Effects of Exercise on Edema, Pain, Exercise Capacity, Lower Extremity Muscle Strength and Function in Patients with Lipedema

Local tissue water percentage

Time Frame: 6 weeks

Local tissue water percentage will be measured with the Moisturemeter-d compact (MMDc, Delfin Technologies, Kuopio, Finland) device. This device calculates the percentage of water under the skin by touching the reference points from the skin surface. 3 measurements will be made for each reference point and the average of these measurements will be recorded. The reference points were determined as the medial of 35 cm above the heel (calf) on both legs, the medial of 3 cm proximal to the patella (medial knee) and the lateral of 20 cm above the line drawn from 3 cm proximal to the patella to the SIAS (lateral hip).

edema

Time Frame: 6 weeks

For the lower extremity, the circumference will be measured at 4 cm intervals starting from the lateral malleolus to the highest point that can be reached on the inner thigh. The circumference measurement is performed while the patient is lying on his back. The results are recorded in cm and the volume calculation will be made according to the Khunke disk method.

Pain severity

Time Frame: 6 weeks

The leg pain due to lipedema will be recorded in cm with the Visual Analog Scale (VAS) according to the patient's statement.

Pain Threshold

Time Frame: 6 weeks

A Baseline brand digital algometer device will be used to assess the pain threshold. A 1 cm2 probe will be used for measurements. Before the measurement process, the midpoint of the quadriceps and tibia will be marked. The measurement will be repeated three times at 5-second intervals and the average values will be recorded in kg. The algometer will be placed at a right angle to each point, the participants will be asked to report the presence of pain by saying "yes" and the value on the device will be recorded as the pain threshold when they first feel pain at the point of touch. There will be a 5-second break between measurements.

Lower extremity muscle strength

Time Frame: 6 weeks

Muscle strength measurements will be made with K-Force hand dynamometer. Quadriceps Femoris and hip flexors muscle strength will be measured in sitting position and hip abductors muscle strength will be measured in side-lying position. During the measurements, patients will be asked to perform maximum isometric contraction for 5 seconds. Muscle strength measurements will be repeated 3 times on the right and left sides separately and maximum value will be recorded in kg.

Lower extremity muscle endurance

Time Frame: 6 weeks

Lower extremity muscle endurance measurement will be evaluated with a 30-second sit-to-stand test. The patient will be asked to stand up and sit down from a back-supported chair with their arms crossed on both shoulders for 30 seconds. Sitting down and standing less than 10 times in 30 seconds indicates a loss of lower extremity strength.

functional exercise capacity

Time Frame: 6 weeks

Exercise capacity will be evaluated with a 6-minute walking test. The distance covered will be recorded and interpreted as normal values. Heart rate and oxygen saturation will be measured with a portable pulse oximeter before and after the test; blood pressure will be measured with a device that automatically measures (Omron-Hem 710 Int, USA). Dyspnea and fatigue levels will be evaluated with the Modified Borg Scale (MBS) at the beginning and end of the test. The Modified Borg Scale is a scale that evaluates fatigue and shortness of breath between 0-10.

lower extremity function

Time Frame: 6 weeks

The lower extremity functional scale is a questionnaire consisting of 20 items developed to evaluate the lower extremity functions of patients. There are 5 options from 0 to 4 for each question (0: Extreme difficulty or inability to perform the activity, 1: Quite a bit of difficulty, 2: Moderate difficulty, 3: Some difficulty, 4: No difficulty at all). The total score varies between 0-80 and higher scores indicate better functional status.