Bioimpedance in the assessment of unilateral lymphedema of a limb: the optimal frequency.

Queensland University of Technology, Brisbane, Australia.
Lymphatic Research and Biology (Impact Factor: 2.33). 01/2011; 9(2):93-9. DOI: 10.1089/lrb.2010.0020
Source: PubMed

ABSTRACT Bioimpedance techniques provide a reliable method of assessing unilateral lymphedema in a clinical setting. Bioimpedance devices are traditionally used to assess body composition at a current frequency of 50 kHz. However, these devices are not transferable to the assessment of lymphedema, as the sensitivity of measuring the impedance of extracellular fluid is frequency dependent. It has previously been shown that the best frequency to detect extracellular fluid is 0 kHz (or DC). However, measurement at this frequency is not possible in practice due to the high skin impedance at DC, and an estimate is usually determined from low frequency measurements. This study investigated the efficacy of various low frequency ranges for the detection of lymphedema.
Limb impedance was measured at 256 frequencies between 3 kHz and 1000 kHz for a sample control population, arm lymphedema population, and leg lymphedema population. Limb impedance was measured using the ImpediMed SFB7 and ImpediMed L-Dex(®) U400 with equipotential electrode placement on the wrists and ankles. The contralateral limb impedance ratio for arms and legs was used to calculate a lymphedema index (L-Dex) at each measurement frequency. The standard deviation of the limb impedance ratio in a healthy control population has been shown to increase with frequency for both the arm and leg. Box and whisker plots of the spread of the control and lymphedema populations show that there exists good differentiation between the arm and leg L-Dex measured for lymphedema subjects and the arm and leg L-Dex measured for control subjects up to a frequency of about 30 kHz.
It can be concluded that impedance measurements above a frequency of 30 kHz decrease sensitivity to extracellular fluid and are not reliable for early detection of lymphedema.

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    ABSTRACT: The successful application of impedance spectroscopy in daily practice requires accurate measurements for modeling complex physiological or electrochemical phenomena in a single frequency or several frequencies at different (or simultaneous) time instants. Nowadays, two approaches are possible for frequency domain impedance spectroscopy measurements: (1) using the classical technique of frequency sweep and (2) using (non-)periodic broadband signals, i.e. multisine excitations. Both techniques share the common problem of how to design the experimental conditions, e.g. the excitation power spectrum, in order to achieve accuracy of maximum impedance model parameters from the impedance data modeling process. The original contribution of this paper is the calculation and design of the D -optimal multisine excitation power spectrum for measuring impedance systems modeled as 2R-1C equivalent electrical circuits. The extension of the results presented for more complex impedance models is also discussed. The influence of the multisine power spectrum on the accuracy of the impedance model parameters is analyzed based on the Fisher information matrix. Furthermore, the optimal measuring frequency range is given based on the properties of the covariance matrix. Finally, simulations and experimental results are provided to validate the theoretical aspects presented.
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