title: Reliability and validity of arm volume measurements for assessment of lymphedema.
abstract: OBJECTIVE
  Arm lymphedema following breast cancer surgery is a continuing problem. In this study, we assessed the reliability and validity of circumferential measurements and water displacement for measuring upper-limb volume.
  
  
  METHODS
  Participants included subjects who had had breast cancer surgery, including axillary dissection--19 with and 22 without a diagnosis of arm lymphedema--and 25 control subjects.
  
  
  METHODS
  Two raters measured each subject by using circumferential tape measurements at specified distances from the fingertips and in relation to anatomic landmarks and by using water displacement. Interrater reliability was calculated by analysis of variance and multilevel modeling. Volumes from circumferential measurements were compared with those from water displacement by use of means and correlation coefficients, respectively. The standard error of measurement, minimum detectable change (MDC), and limits of agreement (LOA) for volumes also were calculated.
  
  
  RESULTS
  Arm volumes obtained with these methods had high reliability. Compared with volumes from water displacement, volumes from circumferential measurements had high validity, although these volumes were slightly larger. Expected differences between subjects with and without clinical lymphedema following breast cancer were found. The MDC of volumes or the error associated with a single measure for data based on anatomic landmarks was lower than that based on distance from fingertips. The mean LOA with water displacement were lower for data based on anatomic landmarks than for data based on distance from fingertips.
  
  
  CONCLUSIONS
  Volumes calculated from anatomic landmarks are reliable, valid, and more accurate than those obtained from circumferential measurements based on distance from fingertips.
authors.affiliation: School of Population Health, Faculty of Health Sciences, University of Queensland, Herston, Queensland, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Taylor
authors.forename: Upali W
authors.initials: UW
authors.lastname: Jayasinghe
authors.forename: Louise
authors.initials: L
authors.lastname: Koelmeyer
authors.forename: Owen
authors.initials: O
authors.lastname: Ung
authors.forename: John
authors.initials: J
authors.lastname: Boyages
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry / Q000379:methods*; D001132:Arm / Q000473:pathology*; D001365:Axilla; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008209:Lymphedema / Q000145:classification / Q000209:etiology / Q000473:pathology*; D008408:Mastectomy / Q000009:adverse effects; D009517:New South Wales; D015588:Observer Variation; D011237:Predictive Value of Tests; D014867:Water
chemical_list: D014867:Water