Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy.
Physical Medicine and Rehabilitation Unit, Sant'Andrea University Hospital, Rome, Italy.
Lymphology. 2023;56(1):13-26.
The aim of this pilot study was to investigate the effects of defocused and radial shock wave therapy, mesotherapy, and kinesio taping on pain, circumferences of lower limbs, echographic/ elastosonographic pattern of subcutaneous adipose tissue (SAT), and quality of life in patients with lipedema. Fifteen women affected by lower limb lipedema in stage II were treated with shock wave therapy, mesotherapy, and kinesio taping on thighs and legs (eight sessions, twice a week). The primary outcome was pain, as assessed by Numeric Rating Scale (NRS). Secondary outcomes included the limb circumferences measurements, the SF-12 Health Survey for quality of life, the International Classification of Functioning (ICF) for disability, and echographic/ elastosonographic changes of SAT. Significant reductions of pain and circumference measurements were seen in patients at each follow up. This was associated with significant reduction of thickness, echographic pattern improvement, and increased elasticity of SAT, with consequent positive impact on the quality of life and disability reported by the patients. The results demonstrate improved clinical and functional ultrasound findings in patients affected by lipedema in the early stages of lower limbs, and this combination therapy needs to be investigated in larger populations at multiple centers to confirm the findings.
本初步研究旨在探讨离焦和径向冲击波治疗、中胚层疗法和肌内效贴布疗法对下肢脂肪水肿患者疼痛、下肢周径、皮下脂肪组织（SAT）的超声/弹性声像图模式和生活质量的影响。15 名患有下肢脂肪水肿 II 期的女性患者接受了大腿和小腿的冲击波治疗、中胚层疗法和肌内效贴布治疗（8 次，每周 2 次）。主要结局指标为疼痛，采用数字评分量表（NRS）评估。次要结局指标包括肢体周径测量、SF-12 健康调查用于生活质量、国际功能、残疾和健康分类（ICF）用于残疾，以及 SAT 的超声/弹性声像图变化。在每次随访时，患者的疼痛和周径测量均显著降低。这与 SAT 的厚度降低、超声模式改善和弹性增加相关，继而对患者报告的生活质量和残疾产生积极影响。结果表明，在下肢脂肪水肿早期阶段的患者中，临床和功能超声检查结果得到改善，需要在多个中心的更大人群中进行这种联合治疗的研究，以证实这些发现。
