Aquatic Versus Land-Based Exercise in Women With Lipedema

NCT07756463 | Not Yet Recruiting

• 1 other identifier: P.T.REC/012/006541
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

To evaluate optimal workout environments, a 12-week study assigned women with moderate-to-severe lipedema to three distinct protocols: supervised pool workouts, equivalent land-based training, or basic standard monitoring. Researchers tracked walking endurance alongside tissue composition, fluid levels, pain intensity, and general well-being. The trial posited that structured activity beats routine care alone, with water-based exercise potentially offering superior relief due to buoyancy and hydrostatic fluid compression.

Conditions

Lipedema

Keywords

lipedema; hydrotherapy; therapeutic exercise; six-minute walk test; symptom burden; quality of life

Outcome Measures

Primary Outcomes (1)

• Functional capacity measured by Six-Minute Walk Test

  Participants will complete a seated rest period of at least 10 minutes before testing. The test will be conducted indoors along a straight 30-m corridor. Participants will be instructed to walk as far as possible during six minutes without running. Rest is permitted when necessary, although the timer continue throughout the test. The total distance walked will be recorded in meters. In the Six-Minute Walk Test (6MWT), a greater distance (more meters walked) indicates better functional capacity, superior cardiorespiratory fitness, and greater lower-limb muscular endurance.

  12 weeks

Secondary Outcomes (6)

• Body Mass Index

  12 weeks

• Waist-to-Height Ratio

  12 weeks

• Three-Dimensional Lower-Limb Scanning

  12 weeks

• Symptom-Related Outcomes

  12 weeks

• Health-Related Quality of Life

  12 weeks

Study Arms (3)

Aquatic therapy group

EXPERIMENTAL

Supervised 12- week water-based exercise program. Each aquatic session consists of four standardized phases. The first five minutes include supported standing, diaphragmatic breathing, and lateral-costal expansion. The subsequent eight-minute warm-up includes forward, backward, and lateral water walking; ankle dorsiflexion and plantarflexion; heel raises; gentle knee flexion; marching; and controlled hip movement. The 25-minute main phase comprises brisk water walking, marching, hip abduction and extension, hamstring curls, supported mini-squats, step-touch movements, calf raises, controlled leg circles, and upper-limb sweeping movements coordinated with breathing. The final seven-minute cool-down includes progressively slower water walking, ankle pumps, and gentle stretching of the gastrocnemius-soleus complex, hamstrings, quadriceps, and hip flexors.

Other: aquatic therapy

land-based exercise group

ACTIVE COMPARATOR

The land-based 12- week program combined low-impact aerobic training, lower-limb strengthening, muscle-pump exercises, flexibility training, postural control, and breathing exercises. Each session will begin with an eight-minute warm-up consisting of diaphragmatic breathing, ankle dorsiflexion and plantarflexion, heel and toe raises, slow marching, gentle trunk rotation, and low-intensity walking. The aerobic phase will last approximately 12 minutes and consist of walking on level ground or on a treadmill. The 18-minute strengthening phase will include sit-to-stand exercises, supported mini-squats, heel raises, standing hip abduction and extension, knee flexion and extension, low step-ups, supine bridging, and side-lying hip abduction.

Other: land- based exercise

control group

OTHER

Participants will receive manual lymphatic drainage, intermittent pneumatic compression, a weight-reduction diet, and a compression garment will be provided by the research team.

Other: usual care

Interventions

aquatic therapy OTHER

Hydotherapy for lipedema. Sessions will be conducted in a therapeutic pool maintained at approximately 28-30°C. Immersion depth will be individualized between the xiphoid process and shoulder level according to participant height, balance, symptom severity, and exercise tolerance.

Aquatic therapy group

usual care OTHER

Participants will receive a standardized education session at baseline addressing lipedema, skin care, symptom monitoring, avoidance of prolonged immobility, maintenance of habitual daily activity, and clinical warning signs requiring medical review

control group

land- based exercise OTHER

Sessions will be supervised by a physiotherapist and conducted in an area equipped with supportive chairs, stable handrails, low steps, exercise mats, and light resistance bands. Participants wear comfortable clothing and supportive footwear.

land-based exercise group

Eligibility Criteria

• Age: 35 Years - 45 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Women diagnosed with lipedema for at least five years
• Had stage 2 or 3 and type 2 or 3 disease
• Had a body mass index of ≥25 and \<40 kg/m²
• Able to walk independently, with or without their usual assistive device
• Had received medical clearance to participate in moderate-intensity aquatic and land-based exercise
• Able to understand the study procedures and provide written informed consent.

You may not qualify if:

• Had clinically significant lymphedema, uncontrolled chronic venous insufficiency, acute thrombosis, or another major cause of lower-limb edema
• Had open wounds, active skin infection, fever, or another infectious condition incompatible with pool use
• Had uncontrolled cardiovascular, metabolic, respiratory, or neurological disorder that could compromise exercise safety; a cardiac pacemaker or congestive heart failure; pregnancy; active cancer or ongoing chemotherapy, immunotherapy, or radiotherapy
• Had history of bariatric surgery, recent major surgery, or liposuction; current use of weight-loss medication
• Had current participation in structured aquatic or lower-limb exercise exceeding the protocol-defined threshold; or severe fear of water or inability to enter and exit the pool safely.

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Lipedema

Interventions

Aquatic Therapy

Condition Hierarchy (Ancestors)

Connective Tissue Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Hydrotherapy; Physical Therapy Modalities; Therapeutics; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor at Physical Therapy Department for Cardiovascular/Respiratory Disorder and Geriartics

Study Record Dates

• First Submitted: August 5, 2026
• First Posted: August 10, 2026
• Study Start (Estimated): August 27, 2026
• Primary Completion (Estimated): September 2, 2027
• Study Completion (Estimated): October 1, 2027
• Last Updated: August 10, 2026

Record last verified: 2026-08