Reliability, Validity, and Feasibility of Water Displacement Method, Figure-of-Eight Method, and Circumference Measurements in Determination of Ankle and Foot Edema

Devoogdt N., Cavaggion C., Van der Gucht E., Dams L., De Groef A., Meeus M., ...More

LYMPHATIC RESEARCH AND BIOLOGY, vol.17, no.5, pp.531-536, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 17 Issue: 5
  • Publication Date: 2019
  • Doi Number: 10.1089/lrb.2018.0045
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.531-536
  • Hacettepe University Affiliated: Yes


Background: To compare interrater reliability and the time-efficiency for the water displacement method, figure-of-eight method, and circumference measurements of the ankle and foot, and to investigate concurrent validity of the figure-of-eight method and circumference measurements with the water displacement method. Methods and Results: Thirty patients (21 women and 9 men) with primary or secondary lower limb lymphedema were evaluated twice. The volume of the foot and ankle was measured in three different ways: water displacement with a volumeter, figure-of-eight method, and circumference measurements at the level of the malleoli and metatarsals with a tapeline. The intraclass correlation coefficients (ICCs) ranged from good to excellent for all measurements (ICCs = 0.99 for water displacement; 0.94 for figure-of-eight; 0.80 and 0.79 for circumference measurement at malleolus and metatarsals). More time was needed to perform the water displacement method than the figure-of-eight method and the circumference measurements (p < 0.001). There was a statistically significant moderate correlation between the water displacement method and the figure-of-eight method (r = 0.65; p < 0.001), whereas the correlation coefficient between water displacement method and circumference measurements at malleolus and metatarsals was weak (r = 0.51, p < 0.001 and r = 0.34, p = 0.06, respectively). Conclusions: Compared to the water displacement method, reliability of the figure-of-eight method is comparable, time-efficiency is better and concurrent validity is acceptable. So, in clinical practice, the figure-of-eight method is a good alternative for the water displacement method to evaluate the volume of the foot and ankle.