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Intraobserver and Interobserver Agreements of Leg Circumference Measurements by Tape Measure Based on 3 Reference Points

Selcuk Study Group, Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya, Turkey, trecep{at}hotmail.com

Aygul Caglayan-Tunc

Selcuk Study Group, Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya

Gurcan Kisakol, MD

Selcuk Study Group, Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya

Gulhan Kanat Unler, MD

Selcuk Study Group, Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya

Taha Hidayetoglu, MD

Selcuk Study Group, Department of Internal Medicine, Meram School of Medicine, Selcuk University, Konya

Hasan Yazici, MD

Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey

The objective of this study was to evaluate the intraobserver and interobserver agreements in tape measurements of the ankle and calf circumference with due emphasis on the 3 main reference points, the patella, the tibial tuberosity, and the medial malleolus. The leg circumference at 2 locations was measured in 66 patients in the mornings of 2 consecutive days by 6 observers. Finally, a blinded couple measured leg circumferences at a line created on calves with a ballpoint pen of 68 outpatients to calculate interobserver agreement for lined regions. Leg circumference measurement was accepted as correct when the difference was less than 0.6 cm in 2 occasions. Intraobserver and interobserver agreements were calculated as the percentage of correct measurements. Chi-square test was used to compare intraobserver and interobserver agreements for each reference point. At the calf region, intraobserver and interobserver agreements based on the tibial tuberosity (88% and 81%) were better than those of the patella (65% and 57%) and the medial malleolus (73% and 65%). On the other hand, at above the ankle region, the agreements (79% and 62%) were also better than those of the patella (60% and 43%) and nearly the same as those of the medial malleolus (86% and 65%). Finally, interobserver agreement of the measurements at the created line with ballpoint pen (96%) was better when compared to those of the tibial tuberosity (81%), the patella (57%), and medial malleolus (65%) (p = 0.005, p < 0.001, and p < 0.001, respectively). The results of this study suggest that the tibial tuberosity as a reference point for leg circumference measurement has better intraobserver and interobserver agreements than those of the patella and the medial malleoli.

Angiology, Vol. 58, No. 5, 593-596 (2007)
DOI: 10.1177/0003319707307844


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