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Comparison of Reliability, Time Cost, and Participant Comfort of Lymphedema Assessments in Upper Extremity

4. listopadu 2026 aktualizováno: Burak Ertürk, Karadeniz Technical University

Comparison of Reliability, Time Cost, and Participant Comfort of Volumetric, Circumference Measurement, LiDAR, and 3D Modeling Methods in Upper Extremity Volume Measurement

This study aims to evaluate and compare the measurement reliability, total time cost (preparation, acquisition, post-processing), and participant comfort of conventional limb volume measurement methods (water displacement volumetry, tape-based circumference measurement) against modern digital techniques (LiDAR-based mobile scanning, stereophotogrammetric 3D optical scanning) in the upper extremity. The evaluation will be conducted on both healthy adults and patients diagnosed with upper extremity lymphedema. Additionally, the impact of assessor experience on digital data post-processing and the sensitivity of the methods to detect small localized volume increases using a simulated edema model (50 mL) will be investigated.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Detailní popis

Upper extremity lymphedema is a chronic and progressive condition characterized by the accumulation of protein-rich interstitial fluid, leading to tissue fibrosis and structural volume increases. Precise, reliable, and practical limb volume measurement is vital for diagnosis, staging, and therapeutic monitoring. While water displacement volumetry remains the gold standard, it poses practical challenges including cross-contamination risks, prolonged setup, and inapplicability to patients with wounds or severe limitations. Circumference tape measurement with frustum modeling is widely used but suffers from high examiner dependency and geometric approximation errors. Emerging non-contact technologies, such as mobile Light Detection and Ranging (LiDAR) sensors and optical 3D surface scanning, offer rapid, hygienic, and objective alternatives. However, gaps remain regarding their sensitivity to subclinical volume variations, the influence of post-processing operator experience, procedural time costs, and participant burden.

This methodological, comparative, cross-sectional pilot study evaluates upper extremity volume assessment methods across two cohorts: healthy adults (n = 40) and individuals clinically diagnosed with upper extremity lymphedema (n = 24). Measurements are conducted on the dominant upper extremity in healthy participants and on the affected upper extremity in patients with lymphedema, demarcated from the ulnar styloid process to 2-3 cm distal to the axilla.

All participants undergo the following sequentially:

  1. Water Displacement Volumetry: Conducted using a custom overflow tank and precision graduated cylinders as the reference standard. The hand volume is measured first and subtracted from the full-arm immersion volume. Strict decontamination protocols are applied between sessions.
  2. Circumference Measurement: Circumferential measures are taken at 4 cm intervals in a supine position and converted to limb volume using the truncated cone (Kuhnke/Frustum) formula. Measurements are obtained independently by both an experienced and an inexperienced evaluator.
  3. LiDAR-Based Scanning: Acquired using an iPad equipped with Structure Sensor 3 (Structure application). Standardized positioning is utilized with adhesive anatomical landmarks.
  4. Photogrammetric/Optical 3D Scanning: Acquired using the Creality Raptor X 3D scanner (Creality Scan software).

To address operator dependency in digital workflows, raw 3D point-cloud processing, mesh trimming, and volumetric integration are performed under a blinded protocol by both an experienced operator and an inexperienced operator.

In the healthy adult cohort, a simulated localized edema protocol is additionally conducted to determine method sensitivity to small volume fluctuations. A non-absorbent medical silicone pad (calibrated to exactly 50 mL via prior water volumetry) is affixed to the participant's forearm, after which circumference, LiDAR, and 3D optical scanning procedures are repeated.

Comprehensive time-motion analyses are recorded with a digital stopwatch across three distinct phases for each modality: equipment preparation, data acquisition, and post-processing computation. Participant-reported outcomes, including physical discomfort and fatigue, are documented using a Visual Analog Scale (VAS, 0-100 mm) immediately after each test and ranked comparatively at session conclusion.

Typ studie

Pozorovací

Zápis (Odhadovaný)

64

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let až 65 let (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ano

Pohlaví způsobilá ke studiu

Všechno

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

Healthy adult volunteers and clinical patients diagnosed with upper extremity lymphedema evaluated at the physical therapy and rehabilitation laboratories.

Popis

Inclusion Criteria:

Healthy Volunteers:

  • Aged between 18 and 65 years
  • Voluntarily willing to participate and providing written informed consent
  • Absence of any known musculoskeletal or neuromuscular deformity, active edema, open wounds, or history of major upper extremity surgery

Lymphedema Patients:

  • Aged between 18 and 65 years
  • Voluntarily willing to participate and providing written informed consent
  • Confirmed clinical diagnosis of upper extremity lymphedema
  • Absence of active skin lesions, open ulcerations, acute cellulitis, or lymphorrhea on the affected upper extremity

Exclusion Criteria (Both Groups):

  • Presence of open wounds, acute skin breakdown, lymphorrhea, active cutaneous infection (cellulitis, fungal infection), or severe dermatological lesions on the tested limb
  • Severe cognitive, systemic, or physical limitations preventing standard testing positioning (supine posture or holding the limb steady) or safe water immersion
  • Known severe skin allergy or dermatological hypersensitivity to silicone or adhesive fixation materials (for the healthy cohort undergoing the simulated edema protocol)

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Observační modely: COHORT
  • Časové perspektivy: CROSS_SECTIONAL

Kohorty a intervence

Skupina / kohorta
Healthy Adults

Forty healthy adult volunteers aged 18 to 65 years with no known deformity, edema, open wound, or prior surgical history in the upper extremity. Participants undergo baseline upper extremity volume assessments on their dominant arm using water displacement volumetry, tape-based circumference measurement (performed independently by experienced and inexperienced evaluators), LiDAR-based scanning (Structure Sensor 3), and stereophotogrammetric 3D optical scanning (Creality Raptor X). Additionally, to determine method sensitivity to small volume fluctuations, participants undergo a simulated edema protocol wherein a calibrated 50 mL non-absorbent medical silicone pad is affixed to the forearm, followed by repeat circumference, LiDAR, and 3D optical scans.

Patients with Lymphedema

Twenty-four adult individuals aged 18 to 65 years clinically diagnosed with upper extremity lymphedema, without active skin lesions, open wounds, or lymphorrhea on the affected limb. Participants undergo upper extremity volume measurements on their affected arm using water displacement volumetry, tape-based circumference measurement (performed independently by experienced and inexperienced evaluators), LiDAR-based scanning (Structure Sensor 3), and stereophotogrammetric 3D optical scanning (Creality Raptor X). The simulated edema protocol is not applied to this cohort.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Upper Extremity Limb Volume
Časové okno: Assessed during the single cross-sectional experimental testing session (approximately 1 to 2 hours per participant).

Total upper extremity limb volume (measured in milliliters, mL) evaluated across four measurement modalities: water displacement volumetry (gold standard reference), circumference tape measurement (calculated using the truncated cone / Frustum formula), LiDAR-based scanning (Structure Sensor 3), and stereophotogrammetric 3D optical scanning (Creality Raptor X). Measurement agreement and reliability will be determined using the Intraclass Correlation Coefficient (ICC Model 3,1) and Bland-Altman limits of agreement. Digital 3D model post-processing and tape measurements will be evaluated comparatively between experienced and inexperienced assessors.

Assessed during the single cross-sectional experimental testing session (approximately 1 to 2 hours per participant).

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Procedural Time Cost (Process Duration)
Časové okno: Throughout the 4-hour experimental protocol window (from 1 hour prior to participant arrival, during the 2-hour assessment session, through 1 hour following participant departure)

Total time cost (measured in minutes and seconds using a digital stopwatch) required for each modality, tracked across three distinct phases: preparation time (equipment setup, sanitation, and participant positioning), data acquisition time (actual measurement/scanning), and analysis/post-processing time (mathematical formula calculation or digital point-cloud cropping and mesh volume computation).

Throughout the 4-hour experimental protocol window (from 1 hour prior to participant arrival, during the 2-hour assessment session, through 1 hour following participant departure)
Participant-Perceived Discomfort and Fatigue
Časové okno: Immediately after each measurement procedure and at the end of the visit (within 2 hours)

Participant-reported physical discomfort and fatigue assessed immediately following each measurement modality using a Visual Analog Scale (VAS, 0 to 10 cm, where 0 represents 'no discomfort/fatigue' and 10 represents 'extreme discomfort/fatigue'). Overall method preference and willingness to repeat the procedure will be ranked at the conclusion of all tests.

Immediately after each measurement procedure and at the end of the visit (within 2 hours)
Sensitivity to Localized Small Volume Changes (Simulated Edema Absolute Error)
Časové okno: Immediately following baseline measurements during the single study visit (at approximately 1 hour post-baseline)

Absolute measurement error (calculated in milliliters, mL) in detecting an artificial, localized 50 mL volume increase. In the healthy adult cohort, a calibrated, non-absorbent medical silicone pad (50 mL verified via water displacement) is affixed to the forearm. The error is determined as the absolute difference between the volume change detected by circumference tape, LiDAR, and 3D optical scanning and the true 50 mL volume of the pad.

Immediately following baseline measurements during the single study visit (at approximately 1 hour post-baseline)

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Vrchní vyšetřovatel: Burak Erturk, PT, PhD, Karadeniz Technical University

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Obecné publikace

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. února 2027

Primární dokončení (Odhadovaný)

1. února 2028

Dokončení studie (Odhadovaný)

1. června 2028

Termíny zápisu do studia

První předloženo

30. října 2026

První předloženo, které splnilo kritéria kontroly kvality

4. listopadu 2026

První zveřejněno (Aktuální)

6. listopadu 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

6. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

4. listopadu 2026

Naposledy ověřeno

1. října 2026

Více informací

Termíny související s touto studií

Klíčová slova

Další identifikační čísla studie

  • 2026-232

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

Individual participant data will not be shared publicly because this investigation constitutes the foundational baseline phase of a multi-stage longitudinal research project. The acquired normative volumetric, photographic, and point-cloud datasets will be actively utilized as prospective control and benchmark data in subsequent interrelated clinical and technological validation phases.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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