Physiotherapy Applications in Upper Extremity Lipedema

Overview

Lipedema which causes excessive accumulation of fat in the subcutaneous tissue, is a rare, progressive disease. This disease generally affects women, following puberty or early adulthood and usually results in the slow increase of the circumference of the legs and/or arms, bilaterally. In a typical presentation of lipedema, the enlargement of the lower extremities is disproportionately greater than that of the trunk and upper extremities When first described in 1940, lipedema was thought to exclusively affect the lower extremities. However, as the disease has been recognized over the years, lipedema has been reported to affect the upper extremities. Upper extremity lipedema, with no involvement of the lower extremities is an extremely rare incident.

Full Title of Study: “The Effects of Complex Decongestive Physiotherapy Applications on Upper Extremity Circumference and Volume in Patients With Lipedema”

Study Type

  • Study Type: Observational [Patient Registry]
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: February 3, 2020

Detailed Description

Due to the hypertrophy in adipose tissue, the link between lymphatic dysfunction and the progression to lipo-lymphedema, lipedema is conservatively treated with physiotherapy, manual lymph drainage and compression, also known as complex decongestive physiotherapy. Furthermore, the consensus of the International Society of Lymphology has stated that intermittent pneumatic compression is an optional treatment which may be applied as an adjuvant therapy to complex decongestive physiotherapy. All participants included in the study were included in a treatment protocol consisting of complex decongestive physiotherapy and intermittent pneumatic compression. The Perometer was used in the measurement of upper extremity volume and circumference before and after treatment.

Interventions

  • Procedure: Complex decongestive physiotherapy
    • Each patient received a treatment protocol of Complex decongestive physiotherapy for 5 days a week until they were discharged from the clinic. All patients fully completed all components of the treatment routine daily. The treatment was performed by a physiotherapist who was certified with Manual Lymph Drainage Combined Decongestive Physiotherapy. After the daily treatment protocol was completed, patients wore standard or individually sized compression grade II or III medical compression stockings for the rest of the day.

Arms, Groups and Cohorts

  • Patients with Lipedema
    • Participants who were diagnosed with upper extremity lipedema by a lymphologist.

Clinical Trial Outcome Measures

Primary Measures

  • Limb Circumference
    • Time Frame: Change from baseline circumference at 4 weeks
    • For every patient, the circumference measurements of the upper limbs were measured with the Perometer.
  • Limb Volume
    • Time Frame: Change from baseline volume at 4 weeks
    • For every patient, the volume measurements of the upper limbs were measured with the Perometer.

Participating in This Clinical Trial

Inclusion Criteria

  • being between the ages of 18-65, – having a diagnosis of upper extremity lipedema – being willing to participate in the study Exclusion Criteria:

  • accompanying diagnosis of lymphedema, – deep vein thrombosis – disease which causes edema in the upper extremities

Gender Eligibility: Female

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Yuksek Ihtisas University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Melek Volkan Yazici, Principal Investigator – Yuksek Ihtisas University
  • Overall Official(s)
    • Melek Volkan-Yazici, PT. PhD, Principal Investigator, Yuksek Ihtisas University
    • Murat Esmer, PT. MSc, Study Director, Gazi University

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