Repeatability of upper limb volume measurements based on the Kuhnke measurement protocol and frustum volume calculation in women after unilateral mastectomy: a cross-sectional methodological study
Abstract
The aim of this study was to assess the repeatability of upper limb volume measurements performed with the Kuhnke method using the Frustum Volume Calculation (FVC) in women with lymphedema after unilateral mastectomy. This cross-sectional methodological study included 101 women (stage I: n = 52; stage II: n = 49). Three independent physiotherapists, each with at least five years of clinical experience, performed two repeated measurements (T1, T2) of both the affected and the healthy limb using the Kuhnke FVC method. Repeatability was evaluated with intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). The mean volume of the healthy limb was ~ 2209–2210 ml, while the affected limb averaged ~ 2438–2440 ml, yielding a mean interlimb difference of 229–230 ml. Intra-rater reliability was excellent, with ICC values of 0.986 for the healthy limb, 0.983 for the affected limb, and 0.945 for the interlimb difference. SEM values ranged from 6 to 8 ml, and MDC values were 16–22 ml, indicating very low measurement error. Inter-rater analysis confirmed high agreement, with no statistically significant differences between raters (p≈0.99). The interlimb volume difference was more than twice as large in stage II lymphedema (314.7 ± 67.1 ml) compared with stage I (148.6 ± 38.7 ml; p < 0.000001). The Kuhnke method with FVC formula demonstrates excellent intra- and inter-rater repeatability and can be recommended as a simple, cost-effective, and clinically reliable tool for diagnosing and monitoring upper limb lymphedema in women after mastectomy.
Related
- Measurement of Tuberculosis treatment adherence: A methodological scoping review of observational studies
- AI‐Based Wound Measurement in a Telemedicine‐Style Workflow: Agreement With In‐Person Reference Measurements Compared With Individual Physicians and Expert Consensus
- Outcomes of real-ear measurement-based fitting in unilateral hearing aid users: Influence of contralateral hearing
- Methodological Quality of Heart Failure Systematic Reviews and Meta-Analyses in the Era of AMSTAR-2 (a Measurement Tool to Assess Systematic Reviews): A Pre-registered Repeat Cross-Sectional Survey.
- Characterizing U.S. community well-being indices: a methodological synthesis and measurement systems perspective.
BibTeX
@article{smoter2026repeatability,
title = {{Repeatability of upper limb volume measurements based on the Kuhnke measurement protocol and frustum volume calculation in women after unilateral mastectomy: a cross-sectional methodological study}},
author = {Małgorzata Smoter and Robert Roczniok and Jarosław Muracki and Daniel Maliszewski and Radosław Tarkowski and Robert Trybulski},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-71363-y},
url = {https://www.nature.com/articles/s41598-026-71363-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Repeatability of upper limb volume measurements based on the Kuhnke measurement protocol and frustum volume calculation in women after unilateral mastectomy: a cross-sectional methodological study
AU - Małgorzata Smoter
AU - Robert Roczniok
AU - Jarosław Muracki
AU - Daniel Maliszewski
AU - Radosław Tarkowski
AU - Robert Trybulski
PY - 2026
DA - 2026/10/01
JO - Scientific Reports
DO - 10.1038/s41598-026-71363-y
UR - https://www.nature.com/articles/s41598-026-71363-y
AB - The aim of this study was to assess the repeatability of upper limb volume measurements performed with the Kuhnke method using the Frustum Volume Calculation (FVC) in women with lymphedema after unilateral mastectomy. This cross-sectional methodological study included 101 women (stage I: n = 52; stage II: n = 49). Three independent physiotherapists, each with at least five years of clinical experience, performed two repeated measurements (T1, T2) of both the affected and the healthy limb using the Kuhnke FVC method. Repeatability was evaluated with intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimal detectable change (MDC). The mean volume of the healthy limb was ~ 2209–2210 ml, while the affected limb averaged ~ 2438–2440 ml, yielding a mean interlimb difference of 229–230 ml. Intra-rater reliability was excellent, with ICC values of 0.986 for the healthy limb, 0.983 for the affected limb, and 0.945 for the interlimb difference. SEM values ranged from 6 to 8 ml, and MDC values were 16–22 ml, indicating very low measurement error. Inter-rater analysis confirmed high agreement, with no statistically significant differences between raters (p≈0.99). The interlimb volume difference was more than twice as large in stage II lymphedema (314.7 ± 67.1 ml) compared with stage I (148.6 ± 38.7 ml; p < 0.000001). The Kuhnke method with FVC formula demonstrates excellent intra- and inter-rater repeatability and can be recommended as a simple, cost-effective, and clinically reliable tool for diagnosing and monitoring upper limb lymphedema in women after mastectomy.
SN - 2045-2322
ER -