Bioimpedance spectroscopy for swelling evaluation following total knee arthroplasty: a validation study
Identifieur interne : 001470 ( Pmc/Checkpoint ); précédent : 001469; suivant : 001471Bioimpedance spectroscopy for swelling evaluation following total knee arthroplasty: a validation study
Auteurs : Claude Pichonnaz [Suisse] ; Jean-Philippe Bassin [Suisse] ; Estelle Lécureux [Suisse] ; Damien Currat [Suisse] ; Brigitte M. Jolles [Suisse]Source :
- BMC Musculoskeletal Disorders [ 1471-2474 ] ; 2015.
Abstract
The evaluation of swelling is important for the outcome of total knee arthroplasty (TKA) surgery. The circumference or volume measurements are applicable at the bedside of the patient but are altered by muscular atrophy and the post-surgical dressing. Bioimpedance spectroscopy might overcome these limitations; however, it should be validated. This study aimed to explore the validity, the reliability and the responsiveness of bioimpedance spectroscopy for measuring swelling after TKA.
The degree of swelling in 25 patients undergoing TKA surgery was measured using bioimpedance spectroscopy (BIS R0), knee circumference and limb volume. The measurements were performed on D-1 (day before surgery), D + 2 (2 days after surgery) and D + 8 (8 days after surgery). The BIS R0 measurements were repeated twice, alternating between two evaluators. The percentage of the difference between the limbs was calculated for BIS R0, circumference and volume. The intra- and inter-observer intraclass correlation coefficients (ICCs), limits of agreement (LOA), effect size (Cohen’s
BIS R0, circumference and volume detected swelling < 3.5% at D-1. The swelling at D2 and D8 was greater with BIS R0 [mean (SD) 29.9% (±9.8) and 38.27 (±7.8)] than with volume [14.7 (±9.5) and 14.9 (±8.2)] and circumference [11.1 (±5.7) and 11.7 (±4.1)].
The BIS R0 intra- and inter-evaluator ICCs ranged from 0.89 to 0.99, whereas the LOA were < 5.2%. The BIS R0 correlation was 0.73 with volume and 0.75 with circumference. The BIS R0 Cohen’s
Bioimpedance is a valid method for the evaluation of swelling following TKA. BIS R0 also demonstrated excellent intra- and inter- evaluator reliability. The diagnostic sensitivity and responsiveness is superior to that of concurrent methods. BIS R0 is an efficient method for post-surgical follow up at the bedside of the patient. The measurement of BIS R0 is a straightforward, valid, reliable and responsive method for lower limb swelling following TKA surgery that could be used in clinics and research.
ClinicalTrials.gov Identifier:
Url:
DOI: 10.1186/s12891-015-0559-5
PubMed: 25907994
PubMed Central: 4422299
Affiliations:
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<series><title level="j">BMC Musculoskeletal Disorders</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The evaluation of swelling is important for the outcome of total knee arthroplasty (TKA) surgery. The circumference or volume measurements are applicable at the bedside of the patient but are altered by muscular atrophy and the post-surgical dressing. Bioimpedance spectroscopy might overcome these limitations; however, it should be validated. This study aimed to explore the validity, the reliability and the responsiveness of bioimpedance spectroscopy for measuring swelling after TKA.</p>
</sec>
<sec><title>Methods</title>
<p>The degree of swelling in 25 patients undergoing TKA surgery was measured using bioimpedance spectroscopy (BIS R0), knee circumference and limb volume. The measurements were performed on D-1 (day before surgery), D + 2 (2 days after surgery) and D + 8 (8 days after surgery). The BIS R0 measurements were repeated twice, alternating between two evaluators. The percentage of the difference between the limbs was calculated for BIS R0, circumference and volume. The intra- and inter-observer intraclass correlation coefficients (ICCs), limits of agreement (LOA), effect size (Cohen’s <italic>d</italic>
), correlations between the methods and diagnostic sensitivity were calculated.</p>
</sec>
<sec><title>Results</title>
<p>BIS R0, circumference and volume detected swelling < 3.5% at D-1. The swelling at D2 and D8 was greater with BIS R0 [mean (SD) 29.9% (±9.8) and 38.27 (±7.8)] than with volume [14.7 (±9.5) and 14.9 (±8.2)] and circumference [11.1 (±5.7) and 11.7 (±4.1)].</p>
<p>The BIS R0 intra- and inter-evaluator ICCs ranged from 0.89 to 0.99, whereas the LOA were < 5.2%. The BIS R0 correlation was 0.73 with volume and 0.75 with circumference. The BIS R0 Cohen’s <italic>d</italic>
was 3.32 for the D-1–D2 evolution. The diagnostic sensitivity was 83% D2 and 96% at D8.</p>
</sec>
<sec><title>Conclusion</title>
<p>Bioimpedance is a valid method for the evaluation of swelling following TKA. BIS R0 also demonstrated excellent intra- and inter- evaluator reliability. The diagnostic sensitivity and responsiveness is superior to that of concurrent methods. BIS R0 is an efficient method for post-surgical follow up at the bedside of the patient. The measurement of BIS R0 is a straightforward, valid, reliable and responsive method for lower limb swelling following TKA surgery that could be used in clinics and research.</p>
</sec>
<sec><title>Trial registration</title>
<p>ClinicalTrials.gov Identifier: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov/NCT00627770">NCT00627770</ext-link>
.</p>
</sec>
</div>
</front>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Musculoskelet Disord</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Musculoskelet Disord</journal-id>
<journal-title-group><journal-title>BMC Musculoskeletal Disorders</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2474</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25907994</article-id>
<article-id pub-id-type="pmc">4422299</article-id>
<article-id pub-id-type="publisher-id">559</article-id>
<article-id pub-id-type="doi">10.1186/s12891-015-0559-5</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Bioimpedance spectroscopy for swelling evaluation following total knee arthroplasty: a validation study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Pichonnaz</surname>
<given-names>Claude</given-names>
</name>
<address><email>claude.pichonnaz@hesav.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bassin</surname>
<given-names>Jean-Philippe</given-names>
</name>
<address><email>jean-philippe.bassin@hesav.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Lécureux</surname>
<given-names>Estelle</given-names>
</name>
<address><email>Estelle.Lecureux@chuv.ch</email>
</address>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Currat</surname>
<given-names>Damien</given-names>
</name>
<address><email>Damien.currat@hesav.ch</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author" equal-contrib="yes"><name><surname>Jolles</surname>
<given-names>Brigitte M</given-names>
</name>
<address><email>Brigitte.Jolles-Haeberli@chuv.ch</email>
</address>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<aff id="Aff1"><label></label>
Physiotherapy Department, Haute Ecole de Santé Vaud (HESAV), HES-SO, University of Applied Sciences Western Switzerland, Delémont, Switzerland</aff>
<aff id="Aff2"><label></label>
CHUV-UNIL, Orthopedics and Traumatology Department, CHUV-UNIL, Avenue du Bugnon 21, 1011 Lausanne, Switzerland</aff>
<aff id="Aff3"><label></label>
CHUV-UNIL, direction médicale, Rue du Bugnon 46, 1011 Lausanne, Switzerland</aff>
</contrib-group>
<pub-date pub-type="epub"><day>25</day>
<month>4</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>25</day>
<month>4</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>16</volume>
<elocation-id>100</elocation-id>
<history><date date-type="received"><day>25</day>
<month>9</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>17</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Pichonnaz et al.; licensee BioMed Central. 2015</copyright-statement>
<license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>The evaluation of swelling is important for the outcome of total knee arthroplasty (TKA) surgery. The circumference or volume measurements are applicable at the bedside of the patient but are altered by muscular atrophy and the post-surgical dressing. Bioimpedance spectroscopy might overcome these limitations; however, it should be validated. This study aimed to explore the validity, the reliability and the responsiveness of bioimpedance spectroscopy for measuring swelling after TKA.</p>
</sec>
<sec><title>Methods</title>
<p>The degree of swelling in 25 patients undergoing TKA surgery was measured using bioimpedance spectroscopy (BIS R0), knee circumference and limb volume. The measurements were performed on D-1 (day before surgery), D + 2 (2 days after surgery) and D + 8 (8 days after surgery). The BIS R0 measurements were repeated twice, alternating between two evaluators. The percentage of the difference between the limbs was calculated for BIS R0, circumference and volume. The intra- and inter-observer intraclass correlation coefficients (ICCs), limits of agreement (LOA), effect size (Cohen’s <italic>d</italic>
), correlations between the methods and diagnostic sensitivity were calculated.</p>
</sec>
<sec><title>Results</title>
<p>BIS R0, circumference and volume detected swelling < 3.5% at D-1. The swelling at D2 and D8 was greater with BIS R0 [mean (SD) 29.9% (±9.8) and 38.27 (±7.8)] than with volume [14.7 (±9.5) and 14.9 (±8.2)] and circumference [11.1 (±5.7) and 11.7 (±4.1)].</p>
<p>The BIS R0 intra- and inter-evaluator ICCs ranged from 0.89 to 0.99, whereas the LOA were < 5.2%. The BIS R0 correlation was 0.73 with volume and 0.75 with circumference. The BIS R0 Cohen’s <italic>d</italic>
was 3.32 for the D-1–D2 evolution. The diagnostic sensitivity was 83% D2 and 96% at D8.</p>
</sec>
<sec><title>Conclusion</title>
<p>Bioimpedance is a valid method for the evaluation of swelling following TKA. BIS R0 also demonstrated excellent intra- and inter- evaluator reliability. The diagnostic sensitivity and responsiveness is superior to that of concurrent methods. BIS R0 is an efficient method for post-surgical follow up at the bedside of the patient. The measurement of BIS R0 is a straightforward, valid, reliable and responsive method for lower limb swelling following TKA surgery that could be used in clinics and research.</p>
</sec>
<sec><title>Trial registration</title>
<p>ClinicalTrials.gov Identifier: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov/NCT00627770">NCT00627770</ext-link>
.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Validation study</kwd>
<kwd>Reproducibility of results</kwd>
<kwd>ROC curve</kwd>
<kwd>Edema</kwd>
<kwd>Arthroplasty</kwd>
<kwd>Replacement (MeSH terms)</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Suisse</li>
</country>
<region><li>Canton de Vaud</li>
</region>
<settlement><li>Lausanne</li>
</settlement>
</list>
<tree><country name="Suisse"><noRegion><name sortKey="Pichonnaz, Claude" sort="Pichonnaz, Claude" uniqKey="Pichonnaz C" first="Claude" last="Pichonnaz">Claude Pichonnaz</name>
</noRegion>
<name sortKey="Bassin, Jean Philippe" sort="Bassin, Jean Philippe" uniqKey="Bassin J" first="Jean-Philippe" last="Bassin">Jean-Philippe Bassin</name>
<name sortKey="Currat, Damien" sort="Currat, Damien" uniqKey="Currat D" first="Damien" last="Currat">Damien Currat</name>
<name sortKey="Jolles, Brigitte M" sort="Jolles, Brigitte M" uniqKey="Jolles B" first="Brigitte M" last="Jolles">Brigitte M. Jolles</name>
<name sortKey="Lecureux, Estelle" sort="Lecureux, Estelle" uniqKey="Lecureux E" first="Estelle" last="Lécureux">Estelle Lécureux</name>
<name sortKey="Pichonnaz, Claude" sort="Pichonnaz, Claude" uniqKey="Pichonnaz C" first="Claude" last="Pichonnaz">Claude Pichonnaz</name>
</country>
</tree>
</affiliations>
</record>
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