Sander Antoinette P, Hajer Nicole M, Hemenway Kristie, Miller Amy C
Department of Physical Therapy and Human Movement Sciences, The Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA.
Phys Ther. 2002 Dec;82(12):1201-12.
Upper-extremity (UE) swelling following breast cancer treatment is a frequent manifestation of lymphedema. In order to document outcomes from lymphedema treatments, reliable, valid, and practical measurements of UE swelling are necessary. The purpose of this study was to compare geometric methods of determining UE volumes with water displacement methods.
The edematous hand, forearm, and upper arm of 50 women with UE swelling secondary to lymphedema were measured.
Upper-extremity volumes were determined by water displacement using arm and hand volumeters. Displaced water was weighed to determine volume. Circumferential girth measurements were taken. Width and depth measurements of the hand were taken with a tension-controlled caliper. Geometric volume formulas for a cylinder, frustum, rectangular solid, and trapezoidal solid were used to calculate volumes of the arm and hand at different measurement intervals.
Intraclass correlation coefficients [2,1] for interrater and intrarater reliability of all water and geometric measurements of the arm and hand were.91 to.99 and.92 to.99, respectively. Water displacement correlated with geometric measurements in the arm (r=.97-.98) and in the hand (r=.81-.91). The limits of agreement (LOA) indicated that water and geometric measurements of arm volume differed by 479 to 655 mL. Scatterplots of the LOA data indicated in that geometric volumes were either larger or smaller than water volumes. The smallest standard error of measurement for the arm measurements was for the 6-cm frustum method at 115 mL; for the hand measurements, the smallest standard error of measurement was for the frustum method at 16 mL.
Volume of an edematous UE calculated by geometric formulas correlated strongly with volume determined by water displacement. Although strongly correlated, the measurements obtained by the 2 methods did not agree.
乳腺癌治疗后上肢（UE）肿胀是淋巴水肿的常见表现。为记录淋巴水肿治疗的结果，需要对UE肿胀进行可靠、有效且实用的测量。本研究的目的是比较确定UE体积的几何方法与水置换法。
对50例因淋巴水肿继发UE肿胀的女性的患侧手、前臂和上臂进行测量。
使用手臂和手部体积计通过水置换法确定上肢体积。称取排出水的重量以确定体积。测量周径。使用张力控制卡尺测量手部的宽度和深度。使用圆柱体、平截头体、长方体和梯形体的几何体积公式计算不同测量间隔时手臂和手部的体积。
手臂和手部所有水测量法及几何测量法的组内相关系数[2,1]，评定者间信度和评定者内信度分别为0.91至0.99和0.92至0.99。手臂水置换法与几何测量法的相关性为r = 0.97 - 0.98，手部为r = 0.81 - 0.91。一致性界限（LOA）表明手臂体积的水测量法和几何测量法相差479至655 mL。LOA数据的散点图表明几何体积要么大于要么小于水体积。手臂测量中最小测量标准误是6厘米平截头体法，为115 mL；手部测量中最小测量标准误是平截头体法，为16 mL。
通过几何公式计算的水肿UE体积与水置换法确定的体积高度相关。尽管相关性很强，但两种方法获得的测量结果并不一致。
