Telerehabilitation Versus Supervised Pilates Training in Lipedema Women

1. Pilates Exercise: The Pilates method is a low-intensity form of movement based on body control, which works the body in a complete way, promoting physical and mental health. PET is different when compared to traditional exercises, which, in turn, tend to isolate the working muscles and have specific training approaches using repetitive motions. 2. Telerehabilitation: Telehealth is emerging as a key method for delivering essential healthcare. Primary care research suggests that telehealth is acceptable and has potential to overcome geographical barriers for individuals needing many times rehabilitation by eliminating the need for extensive and costly travel 3. Diet approach: A customized low-carbohydrate high-fat (LCHF) restricted caloric diet in women with lipedema will be used for 12 weeks. The LCHF diet may be a valuable nutritional strategy for lipedema and overweight/obese women, reducing inflammatory status with a beneficial effect on weight, glucose profile the concentration of triglycerides and HDL

Inclusion Criteria: 1. Sixty female patients diagnosed with lipedema. 2. Their ages will range from 35-45 years old. 3. Patients diagnosed with lipedema ≥ 5 years. 4. Patients with grade 2 and 3 lipedema. 5. Patients with type 2 and 3 lipedema. 6. Patients with BMI ≥ 25 kg/m2 7. All patients will be clinically stable. Exclusion Criteria: Patient with any of the following will be excluded from the study: 1. Patients with lower limb edematous diseases such as lymphedema or chronic venous insufficiency. 2. Patients with history of previous liposuction. 3. Patients with asymmetrical lower limbs. 4. Patients with history of bariatric surgeries. 5. Patients on weight loss medications. 6. Patients any medical condition prohibiting exercise (cardiac pacemakers, diabetes mellitus, uncontrolled hypertension, and congestive heart failure) 7. Pregnant females. 8. Patients with BMI ≥ 40 kg/m2 (morbid obese). 9. Cancer patients (patients on chemotherapy, immunotherapy radiopathy). 10. Infectious diseases (HIV/AIDS, HCV, and Tuberculosis). 11. Chronic inflammatory autoimmune disease such as Sjogren's syndrome 12. Patients with neurological disorders: stroke and epilepsy.