Aerobic Exercise Effects in Lower Extremity Lymphedema

Lower extremity lymphedema negatively affects patients' functional status, quality of life, and activities of daily living. Complete decongestive therapy (CDT) is considered the gold-standard conservative treatment for patients with lymphedema. CDT consists of manual lymph drainage (MLD), skin care, compression bandaging, and exercise. Several studies have demonstrated the effectiveness of CDT in patients with lower extremity lymphedema. However, the results of studies investigating the effectiveness of different types of exercise are inconsistent. Moreover, most of these studies have been conducted in patients with upper extremity lymphedema, and the outcome measures have generally been limited to limb circumference measurements and quality of life assessments. To the best of our knowledge, no previous study has comprehensively evaluated the effects of aerobic exercise on both ultrasonographic parameters (quantitative data) and functional outcomes in patients with lower extremity lymphedema, as planned in the present study. Therefore, this study was designed to contribute to the existing literature by investigating these effects.

Inclusion Criteria: * Diagnosis of lower extremity lymphedema (unilateral or bilateral) * Age ≥18 years * Absence of cognitive impairment * Provision of written informed consent to participate in the study Exclusion Criteria: * Cognitive impairment * Presence of general contraindications to exercise (e.g., hemodynamic instability, uncontrolled hypertension, decompensated heart failure, recent myocardial infarction, or unstable angina pectoris) * Presence of neurological diseases affecting the lower extremities that would preclude participation in the exercise program * Presence of unhealed fractures in the lower extremities preventing exercise therapy * Active systemic infection or local infection in the treatment area, such as cellulitis, erysipelas, or thrombophlebitis in the lower extremities * Acute venous thromboembolic events involving the lower extremities * Heart failure or renal failure that may cause lower extremity edema * Presence of concomitant lipedema * Presence of venous insufficiency * Ongoing chemotherapy or radiotherapy (among patients with malignancy-related lymphedema) * Pregnancy