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Open Access Research article

Reproducibility and day time bias correction of optoelectronic leg volumetry: a prospective cohort study

Rolf P Engelberger1, Claudia Blazek1, Felix Amsler2, Hong H Keo1, Frédéric Baumann1, Werner Blättler1, Iris Baumgartner1 and Torsten Willenberg13*

Author Affiliations

1 Swiss Cardiovascular Center, Division of Clinical and Interventional Angiology Inselspital, University Hospital and University of Bern, Switzerland

2 Amsler Consulting, Basel, Switzerland

3 Academic Section of Vascular Surgery, Imperial College School of Medicine, Charing Cross Hospital, London, UK

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BMC Medical Research Methodology 2011, 11:138  doi:10.1186/1471-2288-11-138

Published: 5 October 2011

Abstract

Background

Leg edema is a common manifestation of various underlying pathologies. Reliable measurement tools are required to quantify edema and monitor therapeutic interventions. Aim of the present work was to investigate the reproducibility of optoelectronic leg volumetry over 3 weeks' time period and to eliminate daytime related within-individual variability.

Methods

Optoelectronic leg volumetry was performed in 63 hairdressers (mean age 45 ± 16 years, 85.7% female) in standing position twice within a minute for each leg and repeated after 3 weeks. Both lower leg (legBD) and whole limb (limbBF) volumetry were analysed. Reproducibility was expressed as analytical and within-individual coefficients of variance (CVA, CVW), and as intra-class correlation coefficients (ICC).

Results

A total of 492 leg volume measurements were analysed. Both legBD and limbBF volumetry were highly reproducible with CVA of 0.5% and 0.7%, respectively. Within-individual reproducibility of legBD and limbBF volumetry over a three weeks' period was high (CVW 1.3% for both; ICC 0.99 for both). At both visits, the second measurement revealed a significantly higher volume compared to the first measurement with a mean increase of 7.3 ml ± 14.1 (0.33% ± 0.58%) for legBD and 30.1 ml ± 48.5 ml (0.52% ± 0.79%) for limbBF volume. A significant linear correlation between absolute and relative leg volume differences and the difference of exact day time of measurement between the two study visits was found (P < .001). A therefore determined time-correction formula permitted further improvement of CVW.

Conclusions

Leg volume changes can be reliably assessed by optoelectronic leg volumetry at a single time point and over a 3 weeks' time period. However, volumetry results are biased by orthostatic and daytime-related volume changes. The bias for day-time related volume changes can be minimized by a time-correction formula.