Respiratory and Relaxation Training in Lower Extremity Lymphedema

This randomized controlled trial aims to investigate the effectiveness of respiratory and relaxation training added to standard complex decongestive therapy (CDT) on muscle oxygenation, functional capacity, and limb volume in patients with lower extremity lymphedema. Participants will be randomly assigned to receive either standard CDT alone or CDT combined with respiratory and relaxation exercises. Outcomes will be assessed before treatment, immediately after treatment, and two months after completion.

Inclusion Criteria: * Female patients aged 18 years or older. * Clinically diagnosed with secondary lower extremity lymphedema. * Presence of lower extremity lymphedema for at least 3 months. * Able to stand and walk independently to complete the Six-Minute Walk Test. * Willing and able to provide written informed consent. Exclusion Criteria: * Acute cellulitis or other active infection within the previous 2-4 weeks. * Current or recent deep vein thrombosis (DVT) or uncontrolled peripheral vascular disease. * Severe cardiovascular, pulmonary, orthopedic, or neurological conditions that could interfere with participation or outcome assessments. * Pregnancy. * Skin lesions or irritation preventing placement of the near-infrared spectroscopy (MOXY) sensor. * Inability to comply with the study protocol or follow-up assessments.