Reliability of a new practical evaluation method for pitting edema based on the depth of the surface imprint

Abstract

[Purpose] To develop and verify the reliability of a new practical evaluation method for pitting edema, which uses the depth of the surface imprint as an indicator. [Subjects] We included 26 inpatients (52 legs). [Methods] The subjects were diagnosed with edema, and we verified the inter- and intra-rater reliabilities of the edema gauge using intraclass correlation coefficients. [Results] For the first and second measurement values and the measured values between the examiners, the intraclass correlation coefficients were high. [Conclusion] Therefore, our findings suggest that the edema gauge, which measures the depth of the surface imprint, has sufficient intra- and inter-rater reliabilities.

Validity of a New Quantitative Evaluation Method that Uses the Depth of the Surface Imprint as an Indicator for Pitting Edema

“…The examiner pressed down with a digital force gauge for 10 seconds on the top of each foot in the central region, along the line that connects the first metatarsal head and the fifth metatarsal head, and recorded the measurement after 10 seconds. The measurement instrument (edema gauge, KM-212-003, Unique Medical Company, Tokyo, Japan) used to measure the depth of the surface imprint has been previously described [ 3 ] ( Fig 1 ). Specifications of the measurement instrument are shown in Fig 2 , and the visualization process of the instrument for the surface imprint is shown in Fig 3 .…”

“…The examiner had 10 years of clinical experience, with high intra-rater correlation coefficients (ICC [1,1]: right, 0.91; left, 0.97) in a previous work [ 3 ]. The examiner collected all measurements for a given subject.…”

“…Almost all cases of edema are pitting edema, and many cases of non-pitting edema are actually lymphedema, in which the tissues proceed to harden. Diseases resulting in symptoms of edema that are encountered at medical institutions vary from internal diseases (e.g., kidney, liver, heart, and endocrine diseases) to orthopedic diseases, central nervous system diseases, and malignant tumors [ 3 ]. Edema of the extremities is a somatic symptom that is also commonly observed in daily life.…”

“…Measuring the depth of the surface imprint is simple and may provide a valuable tool for use in the clinic. We developed a new practical evaluation method for pitting edema and verified the reliability of the method, which uses the depth of a surface imprint as an indicator [ 3 ]. Our previous study yielded high intra-rater correlation coefficients (ICC [1,1]: right, 0.91; left, 0.97) and high inter-rater correlation coefficients (ICC [2,1]: right, 0.99; left, 0.97), indicating that the new practical evaluation is reliable.…”

Miscellaneous venous disorders and lymphedema

“… 4 Others have proposed alternative methods to quantify pitting edema. 5 , 6 , 7 , 8 We developed a novel three-dimensionally (3D) printed edema ruler to quantitatively measure edema and validated its clinical effectiveness.…”