Localized Leg Volume Index: A New Method for Body Type-Corrected Evaluation of Localized Leg Lymphedematous Volume Change.

Abstract

Volume measurement is one of the most common evaluations for lower-extremity lymphedema. However, volume comparison between different patients with different physique may be inappropriate, and it is difficult to evaluate localized limb volume change using leg volume evaluation. Localized leg volumes (Vk, k = 1-5) and localized leg volume indices (LEVIk) at 5 points (1, thigh; 2, knee; 3, lower leg; 4, ankle; 5, foot) of 106 legs of 53 examinees with no leg edema were calculated based on physical measurements, leg circumferences and lengths, and body mass index (BMI). Interrater and intrarater reliabilities of LEVIk were assessed, and Vk and LEVIk were compared between lower BMI (BMI < 22 kg/m) group and higher BMI (BMI ≥ 22 kg/m) group. Interrater and intrarater reliabilities of LEVIk were all high (all: r > 0.98). Between lower and higher BMI groups, significant differences were observed in all Vk: V1 (P = 3.7 × 10), V2 (P = 4.7 × 10), V3 (P = 4.5 × 10), V4 (P = 1.6 × 10), and V5 (P = 2.4 × 10). Regarding LEVI between groups, significant differences were seen in LEVI3 (P = 0.009), LEVI4 (P = 0.004), and LEVI5 (P = 1.3 × 10); no significant difference was seen in LEVI1 (P = 0.23) or LEVI2 (P = 0.51). Localized leg volume index is a highly reproducible and convenient method for evaluation of localized volume change of the lower extremity, which is less affected by body type compared with leg volumetry.