Measuring change in limb volume to evaluate lymphoedema treatment outcome

Abstract

The accurate, non-invasive measurement of limb volume in patients with lymphoedema is important in the clinical and research setting. Aim This paper provides an overview of the practical approaches to assessing limb volume and calculating changes in limb volume after treatments in patients with unilateral lymphoedema. Methods Techniques for assessing limb volume are described, and a case study example is presented. A compression bandaging system comprised of a foam roll and cohesive, inelastic bandages was applied to 9 patients with unilateral lymphoedema on 6 occasions over a 12-day treatment period. Two parameters for measuring the changes in limb volume after the course of treatment were used to evaluate treatment outcomes. n Parameter 1: percentage change in excess limb volume over time. n Parameter 2: percentage change in absolute limb volume over time. Results In 9 patients, the mean percentage change in excess limb volume at Day 12 was 35%, and the mean percentage change in absolute limb volume was 8%. Conclusions The two parameters for calculating changes in limb volume are not interchangeable. Parameter 1 is only suitable for patients with unilateral lymphoedema, but provides the information on the reduction of lymphoedema (excess) volume. Parameter 2 can be used for patients with bilateral lymphoedema, where no comparator or unaffected limb is available. Both parameters should be reported in research, and both limbs should be measured, if possible. However, Parameter 2 should be used with caution, as the percentage change is based on the whole limb volume, rather than the more accurate excess limb volume as a measure of lymphoedema.