Test-Retest Reliability of Local Tissue Water and Circumference Measurements in the Head and Neck Area of Healthy Women and Men

Karin Johansson, Johanna Sjövall, Agneta Hagren, Eva Ekvall Hansson, Christina Brogårdh
Purpose:

The objective of the study was to evaluate the test-retest reliability including measurement errors of local tissue water and neck circumference measurements (CM) in the HN area in a healthy cohort. The study is a partial study in a larger project where the main aim is to study the occurrence and treatment of lymphedema in the HN area after HN cancer treatment. It also aims to investigate how the quality of life is affected.


Methods:

A LymphScanner (Delfin Technologies Ltd, Kupio, Finland) was used to assess local tissue water of the HN. TDC was measured with a probe connected to a control unit. It generates an ultrahigh-frequency electromagnetic wave of 300 MHz and projects it down through the skin to a depth of 2.5 mm when the probe is placed on the skin surface. The reflected electromagnetic wave contains information of the water content in the measured tissue and is calculated as percentage of water content (PWC). Thirty-one women and 29 men were measured on 2 occasions, 14 days apart. PWC was calculated in four facial points and neck CM at three levels. Intraclass correlation coefficient (ICC), changes in mean, standard error of measurement (SEM%), and smallest real difference (SRD%) were calculated. Age, gender, smoking status, weight, and body length were recorded, and Body Mass Index, BMI, (kg/m2) was calculated.

Results:

Reliability for PWC was fair to excellent for both women (ICC 0.67-0.89) and men (ICC 0.71-0.87). Measurement errors were acceptable in all points in both women (SEM% 3.6%-6.4%, SRD% 9.9%-17.7%) and men (SEM% 5.1%-10.9%, SRD% 14.2%-30.3%). For the CM, ICCs were excellent both for women (ICC 0.85-0.90) and men (ICC 0.92-0.94), and measurement errors were low (SEM% for women 1.9%-2.1%, SRD% 5.1%-5.9%; SEM% for men 1.6%-2.0%, SRD% 4.6%-5.6%). Most of the lowest values were found close to bone and vessels.

Conclusion(s):

Measurements for PWC and CM in the HN area are reliable in healthy women and men, with acceptable to low measurement errors and can be used to assess changes of tissue water over time. PWC points close to bony structures and vessels should, however, be used with caution. The methods are promising and prospective studies of PWC measurements in patients with HN lymphedema are warranted.

Implications:

There is a need for valid and reliable measures to assess local tissue water in the HN area. The results show that the PWC method in the HN area and tape measurements of neck circumferences are reliable in healthy women and men. This knowledge is important as a prerequisite to proceeding to assess changes in lymphedema in the HN area over time. It is also of importance when evaluating effects of interventions of HN lymphedema to improve rehabilitation for patients with HN cancer.

Funding acknowledgements:
Swedish Cancer Foundation Academy of Health Care at Skåne University Hospital Swedish Edema Society
Keywords:
Head and neck cancer
Lymphedema
Reproducibility of results
Primary topic:
Oncology, HIV and palliative care
Second topic:
Research methodology, knowledge translation and implementation science
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Swedish Ethical Review Authority. Informed consent was obtained from all participants prior to inclusion in the study.
Provide the ethics approval number:
Approval number 2020-01066
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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