Effects of TECAR Therapy in Lipedema Management

Primary outcomes

1. Circumference measurements

   Time frame: Clinical assessments were conducted at baseline, as well as at 1 and 3 months following the treatment.

   Circumference measurements were performed using a standard non-elastic tape measure at three anatomically defined landmarks: the mid-thigh, identified as the midpoint between the iliac crest and the lower border of the patella, the pretibial region, defined as the midpoint between the anterior tibial tuberosity and the medial malleolus and supramalleolar region. These regions were selected for their clinical relevance in lipedema and their high reproducibility in anthropometric assessments. To enhance measurement reliability, each site was measured three times consecutively, and the mean value was used for analysis. All measurements were conducted with the patient in a relaxed standing position by the same examiner to minimize inter-observer variability.

2. visual analogue scale (VAS)

   Time frame: Clinical assessments were conducted at baseline, as well as at 1 and 3 months following the treatment.

   Pain intensity was evaluated using the Visual Analog Scale (VAS), a 10-cm horizontal line representing a continuum of pain experience, where 0 indicates "no pain" and 10 denotes the "worst imaginable pain". Participants were asked to mark the point that best reflected their pain perception at each evaluation time point.

3. The Lower Extremity Functional Scale (LEFS)

   Time frame: Clinical assessments were conducted at baseline, as well as at 1 and 3 months following the treatment.

   Functional status was evaluated using the LEFS, a widely validated, patient-reported outcome measure specifically designed to assess lower extremity functional impairment. The LEFS consists of 20 items, each addressing a different daily or recreational activity involving the legs, such as walking, climbing stairs, squatting, or running. Participants rated the level of difficulty they experienced performing each activity on a 5-point Likert scale, ranging from 0 (extreme difficulty or unable to perform) to 4 (no difficulty).The total score ranges from 0 to 80, with higher scores reflecting greater functional capacity and less disability

4. The Lymphedema Quality of Life Questionnaire for the Leg (LYMQOL-Leg)

   Time frame: Clinical assessments were conducted at baseline, as well as at 1 and 3 months following the treatment.

   Quality of life was assessed using LYMQOL-Leg, a disease-specific instrument originally designed to evaluate health-related quality of life in patients with lower limb lymphedema. The questionnaire includes 24 items grouped into four distinct domains: function (activities of daily living and physical capacity), appearance (self-perception of leg aesthetics), mood (emotional and psychological well-being), and symptoms (such as heaviness, swelling, and pain). Each item is scored on a Likert scale from 1 to 4, with lower scores indicating greater impairment. In addition to domain scores, the LYMQOL includes a global quality of life score (rated on a scale from 0 to 10), where higher values reflect better overall quality of life [23, 24]. Although originally developed for lymphedema, LYMQOL has been effectively applied in lipedema studies due to symptom overlap.