{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:15:05Z","timestamp":1777922105741,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"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":[[2018,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bioimpedance spectroscopy detects unilateral lymphedema if the ratio of extracellular fluid (ECF) between arms or between legs is outside three standard deviations (SDs) of the normative mean. Detection of bilateral lymphedema, common after bilateral breast or gynecological cancer, is complicated by the unavailability of an unaffected contralateral limb. The objectives of this work were to (1) present normative values for interarm, interleg, and arm-to-leg impedance ratios of ECF and ECF normalized to intracellular fluid (ECF\/ICF); (2) evaluate the influence of sex, age, and body mass index on ratios; and (3) describe the normal change in ratios within healthy individuals over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Data from five studies were combined to generate a normative data set (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009808) from which mean and SD were calculated for interarm, interleg, and arm-to-leg ratios of ECF and ECF\/ICF. The influence of sex, age, and body mass index was evaluated using multiple linear regression, and normative change was calculated for participants with repeated measures by subtracting their lowest ratio from their highest ratio.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Mean (SD) interarm, interleg, dominant arm-to-leg, and nondominant arm-to-leg ratios were 0.987 (0.067), 1.005 (0.072), 1.129 (0.160), and 1.165 (0.174) for ECF ratios; and 0.957 (0.188), 1.024 (0.183), 1.194 (0.453), and 1.117 (0.367) for ECF\/ICF ratios, respectively. Arm-to-leg ratios were significantly affected by sex, age, and body mass index. Mean normative change ranged from 7.2% to 14.7% for ECF ratios and from 14.7% to 67.1% for ECF\/ICF ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings provide the necessary platform for extending bioimpedance-based screening beyond unilateral lymphedema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2017.0082","type":"journal-article","created":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T09:29:34Z","timestamp":1538558974000},"page":"559-566","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Normative Interlimb Impedance Ratios: Implications for Early Diagnosis of Uni- and Bilateral, Upper and Lower Limb Lymphedema"],"prefix":"10.1177","volume":"16","author":[{"given":"Megan L.","family":"Steele","sequence":"first","affiliation":[{"name":"Queensland University of Technology","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Janda","sequence":"additional","affiliation":[{"name":"Queensland University of Technology","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Vagenas","sequence":"additional","affiliation":[{"name":"Queensland University of Technology","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh C.","family":"Ward","sequence":"additional","affiliation":[{"name":"The University of Queensland","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce H.","family":"Cornish","sequence":"additional","affiliation":[{"name":"Queensland University of Technology","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Box","sequence":"additional","affiliation":[{"name":"Queensland Lymphoedema & Breast Oncology Physiotherapy","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Gordon","sequence":"additional","affiliation":[{"name":"James Cook University","place":["Australia"]},{"name":"Flinders University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Matthews","sequence":"additional","affiliation":[{"name":"James Cook University","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally D.","family":"Poppitt","sequence":"additional","affiliation":[{"name":"University of Auckland","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay D.","family":"Plank","sequence":"additional","affiliation":[{"name":"University of Auckland","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Yip","sequence":"additional","affiliation":[{"name":"University of Auckland","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Rowan","sequence":"additional","affiliation":[{"name":"Fonterra Co-operative Group Limited","place":["New Zealand"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hildegard","family":"Reul-Hirche","sequence":"additional","affiliation":[{"name":"Royal Brisbane and Women's Hospital","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Obermair","sequence":"additional","affiliation":[{"name":"The University of Queensland","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra C.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Queensland University of Technology","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,12,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2010.11.017"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-010-0896-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2010.0014"},{"key":"e_1_3_3_5_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, et al. 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