Implementation of Single-Tab Electrodes for Bioimpedance Spectroscopy Measures

Paula M.C. Donahue, DPT, CLT-LANA, MBA,1,2 Rachelle Crescenzi, PhD,3 Liping Du, PhD,4,5 and Manus J. Donahue, PhD3,6,7. Lymphatic Research Biolgy 2019.


Background: Bioimpedance spectroscopy (BIS) demonstrates proficiency in early identification of breast cancer treatment-related lymphedema (BCRL) development. Dual-tab electrodes were designed for consistent and easy electrode placement, however, single-tab electrodes positioned to mimic dual-tab placement on the body may make BIS technology more accessible in community hospitals and outpatient settings. The purpose of this study is to evaluate use of single-tab electrodes for BIS measurements and assess whether single-tab electrodes provide consistent BIS measurements in controls and patients with BCRL.

Methods and Results: Upper limb BIS ratios were obtained using ImpediMed L-DexU400 in controls (n=13; age=23–75 years; 9 repeated measurements) using dual-tab and single-tab electrodes. BCRL patients (n=17; Stage=1.65–0.49; number nodes removed=16.3–7.7; age=50.9–10.6 years; age range=33–77 years) and healthy controls (n=19) were evaluated to determine if single-tab electrodes provided discriminatory capacity for detecting BCRL. Intraclass correlation coefficients (ICC), linear mixed-effects models, Wilcoxon rank-sum tests, and linear regression with two-sided p-values <0.05 required for significance were applied. Single-tab electrodes were found to be statistically interchangeable with dual-tab electrodes (ICC=0.966; 95% confidence interval=0.937–0.982). No evidence of differences in single-tab versus dual-tab measurements were found for L-Dex ratios (p=0.74) from the linear mixed-effects model. Repeated trials involving reuse of the same electrodes revealed a trend toward increases in L-Dex ratio for both styles of electrodes. Single-tab electrodes were significant (p<0.0001) for discriminating between BCRL and control subjects.

Conclusion: Findings expand upon the potential use of BIS in clinic and research settings and suggest that readily available single-tab electrodes provide similar results as dual-tab electrodes for BIS measurements.

Main findings

  • These are interesting findings for those clinicians who use Impedimeds U400 machine.
  • The purpose of this study was to evaluate the use of single-tab electrodes for BIS measurements and to assess whether single-tab electrodes, when positioned similarly to dual-tab electrodes, provided reproducible and consistent BIS measurements as well as offer discriminatory information in age-matched controls and patients with BCRL. The authors observed no significant differences between these two electrode types and the high discriminatory capacity of single-tab electrodes for distinguishing BCRL versus control volunteers. These results suggest that single-tab electrodes may be a cost-effective and widely available alternative to dual-tab electrodes in both clinical and research studies of patients with lymphedema.
  • Figures 1 and 2 below show the placement of electrodes and a template that was developed.