{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:29:17Z","timestamp":1789871357236,"version":"4.0.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T00:00:00Z","timestamp":1474934400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Measurements of tissue compressibility and extracellular fluid (ECF) are used to monitor progression of lymphedema, a chronic swelling of the subcutaneous tissue. Later stages of lymphedema are characterized by fibrotic induration in the subcutis and hyperkeratosis of the skin. Several devices are available to measure these changes, but previous reliability and validity studies have been conducted primarily on adult women with unilateral arm lymphedema using contralateral limbs as controls. To date, no studies have included either adolescents or measurement of leg tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      An intrarater reliability study was conducted to compare three devices measuring skin and subcutaneous tissue compressibility; a mechanical Tonometer, a digital Indurometer, and a SkinFibroMeter. ECF loads were measured using bioimpedance spectroscopy (BIS). Two populations of tropical-dwelling young people were included; Australian residents in North Queensland aged 8\u201321 years (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200934) and people aged 10\u201321 years residing in Central Myanmar (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200938). Neither cohort had any clinical sign of lymphedema or other leg abnormality. The mechanical Tonometer and the digital Indurometer had excellent intraclass correlation coefficient (ICC) scores between 0.792 (95% CI 0.055\u20130.901) and 0.964 (95% CI 0.945\u20130.984) and the SkinFibroMeter had good to excellent reliability with ICC scores of between 0.565 (95% CI 0.384\u20130.747) and 0.877 (95% CI 0.815\u20130.840). BIS exhibited the highest reliability with ICC scores approaching 1.0.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These results support the reliable use of tonometry and BIS to assess tissue compressibility and ECF loads in the legs of adolescent populations in developed and developing tropical countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2016.0021","type":"journal-article","created":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T12:05:56Z","timestamp":1474977956000},"page":"57-63","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Intrarater Reliability of Tonometry and Bioimpedance Spectroscopy to Measure Tissue Compressibility and Extracellular Fluid in the Legs of Healthy Young People in Australia and Myanmar"],"prefix":"10.1177","volume":"15","author":[{"given":"Janet","family":"Douglass","sequence":"first","affiliation":[{"name":"James Cook University","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Graves","sequence":"additional","affiliation":[{"name":"James Cook University","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Gordon","sequence":"additional","affiliation":[{"name":"Flinders University","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,9,27]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"51","article-title":"The diagnosis and treatment of peripheral lymphedema: 2009 Consensus Document of the International Society of Lymphology","volume":"42","author":"International Society of Lymphology","year":"2009","unstructured":"International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2009 Consensus Document of the International Society of Lymphology. Lymphology, 2009; 42:51\u201360.","journal-title":"Lymphology"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003319"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70076-7"},{"key":"e_1_3_3_5_2","volume-title":"Lymphedema Diagnosis and Therapy, 4th ed","author":"Weissleder H","year":"2008","unstructured":"Weissleder H, , Schuchhardt C. Lymphedema Diagnosis and Therapy, 4th ed. Baden-Baden: Viavital Verlag Gmbh; 2008."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2008.1002"},{"key":"e_1_3_3_7_2","unstructured":"World Health Organization. Lymphatic filariasis: Managing morbidity and preventing disability: An aide-m\u00e9moire for national programme managers. WHO Library Catalogue. 2013."},{"key":"e_1_3_3_8_2","first-page":"1","article-title":"A new instrument for the evaluation of tissue tonicity in lymphoedema","volume":"9","author":"Clodius L","year":"1976","unstructured":"Clodius L, , Deak L, , Piller N. A new instrument for the evaluation of tissue tonicity in lymphoedema. Lymphology, 1976; 9:1\u20135.","journal-title":"Lymphology"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01806671"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2010.0020"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e31815b6199"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0032"},{"key":"e_1_3_3_13_2","first-page":"85","article-title":"Correlation between bioelectrical spectroscopy and perometry in assessment of upper extremity swelling","volume":"43","author":"Jain MS","year":"2010","unstructured":"Jain MS, , Danoff JV, , Paul SM. Correlation between bioelectrical spectroscopy and perometry in assessment of upper extremity swelling. Lymphology, 2010; 43:85\u201394.","journal-title":"Lymphology"},{"key":"e_1_3_3_14_2","first-page":"34","article-title":"A new way to assess superficial changes to lymphoedema","volume":"6","author":"Pallotta O","year":"2011","unstructured":"Pallotta O, , McEwen M, , Tilley S, , Wonders T, , Waters M, , Piller N. A new way to assess superficial changes to lymphoedema. J Lymphoedema, 2011; 6:34\u201341.","journal-title":"J Lymphoedema"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0016"},{"key":"e_1_3_3_16_2","first-page":"2","article-title":"Early diagnosis of lymphedema using multiple frequency bioimpedance","volume":"34","author":"Cornish BH","year":"2001","unstructured":"Cornish BH, , Chapman M, , Hirst C, , Mirolo B, , Bunce IH, , Ward LC, , Thomas BJ. Early diagnosis of lymphedema using multiple frequency bioimpedance. Lymphology, 2001; 34:2\u201311.","journal-title":"Lymphology"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126268"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314545803"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.10301"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.002"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781118032923"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1586\/17434440.5.2.239"}],"container-title":["Lymphatic Research and Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/lrb.2016.0021","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2016.0021","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2016.0021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:35:25Z","timestamp":1779190525000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/lrb.2016.0021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,27]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,3,1]]}},"alternative-id":["10.1089\/lrb.2016.0021"],"URL":"https:\/\/doi.org\/10.1089\/lrb.2016.0021","relation":{},"ISSN":["1539-6851","1557-8585"],"issn-type":[{"value":"1539-6851","type":"print"},{"value":"1557-8585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,27]]}}}