Alternate Electrode Positions for the Measurement of Hand Volumes Using Bioimpedance Spectroscopy

Background: Bioimpedance spectroscopy (BIS) is a tool that can be used to measure body composition in a variety of populations. Previous studies have investigated novel applications to utilize BIS to measure localized body composition, including in the hand. According to BIS guidelines, there should be no skin wounds at the site of electrodes, and that electrode positions may be modified in specific circumstances, as our group has validated previously in burn wound populations. Methods and Results: To determine in noninjured participants, whether BIS measurements recorded using alternate electrode positions on the palm of the hand and forearm, or a combination of electrodes on the dorsum and volar surface of the hand and forearm, were comparable with electrode positions on the dorsum of the hand and forearm. The study demonstrated that drive and sense electrodes on the palm of the hand and volar forearm, and a combination of electrodes on the palm of the hand and dorsum of the forearm, resulted in comparable measures of impedance of extracellular water (difference from reference position: 1.26%-4.75%, p = 0.411-0.558) and total water (difference from reference: 2.15%-2.40%, p = 0.258-0.781). Electrodes on the dorsum of the hand and volar forearm resulted in significantly different measures for the same BIS variables (percentage difference range 4.66%-6.15%, p < 0.001-0.003). Conclusion: Electrode positions on the palm of the hand and volar forearm, or on the palm of the hand and dorsum of the forearm, are interchangeable as clinical measures of hand lymphedema and total water impedance.