Telerehabilitation-Supported Exercise in Women With Lipedema

This prospective, single-blind, randomized controlled trial aims to evaluate the effectiveness of a telerehabilitation-supported exercise program in women with lipedema. A total of 66 women aged 18 to 65 years with stage I-III lipedema will be included and randomly assigned to either the telerehabilitation group or the home exercise group. Participants in the telerehabilitation group will perform a supervised exercise program delivered synchronously via Zoom three times per week for 12 weeks. Participants in the control group will perform a similar home-based exercise program independently three times per week for 12 weeks. Both groups will receive education about lipedema and instructions regarding the exercise program. The primary outcome is pain intensity assessed using the Visual Analog Scale (VAS). Secondary outcomes include pressure pain threshold, lipedema-related symptoms, lower-extremity volume, subcutaneous tissue thickness, body composition, functional capacity, mobility, quality of life, and exercise adherence.

Inclusion Criteria: * Female participants with a clinical diagnosis of lipedema confirmed according to the revised Wold criteria * Stage I-III lipedema * Age between 18 and 65 years * Body mass index ≤40 kg/m² * No cardiac, pulmonary, or orthopedic medical contraindication to exercise * Ability to use a smartphone, tablet, or computer and access to an active internet connection * Ability and motivation to participate regularly in telerehabilitation sessions * Willingness to participate voluntarily and provide written informed consent * Ability to ambulate independently on level surfaces without an assistive device or assistance from another person Exclusion Criteria: * Presence of systemic disease that may prevent safe participation in exercise, including uncontrolled cardiovascular, metabolic, or pulmonary disease; neurological, hematological, or rheumatological disease; or malignancy * Musculoskeletal pathology that may limit exercise performance, including advanced knee or hip osteoarthritis, severe deformity, or acute muscle or joint injury * Pregnancy or breastfeeding * Acute infection, open skin lesion, skin ulcer, or advanced lipodermatosclerosis * Liposuction or major surgery within the previous three months * Participation in physical therapy or a regular exercise program within the previous three months * Severe psychiatric or cognitive disorder that may interfere with treatment adherence