{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T02:25:26Z","timestamp":1792376726663,"version":"4.4.0"},"reference-count":44,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      Participants with Stage 1\u20132 lipedema and early Stage 0\u20131 lymphedema (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20095, age\u2009=\u200938.4\u2009\u00b1\u200913.4 years, body mass index\u2009=\u200927.2\u2009\u00b1\u20094.3\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) 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\u201310 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\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      for pain VAS\u2009=\u2009\u22122.5 and PSFS\u2009=\u20094.4). The primary sodium MRI measures, leg skin sodium, and subcutaneous adipose tissue (SAT) sodium, reduced following treatment and revealed large treatment effects (Cohen's\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      for skin sodium\u2009=\u2009\u22121.2 and SAT sodium\u2009=\u2009\u22120.9).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0039","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T15:23:22Z","timestamp":1636385002000},"page":"382-390","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["Physical Therapy in Women with Early Stage Lipedema: Potential Impact of Multimodal Manual Therapy, Compression, Exercise, and Education Interventions"],"prefix":"10.1177","volume":"20","author":[{"given":"Paula M.C.","family":"Donahue","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachelle","family":"Crescenzi","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalen J.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Garza","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niral","family":"Patel","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea","family":"Lee","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheau-Chiann","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manus J.","family":"Donahue","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"F\u00f6ldi's Textbook of Lymphology for Physicians and Lymphedema Therapists","author":"F\u00f6ldi M","unstructured":"F\u00f6ldi M, , Foldi E, , Strossenreuther RHK, , Kubik S. F\u00f6ldi's Textbook of Lymphology for Physicians and Lymphedema Therapists, 2nd ed. Trento, Italy: Urban & Fischer; 2006."},{"key":"e_1_3_5_3_2","article-title":"Lipedema: Friend and foe","volume":"33","author":"Torre YS","year":"2018","unstructured":"Torre YS, , Wadeea R, , Rosas V, , Herbst KL. Lipedema: Friend and foe. Horm Mol Biol Clin Investig, 2018; 33(1). DOI: 10.1515\/hmbci-2017-0076. PMID: 29522416; 33(1). DOI: PMC5935449.","journal-title":"Horm Mol Biol Clin Investig"},{"key":"e_1_3_5_4_2","doi-asserted-by":"crossref","unstructured":"Herbst KL Kahn LA Iker E et al. Standard of care for lipedema in the United States. 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