Paula M C Donahue1,2, Rachelle Crescenzi3,4,5, Kalen J Petersen3,4, Maria Garza3,4, Niral Patel4,6, Chelsea Lee4,6, Sheau-Chiann Chen7, Manus J Donahue3,4,8,9. 1. Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 2. Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 3. Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 4. Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 5. Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA. 6. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 7. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 8. Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. 9. Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Abstract
Background: Lipedema is a distinct adipose disorder from obesity necessitating awareness as well as different management approaches to address pain and optimize quality of life (QoL). The purpose of this proof-of-principle study is to evaluate the therapeutic potential of physical therapy interventions in women with lipedema. Methods and Results: Participants with Stage 1-2 lipedema and early Stage 0-1 lymphedema (n = 5, age = 38.4 ± 13.4 years, body mass index = 27.2 ± 4.3 kg/m2) underwent nine visits of physical therapy in 6 weeks for management of symptoms impacting functional mobility and QoL. Pre- and post-therapy, participants were scanned with 3 Tesla sodium and water magnetic resonance imaging (MRI), underwent biophysical measurements, and completed questionnaires measuring function and QoL (patient-specific functional scale, PSFS, and RAND-36). Pain was measured at each visit using the 0-10 visual analog scale (VAS). Treatment effect was calculated for all study variables. The primary symptomatology measures of pain and function revealed clinically significant post-treatment improvements and large treatment effects (Cohen's d for pain VAS = -2.5 and PSFS = 4.4). The primary sodium MRI measures, leg skin sodium, and subcutaneous adipose tissue (SAT) sodium, reduced following treatment and revealed large treatment effects (Cohen's d for skin sodium = -1.2 and SAT sodium = -0.9). Conclusions: This proof-of-principle study provides support that persons with lipedema can benefit from physical therapy to manage characteristic symptoms of leg pain and improve QoL. Objective MRI measurement of reduced tissue sodium in the skin and SAT regions indicates reduced inflammation in the treated limbs. Further research is warranted to optimize the conservative therapy approach in lipedema, a condition for which curative and disease-modifying treatments are unavailable.
Background: Lipedema is a distinct adipose disorder from obesity necessitating awareness as well as different management approaches to address pain and optimize quality of life (QoL). The purpose of this proof-of-principle study is to evaluate the therapeutic potential of physical therapy interventions in women with lipedema. Methods and Results: Participants with Stage 1-2 lipedema and early Stage 0-1 lymphedema (n = 5, age = 38.4 ± 13.4 years, body mass index = 27.2 ± 4.3 kg/m2) underwent nine visits of physical therapy in 6 weeks for management of symptoms impacting functional mobility and QoL. Pre- and post-therapy, participants were scanned with 3 Tesla sodium and water magnetic resonance imaging (MRI), underwent biophysical measurements, and completed questionnaires measuring function and QoL (patient-specific functional scale, PSFS, and RAND-36). Pain was measured at each visit using the 0-10 visual analog scale (VAS). Treatment effect was calculated for all study variables. The primary symptomatology measures of pain and function revealed clinically significant post-treatment improvements and large treatment effects (Cohen's d for pain VAS = -2.5 and PSFS = 4.4). The primary sodium MRI measures, leg skin sodium, and subcutaneous adipose tissue (SAT) sodium, reduced following treatment and revealed large treatment effects (Cohen's d for skin sodium = -1.2 and SAT sodium = -0.9). Conclusions: This proof-of-principle study provides support that persons with lipedema can benefit from physical therapy to manage characteristic symptoms of leg pain and improve QoL. Objective MRI measurement of reduced tissue sodium in the skin and SAT regions indicates reduced inflammation in the treated limbs. Further research is warranted to optimize the conservative therapy approach in lipedema, a condition for which curative and disease-modifying treatments are unavailable.
Authors: Agnes Machnik; Anke Dahlmann; Christoph Kopp; Jennifer Goss; Hubertus Wagner; Nico van Rooijen; Kai-Uwe Eckardt; Dominik N Müller; Joon-Keun Park; Friedrich C Luft; Dontscho Kerjaschki; Jens Titze Journal: Hypertension Date: 2010-02-08 Impact factor: 10.190
Authors: Karen L Herbst; Linda Anne Kahn; Emily Iker; Chuck Ehrlich; Thomas Wright; Lindy McHutchison; Jaime Schwartz; Molly Sleigh; Paula Mc Donahue; Kathleen H Lisson; Tami Faris; Janis Miller; Erik Lontok; Michael S Schwartz; Steven M Dean; John R Bartholomew; Polly Armour; Margarita Correa-Perez; Nicholas Pennings; Edely L Wallace; Ethan Larson Journal: Phlebology Date: 2021-05-28 Impact factor: 1.740