of lymphoedema in post‐mastectomy patients

Ward, LC; Bunce, Ian; Cornish, Bruce; Mirolo, Beverley R.; Thomas, Brian; Jones, Luke

doi:10.1111/j.1365-2362.1992.tb01440.x

Cited by 105 publications

(74 citation statements)

References 7 publications

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“…Adapted from Piccoli et al 54 affected arm compared with the unaffected arm of women with lymphoedema, and these values were also significantly less than those in the matched arms of control women. 62 This novel approach used current-injecting electrodes placed on the conventional hand and foot locations, with detector electrodes positioned on the wrist and at the end of a 40-cm length up the arm to maximise the potential to fluid-related effects on impedance measurements. 63 Because of the wide biological variation between individuals in arm impedance values, impedance per se does not differentiate well between the affected and the unaffected limb.…”

Section: Less Fluidsmentioning

confidence: 99%

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

2013

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BACKGROUND/OBJECTIVES:Bioimpedance is the collective term that describes safe, non-invasive methods to measure the electrical responses to the introduction of a low-level, alternating current into a living organism, and the biophysical models to estimate body composition from bioelectrical measurements. Although bioimpedance techniques have been used for more than 100 years to monitor assorted biological components, the desire to translate bioelectrical measurements into physiological variables advanced the creation of empirical prediction models that produced inconsistent results. SUBJECTS/METHODS: This paper succinctly reviews the origin, and critically evaluates the conceptual models and the implementation of bioimpedance in clinical research, including indirect assessment of assorted physiological functions and body composition (fluid volumes and fat-free mass), classification of hydration, regional fluid accumulation, prognosis in disease and wound healing. RESULTS: Despite widespread and mounting interest in the use of bioimpedance to characterise body structure and function, most experimental findings reveal the limitations of existing physical models and reliance on multiple regression models for use in assessments of an individual. CONCLUSIONS: Contemporary applications of bioimpedance emphasise the value of bioimpedance variables per se in some novel biomedical applications with the objective of identifying opportunities for future outcome-based research.European Journal of Clinical Nutrition (2013) 67, S2-S9; doi:10.1038/ejcn.2012.149Keywords: resistance; reactance; impedance; phase angle; hydration; prognosis INTRODUCTIONThe history of the use of electrical current to explore tissues and reveal information about its composition and function recognises various contributions that are the basis for contemporary bioimpedance analysis.1 The chronology of bioimpedance research highlights an interesting sequence of events that range from the development of biophysical models to address applications in the estimation of pulsatile blood flow 2-4 to assessment of body composition.

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Section: Less Fluidsmentioning

confidence: 99%

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

2013

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“…Participants had a histological diagnosis of breast cancer at least 1 year prior to the study, a clinical diagnosis of BCRL, and obtained medical clearance from their physician. Clinical diagnosis of lymphedema was defined as having (a) an impedance ratio of at least 3 standard deviations greater than normative data, 32,33 (b) a volume difference between affected and unaffected limbs of 5% or more, 33,34 and (c) a difference in circumference between affected and unaffected limbs of 5% or more. 21,33,34 Participants were excluded if they had (a) unstable lymphedema, defined as receiving intensive therapy (ie, decongestive therapy or antibiotics for infection) within the previous 3 months, or (b) musculoskeletal, cardiovascular, and/or neurological disorders that could inhibit them from exercising.…”

Section: Methods Participantsmentioning

confidence: 99%

“…33,[36][37][38] Impedance of the extracellular fluid in the affected and non-affected arms was assessed and compared using a range of frequencies according to guidelines of the BIS device manufacturer (ImpediMed IMPTM DF50; ImpediMed, San Diego, CA). 32 The impedance values of the affected and unaffected arms were compared and the ratio reported (L-Dex score). DXA (Hologic Discovery A, Waltham, MA) was used to assess tissue composition of the limbs using a 3-compartment model sensitive to changes in fluid retention.…”

Section: Outcome Measuresmentioning

confidence: 99%

Neither Heavy nor Light Load Resistance Exercise Acutely Exacerbates Lymphedema in Breast Cancer Survivor

et al. 2013

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Resistance exercise has great potential to aid in the management of breast cancer-related lymphedema (BCRL), but little is known regarding the acute response of performing resistance exercises with the affected limb. Purpose. To examine the acute impact of upper body resistance exercise on the amount of swelling and severity of symptoms in women with BCRL and to compare these effects between resistance exercise involving high and low loads (heavier vs lighter weights). Methods. Seventeen women aged 61 ± 9 years with mild to severe BCRL participated in this study. Participants completed a high load (6-8 repetition maximum) and low load (15-20 repetition maximum) exercise session consisting of 2 sets of 5 upper body resistance exercises in a randomized order separated by a 10-to 12-day wash-out period. The extent of swelling was assessed using bioimpedance spectroscopy, dual-energy x-ray absorptiometry, and arm circumference measurements. The severity symptoms were assessed using the visual analogue scale (pain, heaviness, and tightness) and a modified Brief Pain Inventory. Measurements were taken pre-exercise, immediately post-exercise, 24 hours post-exercise, and 72 hours postexercise. Results. No changes in the extent of swelling or the severity of symptoms were observed between pre-exercise and immediately post-exercise, 24 hours post-exercise, or 72 hours post-exercise. No differences in the response to the high or low load exercise were observed. Conclusions. Upper body resistance exercise does not acutely increase swelling or feelings of discomfort/pain, heaviness tightness in the affected limb of BCRL patients when performed at either high or low loads.

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“…86% (19 out of 22) of the values are within these limits. Lymphoedema after mastectomy is known to in¯uence the bioelectric impedance analysis (Ward et al, 1992). Although objective lymphoedema was not systematically registered in this study, lymphoedema was not reported in any cases.…”

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confidence: 68%

Estimates of the sources of variation (variance components) of bioelectric impedance and anthropometric measurements in an epidemiological case-control study of breast cancer

et al. 1997

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Objective: This study investigated the variability of anthropometric measurements and body fat estimated by bioelectric impedance analysis. Subsequently the methods were applied in a case-control study to investigate the association with breast cancer. Design, Subjects: The study group included 50 consecutive cases and 75 age-matched controls from the same area. The variation was investigated in 50 healthy women from the control group, who were repeatably measured using standardised measurement procedures, and the variation between-subjects, within-subjects, betweenobservers, and within-observers were estimated. Results, Conclusions: The study showed that the variance components between-subjects were 64±99% of the total variance. The variables of skinfold thicknesses were characterised by having the highest relative observer variation and having many unavailable values that were out of the range of the Harpenden callipers. The mean body fat by bioelectric impedance analysis was 31.2%, and the total coef®cient of variation 23%, while the variance components related to subject time, observer and measurement were 98.4%, 1.1%, 0.2%, and 0.4%, respectively. The body fat was signi®cantly correlated with the variables of skinfold thicknesses. We decided to exclude the variables of skinfold thicknesses from the case-control study, and for the other variables to measure each subject only at one time by one observer. The case-control part of the study indicated a non-signi®cant increase in body weight in the postmenopausal breast cancer patients (mean difference 3.6 kg; con®dence interval from 70.9 kg to 8.0 kg). Similarly the body fat tended to be higher in the breast cancer patients (mean difference 1.2%; con®dence interval from 71.6% to 4.0%).

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MuIti‐frequency bioelectrical impedance augments the diagnosis and management of lymphoedema in post‐mastectomy patients

Cited by 105 publications

References 7 publications

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research

Neither Heavy nor Light Load Resistance Exercise Acutely Exacerbates Lymphedema in Breast Cancer Survivor

Estimates of the sources of variation (variance components) of bioelectric impedance and anthropometric measurements in an epidemiological case-control study of breast cancer

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