ASSESSING LYMPHEDEMA BY TISSUE INDENTATION FORCE AND LOCAL TISSUE WATER

Abstract

Tissue water and mechanical propertychanges accompany lymphedema, however therelationship between these changes, if any, isunclear. Local tissue water is quantifiableusing the tissue’s dielectric constant (TDC),but a non-gravity dependent handheld clinicalassessment tool to easily quantify correspondinglocal tissue properties is not widely available.Herein such a tool is described along withresults obtained with it and with TDCmeasurements made in healthy legs and inlymphedematous legs before and after onemanual lymphatic drainage (MLD) treatment.Using the handheld device, tissue indentationsto various depths could be completedand corresponding indentation forces (IF)recorded. Following tests in gels, foams, and24 healthy human legs to confirm linearityand repeatability, IF and TDC were measuredin 22 legs of 18 lymphedema patients prior toand after one MLD treatment. Results showedthat pre-MLD both IF and TDC were significantly(p<0.001) greater in lymphedematouslegs compared to healthy legs and that bothIF and TDC significantly (p<0.001) decreasedafter MLD. However, no correlation wasfound between pretreatment IF and TDC norbetween post-MLD changes. Thus, measurementsof local IF and tissue water provideuseful but apparently independent informationas to lymphedematous status and its potentialchange with therapy.