Quadrivas Therapy® to Reduce Lipedema Subcutaneous Adipose Tissue (QUADRIVAS)
Condition: Lipedema
MeSH terms: Lipedema
Study type: Interventional

Summary: 
      Quad Rivas Therapy has been developed by Alyna Eekma from the Netherlands for over thirteen
      years; anecdotally she has been able to significantly reduce lipedema SAT in women with Stage
      1 and 2 lipedema, and can reduce lipedema SAT by 80% in women with Stage 3 lipedema. The
      study will last for one month, for a total of 12 treatments per subject, seven subjects
      total, to see if there is a change in percent body fat percentage over the course of these
      treatments.
    

Detailed description: 
      Lipedema

      According to an epidemiological study by Földi E and Földi M, lipedema affects 11% of the
      female population. Rarely, men with hypogonadism, growth hormone deficiency, or liver disease
      may develop lipedema. Drs. Allen and Hines from the Mayo clinic defined lipedema in 1940 and
      shortly thereafter provided the diagnostic criteria for lipedema:

        1. Almost exclusive occurrence in women developing by the third decade of life

        2. Bilateral and symmetrical nature with minimal involvement of the feet, resulting in an
           ''inverse shouldering'', ''bracelet'' or "cuff" effect at the ankle

        3. Minimal pitting edema (non-pitting edema is present)

        4. Pain, tenderness, and easy bruising

        5. Persistent enlargement despite elevation of the extremities or weight loss.

        6. Increased vascular fragility; easy bruising

      There are three stages of lipedema Stage 1: Normal skin surface with enlarged hypodermis
      Stage 2: Uneven skin with a peau d'orange or mattress-like texture with larger mounds of
      tissue the size of a walnut or apple including the formation of lipomas and angiolipomas, and
      larger indentations in the fat Stage 3: Much larger mounds or huge lobules of tissue occurs
      causing deformations especially around the knees

      Progression to lymphedema, called lipolymphedema (Stage 4) can develop during any Stage but
      most commonly occurs in people with Stage 3. Obesity can occur along with lipedema especially
      in Stage 3. Lifestyle improvements should always be considered for obesity associated with
      lipedema but lifestyle is not the cause of lipedema nor the cure.

      Women with lipedema have an obvious disparity between the larger quantity of gynoid
      distributed painful fat on the lower body (hips, buttocks, legs) compared to the trunk, head
      and face resulting in a low waist to hip ratio (WHR). The disparity results from the failure
      of lipedema SAT to reduce in response to extreme caloric restriction, including bariatric
      procedures, or intensive daily exercise. It is unclear why there is a drive to maintain
      lipedema SAT on the body. The SAT begins in typical gynoid locations (hips, buttocks, legs)
      and few women with lipedema have diabetes or metabolic syndrome suggesting that the lipedema
      SAT may be protective against cardiovascular disease similar to gynoid fat. However, in
      addition to being cosmetically devastating to many women, lipedema fat increases the risk of
      development of mobility issues, joint damage, chronic pain and lymphedema.

      Quad Rivas Therapy®

      The Quad Rivas Therapy® is a deep tissue "hands on" touch therapy of SAT which treats the
      body as an anatomical and physiological unit - all areas containing SAT are treated with a
      focus to improve functioning of blood vasculature, lymph vasculature, nerves, and the
      biomechanical system (muscle, tendons and fascia). The Quad Rivas Therapy® ensures these four
      systems are improved, but focuses on the vascular system. Tissues with decreased blood supply
      due to enlarged SAT mass, fibrosis or fascia disease need manipulation to be able to function
      properly again, allowing easy flow through the tissue. The Quad Rivas Therapy, therapist uses
      specialized grip techniques which enable the therapist to 'open' and 'unravel' tissues for an
      optimal blood supply. Another tissue technique, called the "hook technique" allows the
      therapist to ensure stimulation of blood flow. Blood vessels gain elasticity back, fibrosis
      in the veins resolves and the body is able to repair itself.

      The Quad Rivas Therapy® theory is that during puberty under the influence of hormones, the
      lipedema SAT outgrows the ability of muscles to use and break down fat resulting in excess
      SAT mass. This in combination with vascular, especially venous, insufficiency, which affects
      many women at a young age, creates a progressive disease that generates a blockage in
      metabolism associated due to setting up a hypoxic environment for the fat cells. Stimulating
      the affected area with Quad Rivas Therapy®, focusing on getting vessels back in top condition
      ensures the disappearance of lipedema SAT.

      Quad Rivas Therapy® results in the following:

        1. Recovery of the walls of the veins;

        2. Increased basal metabolic rate in muscles;

        3. Improved condition of the connective tissue.
    

Intervention name(s): Quadrivas Therapy
Intervention type(s): Other
Intervention description(s): Quadrivas therapy will be applied to subjects. Quadrivas therapy is a intensive massage therapy for different tissues. Subjects will receive 12 treatments. The first lasting 2.5 hours and the remaining 11 lasting 1.5 hours.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Quadrivas; Veins; Lipedema; Lymphedema