Measuring Biomechanical Properties Using a Noninvasive Myoton Device for Lymphedema Detection and Tracking: A Pilot Study
Authors: Gabriella E Glassman 1, Laura Dellalana 2, Eric R Tkaczyk 2, 3, 4, Isaac Manzanera Esteve 1, Joyce Yongxu Huang 3, Austin Cronin 2, J Randall Patrinely 3, Shervin Etemad 3, Patrick E Assi 1, Shelia Ridner 4, Antonio Jorge Forte 5, Salam Al Kassis 1, Galen Perdikis 1
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
- Department of Veterans Affairs and Vanderbilt Dermatology Translational Research Clinic (VDTRC.org), Nashville, TN
- Vanderbilt University School of Medicine, Nashville, TN
- Vanderbilt-Ingram Cancer Center, Nashville, TN
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Jacksonville, FL
Journal: ePlasty - November 2022, Volume 22, e54
- Our results suggest that MyotonPRO can infer differences in the affected and unaffected skin in the arms of patients with breast cancer–related lymphedema.
Background: Improved techniques for lymphedema detection and monitoring of disease progression are needed. This study aims to use the noninvasive MyotonPRO Device to detect differences in biomechanical skin characteristics in patients with breast cancer–related lymphedema (BCRL).
Methods: The handheld MyotonPRO device was used to measure skin parameters including dynamic skin stiffness, oscillation frequency (tone), mechanical stress relaxation time, and creep in 11 women diagnosed with BCRL. Seven anatomical sites were measured bilaterally for each participant. The average values in the affected arms were compared with those in the contralateral unaffected arms.
Results: Among the 11 female participants with unilateral BCRL Stages 0 to II, the combined averages for dynamic skin stiffness and frequency measurements were decreased in the affected arms when compared with those for the contralateral control arms (ratio < 1). The median ratio of stiffness (affected to unaffected control arm) was 0.91 (interquartile range [IQR] 0.78-1.03) while frequency was 0.94 (IQR 0.89-1.0). Skin relaxation time and creep averages were increased in the affected arms. The relaxation time median ratio (affected to unaffected control arm) was 1.07 (IQR 1.02-1.14) and the median ratio of creep was 1.06 (IQR 1.03-1.16).
Conclusions: This study suggests the MyotonPRO can detect differences in skin biomechanical parameters of the affected and unaffected arms in patients with BCRL. Larger studies are needed to draw strong conclusions.
Keywords: myoton, skin stiffness, lymphedema, breast cancer
Earlier detection of BCRL could optimize therapeutic and surgical interventions and lessen the severity of the consequent arm heaviness, disability, and negative psychosocial impact. These preliminary results show that the MyotonPRO device, when used in this patient population, can depict some differences and changes in stiffness, frequency, relaxation time, and creep in lymphedematous limbs when compared with the contralateral, unaffected sides. Larger longitudinal studies are still needed to test the device’s reliability and accuracy in this patient population. Future studies should control for specific variables, including age, compression sleeve use, physical therapy compliance, and lymphedema staging.