Manual and Self-Lymphatic Drainage Combined With Exercise in Women With Lipedema

This randomized controlled study aims to compare the effects of two physiotherapy approaches in women with lipedema. Participants will be assigned to either manual lymphatic drainage combined with supervised aerobic exercise or self-lymphatic drainage combined with physical activity guidance. Both programs will be applied for six weeks. The study will investigate whether these two approaches differ in their effects on pain, lower extremity function, limb volume, mobility, quality of life, and depressive symptoms. Assessments will be performed before the intervention and at the end of the six-week program.

Inclusion Criteria: Female sex. Aged 18 to 65 years. Diagnosed with lipedema. Diagnosed with Stage I, II, III, or IV lipedema. No participation in any physiotherapy program within the previous 3 months. No previous liposuction surgery. Not currently following a weight-loss diet. No change in body weight greater than 10% within the previous 6 months. Willing to participate in the study and provide informed consent. Exclusion Criteria: Severe visual or cognitive impairment. Severe cardiovascular disease. Musculoskeletal conditions or injuries affecting the lower extremities, including osteoarthritis, contracture, or osteoporosis, that may interfere with participation in the study. Skin conditions that may interfere with the intervention, such as pressure ulcers. Uncontrolled endocrine disorders, including type 1 or type 2 diabetes mellitus or hypothyroidism. Obesity secondary to endocrine disorders or medication-induced obesity. Use of estrogen-progestin therapy within the previous 2 months. Pregnancy or a positive pregnancy test. Breastfeeding. Concurrent participation in another clinical trial.