LYMPHEDEMA
Segmental Body Water Aids in Identifying, Treating,
and Managing Lymphedema
Disclaimer: InBody devices should be used as an adjunct tool for clinical decision-making and are not intended to diagnose or treat any diseases
Why is body composition analysis an effective tool for lymphedema specialists?
Lymphedema is a poorly understood condition characterized by chronic swelling due to impaired lymphatic flow. Secondary lymphedema is a common occurrence after cancer treatment or surgery. As advanced stages are not reversible, early detection is crucial for disease monitoring and management, while improving patients’ outcomes and quality of life.
As lymphedema progresses, mobility issues and the development of fibrotic tissue cause the quality of life to deteriorate. The development of conditions such as fibrosis can cause increased pain and hinder activities of daily living.
Healthcare providers are pivotal in identifying, treating, and monitoring the disease while educating patients on self-care. To enhance patient care, clinicians can utilize the InBody, a medical-grade bioimpedance device, that provides objective measures of fluid and muscle-fat balance. The InBody test is non-invasive and convenient, providing educational tools such as comprehensive results sheets to assist with patient engagement, while gaining insight into their condition, documenting progress, and guiding treatments. (Yasunaga, et al., 2020)
Accurate and objective measurements provided by the InBody in just 70 seconds aid healthcare providers in monitoring the effectiveness of treatments and interventions:
- Monitor body water and composition for early detection and treatment of lymphedema
- Track segmental body water and edema index (ECW/TBW) to detect fluid imbalances
- Evaluate increased health risks related to muscle-fat balance
Empowered by objective data, healthcare providers can better identify, treat, and manage lymphedema, leading to more effective patient programs and improved outcomes.
ECW/TBW RATIO ANALYSIS
Evaluate lymphedema progression for improved treatment
Changes in ECW/TBW reflect altered fluid balance, and segmental ICW and ECW values can be evaluated to determine whether they are a result of changes in body composition or progression of lymphedema.
Lymphedema symptom management and patient care present difficulties as progression occurs. While early detection improves patient outcomes, delayed diagnosis and tool availability limitations often prevent implementation of early treatment plans. Zhuang, et al., 2022 looks at the usefulness of ECW/TBW in early screening of subclinical lymphedema, which can enable physicians to implement more precise patient treatment plans.
Yasunaga, et al., 2023 reported that ECW parameters may help to assess the severity of breast cancer-related lymphedema quickly, and in a noninvasive manner. Additionally, they showed that ECW values strongly correlated with excess body water in the upper extremities, indicating the severity of unilateral arm lymphedema.
SEGMENTAL ECW RATIO - LIMBS
Detect fluid imbalances for both unilateral and bilateral monitoring
Common measures (circumference and perometry) used in lymphedema do not accurately show changes in body fluids that can be assessed by an InBody device. These methods can mistake changes in lean or fat mass for swelling. Healthcare providers need objective measures for the accuracy of diagnosis and tracking. In a study by Roh, et al., 2022, segmental body water analysis was found to be useful in the assessment of the severity of lymphedema, while also providing the ability to monitor patient outcomes.
InBody distinguishes intracellular (within tissues) and extracellular (within blood and interstitial fluids) water compartments. The Edema Index detects fluid imbalances resulting from lymphedema by providing separate assessments for each segment, avoiding comparisons to unaffected segments. As shown by Yasunaga, et al., 2023, this allows for diagnosing and monitoring both unilateral and bilateral lymphedema over time.
Whether the patient is undergoing surgery or complete decongestive therapy, obtaining baseline measures and monitoring changes in ECW/TBW over time provides valuable information about how the treatment is improving symptoms. (Son, et al., 2022) InBody’s precise water measures reflect changes in lymphedema status, helping tailor treatments and improve patient outcomes.
SEGMENTAL ECW RATIO - TRUNK
Asses edema presence in the trunk, separately from limbs
Truncal edema, whether in the breast or resulting from lymphedematous limb(s), is challenging to quantify. In their study, Qin, et al., 2020 showed how InBody measures the trunk separately, providing objective data to monitor and treat truncal edema effectively. While lymphedema primarily affects the limbs, trunk lymphatics can also become imbalanced, leading to trunk edema. Typically, subjective assessment and physical examination are used to identify truncal lymphedema, but tracking progress remains a challenge.
Equipped with objective data on body water in the trunk, healthcare providers can make better decisions to treat lymphedema, and both patient and provider can understand the body’s response to treatment.
SEGMENTAL PHASE ANGLE (PhA)
Evaluate health status improvements
Segmental PhA tracks cell membrane integrity to assess patient health, as indicated in this study by Short, et al., 2022, where PhA was shown to be a useful tool in evaluating the health status improvement of breast cancer survivors. Further, Gutierrez-Santamaria, et al., 2023 also showed that, due to the high correlation between physical function and PhA, PhA is of great importance during cancer treatment, as an evaluation of patients’ health status.
BODY WATER COMPOSITION HISTORY
Track trends in patient progress over time to determine treatment effectiveness
Evaluation of treatments, such as massage therapy, compression, and surgery to promote lymphatic flow is often difficult. Tracking treatment effectiveness for lymphatic flow is crucial. InBody provides objective data to tailor care, reduce progression, and improve patient outcomes. Lee, et al., 2020 found ECW/TBW parameters useful in measuring the success of a 3-week breast cancer-related lymphedema therapy program. InBody’s use may help enhance patient satisfaction, compliance, and long-term outcomes, while obtaining baseline measures and monitoring body water changes over time.
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