Diathermy Effectiveness in Reducing Subcutaneous Adipose Tissue Affected by Lipedema

Study Overview
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Brief Summary
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Diathermy, a therapy that uses deep heat to reach deep tissue layers, is known to induce the breaking down of fatty cells and fibrotic tissue. In lipedema, patients develop fibrosis of their subcutaneous adipose tissue. Therefore, diathermy could be an interesting tool to treat this disease. To test the effectiveness of diathermy on these patients, the investigators will select women with lipedema (18 to 70 yo) and place them in two groups (experimental and control group). The experimental group will receive the treatment, that is, 10 minutes of diathermy on the medial knee surface of both knees, with an intensity that produces heat just below the participants' pain threshold. Participants from the control group will receive sham diathermy, that is, placebo. The intervention consists of 10 sessions, 3 times a week, for 4 weeks. Researchers will collect data pre and post intervention and one month after the intervention ends. Data will consist of measurements at knee level with tape and an ultrasound device, pain threshold with an algometer, a VAS score and an SF-12 questionnaire for quality of life.

Detailed Description
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The goal of this clinical trial is to test the effectiveness of diathermy in reducing the subcutaneous adipose tissue affected by lipedema in women suffering from this disorder. The main questions it aims to answer are: Does diathermy produce changes in subcutaneous adipose tissue affected by lipedema? Is it effective as a tool for lipolysis and/or fibrolysis of said subcutaneous adipose tissue affected by lipedema? Do these changes result in a reduction of subcutaneous adipose tissue affected by lipedema? Do these changes decrease pain in the area treated with diathermy? Participants will: Be assesed prior to receiving treatment: Circometry of both knees (at joint space level) Pain threshold using an algometer. Area: medial below knee region, at fibular head level SF-12 questionnaire VAS score Ultrasound mesurements at medial collateral ligament (distance from skin to ligament) Receive 10 diathermy sessions. 10 minutes per knee (medial knee surface), 3 times a week for 4 weeks. Parameters: 470 KHz, capacitive head, intensity: heat below pain threshold. Be assesed after receiving treatment: Circometry of both knees (at joint space level) Pain threshold using an algometer. Area: medial below knee region, at fibular head level SF-12 questionnaire VAS score Ultrasound mesurements at medial collateral ligament (distance from skin to ligament) Be assesed after receiving treatment (one month post intervention): Circometry of both knees (at joint space level) Pain threshold using an algometer. Area: medial below knee region, at fibular head level SF-12 questionnaire VAS score Ultrasound mesurements at medial collateral ligament (distance from skin to ligament) Researchers will compare an experimental group to a placebo group to see if treatment with diathermy is effective in reducing subcutaneous adipose tissue affected by lipedema.

Official Title
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Diathermy Effectiveness in Reducing Subcutaneous Adipose Tissue Affected by Lipedema

Conditions
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Lipedema

Intervention / Treatment
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* Other: Diathermy
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women between 18-70 years old. Diagnosed with lipedema by a medical service. Patients with type III or V lipedema (involvement of legs). Patients with type II lipedema are also admitted if they have a fat pad on the inner side of the knee Exclusion Criteria: Pregnant Pacemaker or some other electronic implant Metal implants or knee prostheses Open wounds or burns on the inside of the knee Thrombophlebitis Malignant growths (cancer) Infectious processes Follow other non-conservative treatment related to lipedema at that time

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diathermy<br>The experimental group will receive 10 diathermy sessions. | Other: Diathermy<br>* The patients belonging to the experimental group will undergo 10 diathermy sessions. The control group will have the same sessions but in athermy (placebo)<br>|
| Placebo Comparator: Placebo<br>The placebo comparator, will receive 10 placebo sessions. | Other: Placebo<br>* The patients belonging to the placebo group will undergo 10 placebo sessions (athermya)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of adipose tissue in the knee | Using ultrasound, it is intended to know if a reduction in adipose tissue has occurred after the application of diathermy. | baseline | 
| Change of adipose tissue in the knee | Using ultrasound, it is intended to know if a reduction in adipose tissue has occurred after the application of diathermy. | after finishing the treatment (one month) | 
| Change of adipose tissue in the knee | Using ultrasound, it is intended to know if a reduction in adipose tissue has occurred after the application of diathermy. | 30 days after finishing the treatment. | 
| Contour change in the knee. | By using a tape measure, the circummetry of the knees on both sides will be assessed. The greater the contour, the more volume the patient will show. | baseline | 
| Contour change in the knee. | By using a tape measure, the circummetry of the knees on both sides will be assessed. The greater the contour, the more volume the patient will show. | after finishing the treatment (one month) | 
| Contour change in the knee. | By using a tape measure, the circummetry of the knees on both sides will be assessed. The greater the contour, the more volume the patient will show. | 30 days after finishing the treatment. | 
| Quality of life (SF-12). | SF-12 quality of life questionnaire. The higher the score obtained in the questionnaire, the better the patient's quality of life. The maximum value that can be reached is 100 and the minimum is 0. | baseline | 
| Quality of life (SF-12). | SF-12 quality of life questionnaire. The higher the score obtained in the questionnaire, the better the patient's quality of life. The maximum value that can be reached is 100 and the minimum is 0. | after finishing the treatment (one month) | 
| Quality of life (SF-12). | SF-12 quality of life questionnaire. The higher the score obtained in the questionnaire, the better the patient's quality of life. The maximum value that can be reached is 100 and the minimum is 0. | 30 days after finishing the treatment. | 
| Measure pain | Visual analogic scale (VAS). The higher the visual analogue scale score, the more pain the patient presents. The maximum value that can be reached is 10 and the minimum is 0. | baseline | 
| Measure pain | Visual analogic scale (VAS). The higher the visual analogue scale score, the more pain the patient presents. The maximum value that can be reached is 10 and the minimum is 0. | after finishing the treatment (one month) | 
| Measure pain | Visual analogic scale (VAS). The higher the visual analogue scale score, the more pain the patient presents. The maximum value that can be reached is 10 and the minimum is 0. | 30 days after finishing the treatment. | 
| Algometry. | Using the algometer, pain sensitivity will be assessed when pressing medial infracondylar leg at the level of the fibular head. The lower the algometry score, the more pain the patient will have. The maximum value that can be reached is 5 and the minimum value is 0. | baseline | 
| Algometry. | Using the algometer, pain sensitivity will be assessed when pressing medial infracondylar leg at the level of the fibular head. The lower the algometry score, the more pain the patient will have. The maximum value that can be reached is 5 and the minimum value is 0. | after finishing the treatment (one month) | 
| Algometry. | Using the algometer, pain sensitivity will be assessed when pressing medial infracondylar leg at the level of the fibular head. The lower the algometry score, the more pain the patient will have. The maximum value that can be reached is 5 and the minimum value is 0. | 30 days after finishing the treatment. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sociodemographic variables | Sociodemographic data such as age, weight, height and marital status will be collected | baseline. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lipedema