Dale O Edwick1,2,3, Jeremy M Rawlins2, Fiona M Wood1,2,4, Dale W Edgar1,2,3,4
1 Fiona Wood Foundation, Fiona Stanley Hospital, Murdoch, Western Australia
2 Burns Service of Western Australia, Fiona Stanley Hospital, Murdoch, Western Australia
3 Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, Western Australia
4 Burn Injury Research Unit, University of Western Australia, Perth, Western Australia
Bioimpedance spectroscopy (BIS) is a measure of body composition that is frequently used in healthy and clinical populations. BIS has been demonstrated to be sufficiently sensitive to detect a change in hand volume elicited by the decrease in vascular volume due to blood draining from the hand on elevation. The clinical guidelines state that there should be no skin lesions at the site of the electrodes, and that if lesions are present, the electrode position should be changed.
The aim of this study is to determine if electrode placement on the volar surface of the hand and forearm, or a combination of volar and dorsal electrode placements, are suitable alternatives for the measurement of hand BIS, when compared to the standard dorsal electrode placement.
Interim results demonstrated that for hand volume impedance measures, when compared to the standard electrode placement on the dorsum of the hand and forearm, the impedance values were comparable for dorsal hand and volar forearm (percentage difference range 1.02 to 1.07%), volar hand and dorsal forearm (percentage difference 1.07 to 1.09%), and volar hand and forearm (1.145 to 1.147%). Body Mass Index range was 18 to 29.48 kg.m-2. Further analysis on the full sample size will consist of multi-level regression analysis to determine clinically meaningful statistical changes.
Preliminary results indicate that a combination of alternate electrode placement is comparable to the standard. This highlights the feasibility of utilising this measure of hand volumes in hands with wounds.
Bioelectrical impedance analysis, electrode sites, wounds, body composition, hand volume, oedema
I am a senior physiotherapist in the State Adult Burns Unit at Fiona Stanley Hospital in Western Australia. I have worked as a physiotherapist in the burns service for 2 years, with extensive prior experience in hand therapy and plastic surgery. I am undertaking a PhD at The University of Notre Dame Australia, and the title of my thesis is “Measurement and management of oedema after hand burn injury”.