Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt Dayani Center for Health and Wellness, Nashville, Tennessee.
Lymphat Res Biol. 2020 Jun;18(3):277-283. doi: 10.1089/lrb.2019.0035. Epub 2019 Sep 19.
Bioimpedance spectroscopy (BIS) demonstrates proficiency in early identification of breast cancer treatment-related lymphedema (BCRL) development. Dual-tab electrodes were designed for consistent and easy electrode placement, however, single-tab electrodes positioned to mimic dual-tab placement on the body may make BIS technology more accessible in community hospitals and outpatient settings. The purpose of this study is to evaluate use of single-tab electrodes for BIS measurements and assess whether single-tab electrodes provide consistent BIS measurements in controls and patients with BCRL. Upper limb BIS ratios were obtained using ImpediMed L-Dex U400 in controls ( = 13; age = 23-75 years; 9 repeated measurements) using dual-tab and single-tab electrodes. BCRL patients ( = 17; Stage = 1.65 ± 0.49; number nodes removed = 16.3 ± 7.7; age = 50.9 ± 10.6 years; age range = 33-77 years) and healthy controls ( = 19) were evaluated to determine if single-tab electrodes provided discriminatory capacity for detecting BCRL. Intraclass correlation coefficients (ICC), linear mixed-effects models, Wilcoxon rank-sum tests, and linear regression with two-sided -values <0.05 required for significance were applied. Single-tab electrodes were found to be statistically interchangeable with dual-tab electrodes (ICC = 0.966; 95% confidence interval = 0.937-0.982). No evidence of differences in single-tab versus dual-tab measurements were found for L-Dex ratios ( = 0.74) from the linear mixed-effects model. Repeated trials involving reuse of the same electrodes revealed a trend toward increases in L-Dex ratio for both styles of electrodes. Single-tab electrodes were significant ( < 0.0001) for discriminating between BCRL and control subjects. Findings expand upon the potential use of BIS in clinic and research settings and suggest that readily available single-tab electrodes provide similar results as dual-tab electrodes for BIS measurements.
生物阻抗谱(BIS)在早期识别乳腺癌治疗相关淋巴水肿(BCRL)的发展方面表现出色。双电极设计用于一致且易于放置电极,但是,为了模拟双电极在身体上的放置位置而定位的单电极可能会使 BIS 技术在社区医院和门诊环境中更容易获得。本研究的目的是评估单电极用于 BIS 测量的效果,并评估单电极在 BCRL 患者和对照者中是否提供一致的 BIS 测量结果。使用 ImpediMed L-Dex U400 在对照者(n=13;年龄 23-75 岁;9 次重复测量)中使用双电极和单电极获得上肢 BIS 比值。评估 BCRL 患者(n=17;阶段 1.65±0.49;切除的淋巴结数 16.3±7.7;年龄 50.9±10.6 岁;年龄范围 33-77 岁)和健康对照者(n=19),以确定单电极是否具有检测 BCRL 的鉴别能力。应用组内相关系数(ICC)、线性混合效应模型、Wilcoxon 秩和检验和双侧线性回归,具有统计学意义的-值 <0.05。单电极与双电极在统计学上是可互换的(ICC=0.966;95%置信区间 0.937-0.982)。线性混合效应模型显示,L-Dex 比值的单电极与双电极测量之间没有差异(=0.74)。涉及相同电极重复使用的重复试验显示出两种电极的 L-Dex 比值均有增加的趋势。单电极在区分 BCRL 和对照组方面具有统计学意义(<0.0001)。这些发现扩展了 BIS 在临床和研究环境中的潜在用途,并表明易于获得的单电极可提供与双电极相似的 BIS 测量结果。