Low-frequency vibrotherapy considerably improves the effectiveness of manual lymphatic drainage (MLD) in patients with lipedema: A two-armed, randomized, controlled pragmatic trial

Purpose: Although the exact prevalence of lipedema is unknown the number of women suffering from this condition is ever-growing. When treated conservatively, manual lymphatic drainage is regarded the gold standard. However, the rate of its effectiveness varies considerably with some women showing minimal to no improvement depending on severity of the disease and medical history. Methods: Thirty female patients diagnosed with lipedema stage 2-3 referred to physiotherapeutic treatment were randomly allocated to either six treatments of MLD or to six treatments of combined MLD and vibrotherapy treatment. Outcome parameters were the volume of lipedema at four locations of either the lower (n = 29) or the upper extremities (n = 1), as well as quality of life. Findings: A very large superiority of effectiveness was found for the combined treatment. Reduction of the sizes of lipedema varied between 1.1 < d < 3.2. These patients' quality of life was also considerably better (d = 1.0). Conclusions: Combining MLD with vibrotherapy treatment drastically enhances the effectiveness of treating lipedema.