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Vol. 23. Issue 6.
Pages 532-540 (01 November 2019)
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Vol. 23. Issue 6.
Pages 532-540 (01 November 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.10.015
Communicating vessels volumeter to measure upper extremity lymphedema after breast cancer: reliability and criterion validity compared to the gold standard
NOTICE Undefined index: totales (includes_ws_v2/modulos/cuerpo/info-item.php[202])
Rogério Mendonça de Carvalhoa, Fausto Miranda Jrb,
Corresponding author

Corresponding author at: Rua Estela, 515, bloco G, conj. 81, 04011-002 São Paulo, SP, Brazil.
a Department of Physical Therapy, Universidade Federal de Uberlândia (UFU), Uberlândia, MG, Brazil
b Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil

  • Lymphedema reduces the quality of life of patients after breast cancer.

  • Objective measurement of lymphedema is essential to monitor treatment.

  • Circumference and costly measurements are inaccurate for irregular surfaces.

  • CVV volumes were statistically equal to those of the overflow method.

  • CVV volumes were closer to the actual volume of the phantom.

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Figures (2)
Tables (4)
Table 1. (A) Mean, median and SD of cylinder volume measured by OV and CVV, per rater and total; (B) Mean, median and SD of OV and CVV measurements, per rater and total, followed by inter-rater and intra-rater intraclass correlation coefficients, in lymphedematous upper extremities.
Table 2. (A) Construct validity of CVV and OV for cylinder measurement (999.68mL); (B) criterion validity of CVV in relation to OV for volume measurement of lymphedematous upper extremities (n=12).
Table 3. Mean, median and SD of OV and CVV measurements and the respective differences in relation to the cylinder.
Mean, median and SD of volume, temperature and time records for OV and CVV, followed by the p-value of the sign test, in lymphedematous upper extremities.
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The traditional overflow method for measuring limb volume remains the gold standard, but many disadvantages still inhibit its routine use in clinical practice.


To assess the intra-rater and inter-rater reliability and criterion validity of the ‘communicating vessels volumeter’ (CVV) for volume measurement of lymphedematous upper extremities (LUE) by using the overflow volumeter (OV) as the reference standard.


Twelve LUE of 12 women undergoing mastectomy for breast cancer were measured three times each by three raters using both methods, totaling 216 volume measurements. Criterion validity was estimated by 33 volume measurements of one cylinder of known volume by three raters using both methods, totaling 198 measurements.


Measurement time was short with both CVV and OV. The intraclass correlation coefficient3,1 was high for both CVV and OV in intra-rater (0.99 vs 0.99) and inter-rater (0.99 vs 0.99) analyses. The bias between methods was low (7.50mL; 0.40%) and the limits of agreement were narrow (−5.80 to 6.50%). The volumes were statistically equal with a strong correlation (R2=0.98) between methods. CVV was more accurate than OV (0.00 vs 0.02%) in cylinder measurements.


The high intra-rater and inter-rater reliability rates of CVV were comparable to those of OV, and the volumes resulting from LUE measurements were statistically equal in the two methods. Criterion validity rates indicated that CVV measurements were closer to the actual value of the cylinder than those obtained with the OV.

Measurement equipment
Medical devices
Biomedical technology


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