LipedemaPODUSGNCT07724483
Ultrasonographic Evaluation and Pedobarographic Correlation of Lower Extremity Muscles in Lipedema Patients
An observational study of Lipedema and Obesity & Overweight, run by Marmara University at 1 site in Turkey (Türkiye).
Trial summary
The primary aim of this study is to evaluate the lower extremity muscle structure, lower extremity alignment, and foot posture in lipedema; secondly, to reveal the chain relationship and biomechanical problems that may be observed in lipedema patients. Read more about this study
- Who is it for?
- Ages 18 to 65 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Lipedema, Obesity & Overweight
- How many people
- 100 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Jul 2026to 15 Sep 2026
- How long will I take part?
- 1 Day
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Study population: Female patients aged 18-65 years diagnosed with lipedema by a clinician and their age- and BMI-matched healthy volunteers
Who may be able to join
- Female patients aged 18-65 years and diagnosed with lipedema by a clinician.
- To agree to participate in the research.
Who cannot join
- Positivity of Stemmer's sign (inability to compress the skin between the proximal phalanges of the 2nd and 3rd fingers)
- Patients with Heart Failure
- Patients with Chronic Kidney Disease
- Motor neuron diseases or myositis
- Diseases causing myositis
- Patients diagnosed with polyneuropathy
Show all 11Show fewer
- Patients with motor-involved L3, L4, L5, or S1 radiculopathy
- Those unable to ambulate independently
- Those who cannot tolerate the assessments
- Pregnant women
- Congenital or traumatic lower extremity disorders (e.g., developmental hip dysplasia, previous lower extremity fractures with orthopaedic implants).
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Marmara University School of Medicine Pendik Research and Training Hospital
Istanbul, Pendik, 34899
About this study
The primary aim of this study is to evaluate the lower extremity muscle structure, lower extremity alignment, and foot posture in lipedema; secondly, to reveal the chain relationship and biomechanical problems that may be observed in lipedema patients. Lipedema is a condition characterized by abnormal fat accumulation that can lead to walking difficulties and joint problems. We will use ultrasonography to measure muscle thickness and tendon structures, and a pedobarography system to analyze foot pressure distribution during standing and walking. By comparing 50 women diagnosed lipedema with 50 healthy volunteers, we aim to identify the musculoskeletal causes of gait disorders in lipedema to help develop better prevention and treatment strategies
Read the detailed description
Lipedema is a disease affecting fat tissues. Fat accumulates abnormally, especially in the hips and lower extremities. It was first described by Worl et al. The cause of the disease is unknown at the current level of scientific knowledge. Lipedema usually occurs in women during adolescence and the third decade. Although there is usually no lymphatic flow dysfunction in these patients, they are often misdiagnosed with lymphedema, but lipedema can cause secondary lymphatic dysfunction, leading to the development of lipolymphedema.
Lipedema is a clinical diagnosis. It is evaluated with appropriate history taking and physical examination. It can be detected by symptoms such as easy bruising, difficulty in losing weight from the legs while losing weight from the trunk, the presence of women with similar conditions in the family, pain on pressure, disproportion between the upper and lower body, pearl-sized nodules on the thighs, and decreased tissue and fascia elasticity on physical examination.
Ultrasonography (USG) muscle thickness measurement is a reliable method for determining regional muscle mass. Previous studies in the literature have evaluated the rectus femoris, gastrocnemius, gluteus medius and posterior tibialis muscles with USG and appropriate measurement techniques have been determined in these studies.
Pedobarography is a technology that evaluates a person's gait, balance, and consequently their locomotor system by examining the pressure distributions on the sole of the foot. It can be used diagnostically in the evaluation of lower extremity pathologies. Pedobarographic examination can provide static, postural, and dynamic evaluation. Static evaluation assesses the plantar pressure distribution during a certain standing time, while postural evaluation examines the pressure distributions in different standing positions. Dynamic evaluation assesses the load distribution on the sole of the foot during walking.
It is known that foot mechanics are affected in patients with lipedema. Considering that the load on the foot is increased in this patient group and that the majority of this load is caused by atypically stored fat, impairment of foot function is inevitable, especially in advanced stages. This is attributed to the valgus position of the knee and the disruption of the medial arch of the foot due to weakness of the knee extensors and hip abductors, and it has also been stated that these alignment problems may be due to gait disorders. Furthermore, it is known that obesity, which may occur simultaneously with lipedema, can lead to additional problems in mobility, and this limited mobility also increases the risk of depression. In addition, predominant sarcopenia in the thigh can be observed in these patients. In this case, weakness of the gluteus medius and quadriceps femoris that may develop contributes to the development of dynamic valgus in the knee. With the development of dynamic valgus, patellar displacement may occur, and as a result, chondromalacia may develop.
Considering the walking problems frequently observed in lipedema patients, it is crucial to address the root causes of these problems, preventing them where possible and detecting them when intervention is required. To achieve this, an assessment of potential problems and identification of related muscle and tendon dysfunctions are necessary to determine their causes. The aim of this study is to evaluate musculoskeletal problems in the lower extremities of lipedema patients, particularly those related to gait and posture, and their functional implications, and to determine the relationship between these functional problems and measurements of muscles and tendons using ultrasonography.
Study Methodology:
Design: Cross-sectional case-control study. Participants: 45 female patients with lipedema and 45 healthy controls. Clinical Evaluation: BMI, waist-hip ratio, leg volume calculation, and Foot Posture Index-6.
Functional Assessment: 6-Minute Walk Test. Questionnaires: Rapprich Lipedema Symptomatic Assessment, LYMPQOL-LEG and Short Form-36 USG Protocol: Measurement of M. Rectus Femoris, Gastrocnemius, Tibialis Posterior, and Gluteus Medius thickness using Esaote MyLab Seven lineer probe [SL1543].
Pedobarography: Static and dynamic 6-phase gait analysis using ACK Medical pedogram system.
Statistical Analysis: Group comparisons and Pearson/Spearman correlation analysis will be performed using SPSS.
- Conditions
- Lipedema, Obesity & Overweight
- Keywords
- Lipedema, Pedobarography, Musculoskeletal Ultrasound, Rectus Femoris, Gastrocnemius, Posterior Tibialis, Gluteus Medius, Achilles, STAR
- Medical subject headings
- Lipedema, Obesity, Overweight
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Lipedema | Patients Diagnosed Lipedema | |
| Healthy Volunteer | Healthy Volunteers thoose age- and BMI-matched |
What is being measured
The primary outcome is the main question the study is designed to answer.
M. Rectus Femoris Muscle Thickness
Measurement of thickness (mm) for M. Rectus Femoris with B-mode Ultrasonography (Esaote MyLab Seven). With the participant's knee fully extended and in a supine position, the transverse section of the image obtained from the midpoint of the distance between the SIAS and the upper edge of the patella was used to measure the RF thickness, excluding the fascial boundaries.
Measured: At baseline (Day 0)
M. Gastrocnemius Medialis Muscle Thickness
Measurement of thickness (mm) for Gastrocnemius Medialis via B-mode Ultrasonography (Esaote MyLab Seven). With the participant in the prone position, muscle thickness (distance between superficial and deep fascia) was measured in a longitudinal section at the proximal 1/3 of the muscle, where it is widest.
Measured: At baseline (Day 0)
M. Tibialis Posterior Muscle Thickness
Measurement of thickness (mm) for M. Tibialis Posterior via B-mode Ultrasonography (Esaote MyLab Seven). With the participant in the supine position, the muscle running deep within the tibialis anterior, at approximately 30% of the lateral malleolus and between the lateral knee joint space, was identified. The thickness of the muscle was assessed at the midline in the transverse section.
Measured: At Baseline (Day 0)
M. Gluteus Medius Muscle Thickness
Measurement of thickness (mm) for M. Gluteus Medius via B-mode Ultrasonography (Esaote MyLab Seven). The participant was positioned in the LD position, with both legs crossed and hips and knees flexed at 30°. The midpoint between the major trochanter and the crista iliaca was located and measured longitudinally. The thickness of the muscle located in the deep compartment was evaluated in the longitudinal section.
Measured: At Baseline (Day 0)
Clarke's Angle
Measurement of Clarke's angle (in degrees) derived from the plantar pressure distribution to objectively evaluate the integrity of the medial longitudinal arch.
Measured: At baseline (Day 0).
Foot Posture Index-6 (FPI-6) Score
Assessment of foot posture (pronation, supination, or neutral) based on six clinical criteria, providing a total score for foot alignment
Measured: At baseline (Day 0)
Genu Valgum
In genu valgum examination, the intermalleolar distance was measured while the participant had both knees together, and values greater than 8 cm were considered positive. In participants with an increase in intermalleolar distance, the tibiofemoral angle was measured, and values above 5° were considered genu valgum.
Measured: At baseline (Day 0)
Genu Recurvatum
In the genu recurvatum assessment, participants were placed in a supine position with a cushion under their heels, the goniometer was placed on the lateral femoral condyle, the tips of the goniometer were aligned with the greater trochanter and the lateral malleolus, and goniometric knee hyperextension was measured; values above 5° were considered positive.
Measured: At Baseline (Day 0)
Secondary outcomes (8)
Static Pedobarographic Weight Distribution Left& Right
Evaluation of the percentage (%) of weight distribution between left and right feet during static standing.
Measured: At baseline (Day 0)
Static Pedobarographic Weight Distribution Forefoot& Hindfoot
Evaluation of the percentage (%) of weight distribution between forefoot and hindfoot pressure ratio during static standing.
Measured: At Baseline (Day 0)
Center of Pressure (COP) Sway Area
Measurement of the area (mm^2) covered by the center of pressure during static standing to assess postural stability.
Measured: At baseline (Day 0)
Center of Pressure (COP) Sway Velocity
Measurement of the movement speed (mm/s) of the center of pressure during static standing.
Measured: At baseline (Day 0)
Dynamic Peak Plantar Pressures
Measurement of maximum peak pressure (N/cm^2) during 6 gait phases (Heel Strike, Foot Flat, Mid-stance, Heel Off, Toe Off) using the pedogram system.
Measured: At baseline (Day 0)
Patellar Tendon Cross-Sectional Area (CSA)
Measurement of cross-sectional area (mm^2) for Patellar tendon using B-mode Ultrasonography (Esaote MyLab Seven). For the patellar tendon, a cross-sectional area (CSA, mm²) was drawn in a transverse section between the lower end of the patella and the midpoint of the tibial tuberosity with the knee flexed at 30°; the tendon thickness was measured in millimeters in a longitudinal section.
Measured: At baseline (Day 0)
Achilles Tendon Cross-Sectional Area (CSA)
Measurement of cross-sectional area (mm^2) for Achilles tendon using B-mode Ultrasonography (Esaote MyLab Seven). With the ankle in a 90° neutral position, and the participant in the prone position, CSA (mm²) measurement was performed in a transverse section with the probe positioned at a perfect right angle to the tendon at the level of the medial malleolus, with a dense gel layer underneath.
Measured: At Baseline (Day 0)
Tibialis Posterior Tendon Cross-Sectional Area (CSA)
Measurement of cross-sectional area (mm^2) for tibialis posterior tendon using B-mode Ultrasonography (Esaote MyLab Seven). For the tendon, the participant was positioned in the lateral decubitus position, with the side to be evaluated close to the operator and medial to the anterior aspect. Images were acquired through the retromalleolar canal immediately behind the Medial Malleolus. A transverse section was obtained and measured at the point where the tendon wraps around the MM.
Measured: At Baseline (Day 0)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2026
- Study start15 Jul 2026
- Primary completion31 Aug 2026
- Study completion15 Sep 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (19)Papers the sponsor has linked to this study.
- Other trials for LipedemaStudies of the same condition, open and under way.
- More trials run by Marmara UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Enrolment
- 100 participants (actual)
- Target duration
- 1 Day
Sponsor and investigators
- Lead sponsor
- Marmara University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Canan Şanal, Assoc. Prof., Principal investigator, Marmara University Faculty of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07724483
- Sponsor's protocol ID
- MARPODUSG
- Other IDs
- PODUSG
- Acronym
- PODUSG
- Status last verified
- Oct 2026
- First submitted
- 17 Jul 2026
- Last updated
- 7 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Rapprich S, Dingler A, Podda M. Liposuction is an effective treatment for lipedema-results of a study with 25 patients. J Dtsch Dermatol Ges. 2011 Jan;9(1):33-40. doi: 10.1111/j.1610-0387.2010.07504.x. Epub 2010 Sep 7. English, German.
PubMed 21166777Yalfani A, Ahmadi M, Asgarpoor A. The effect of kinetic factors of dynamic knee valgus on patellofemoral pain: A systematic review and meta-analysis. J Bodyw Mov Ther. 2024 Jan;37:246-253. doi: 10.1016/j.jbmt.2023.11.001. Epub 2023 Nov 14.
PubMed 38432813Linsmayer D, Neidlinger PK, Braus DF. [Rheumatism and the mind-A mini review]. Orthopade. 2019 Nov;48(11):957-962. doi: 10.1007/s00132-019-03812-8. German.
PubMed 31559467Volkan-Yazici M, Yazici G, Esmer M. The Effects of Complex Decongestive Physiotherapy Applications on Lower Extremity Circumference and Volume in Patients with Lipedema. Lymphat Res Biol. 2021 Feb;19(1):111-114. doi: 10.1089/lrb.2020.0080. Epub 2020 Oct 30.
PubMed 33124947Amato AC. Chondromalacia in Lipedema: The Sarcopenic-Valgus Cascade That Keeps Getting Missed. Cureus. 2025 Oct 24;17(10):e95299. doi: 10.7759/cureus.95299. eCollection 2025 Oct.
PubMed 41287673Faerber G, Cornely M, Daubert C, Erbacher G, Fink J, Hirsch T, Mendoza E, Miller A, Rabe E, Rapprich S, Reich-Schupke S, Stucker M, Brenner E. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024 Sep;22(9):1303-1315. doi: 10.1111/ddg.15513. Epub 2024 Aug 27.
PubMed 39188170Buso G, Depairon M, Tomson D, Raffoul W, Vettor R, Mazzolai L. Lipedema: A Call to Action! Obesity (Silver Spring). 2019 Oct;27(10):1567-1576. doi: 10.1002/oby.22597.
PubMed 31544340Guven M, Kocadal O, Akman B, Poyanli OS, Kemah B, Atay EF. Proximal femoral nail shows better concordance of gait analysis between operated and uninjured limbs compared to hemiarthroplasty in intertrochanteric femoral fractures. Injury. 2016 Jun;47(6):1325-31. doi: 10.1016/j.injury.2016.03.009. Epub 2016 Mar 12.
PubMed 27017452Lorkowski J, Zarzycki D. [Clinical use of pedobarographic examination--own experience and review of literature]. Przegl Lek. 2006;63 Suppl 5:28-32. Polish.
PubMed 17469520Lorkowski J, Gawronska K. Pedobarography in Physiotherapy: A Narrative Review on Current Knowledge. Adv Exp Med Biol. 2022;1375:13-22. doi: 10.1007/5584_2021_636.
PubMed 33914289Neville C, Meyers K, Hojnowski L. Ultrasound assessment of the tibialis posterior tendon. J Orthop Sports Phys Ther. 2010 Oct;40(10):667. doi: 10.2519/jospt.2010.0417. No abstract available.
PubMed 20885025Johnson AW, Bruening DA, Violette VA, Perkins KV, Thompson CL, Ridge ST. Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements. J Ultrasound Med. 2020 Dec;39(12):2305-2312. doi: 10.1002/jum.15340. Epub 2020 May 15.
PubMed 32412115Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014 Aug;44(8):627-32. doi: 10.2519/jospt.2014.5315. Epub 2014 Jul 16.
PubMed 25029916Sheptulina AF, Yafarova AA, Mamutova EM, Drapkina OM. Sonographic Features of Rectus Femoris Muscle in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease and Their Correlation with Body Composition Parameters and Muscle Strength: Results of a Single-Center Cross-Sectional Study. Biomedicines. 2024 Jul 28;12(8):1684. doi: 10.3390/biomedicines12081684.
PubMed 39200149Kara M, Kaymak B, Ata AM, Ozkal O, Kara O, Baki A, Sengul Aycicek G, Topuz S, Karahan S, Soylu AR, Cakir B, Halil M, Ozcakar L. STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia. Am J Phys Med Rehabil. 2020 Oct;99(10):902-908. doi: 10.1097/PHM.0000000000001439.
PubMed 32941253
Study at a glance
From the registry record, last updated by the sponsor on 7 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasonographic Evaluation and Pedobarographic Correlation of Lower Extremity Muscles in Lipedema Patients
- ClinicalTrials.gov ID
- NCT07724483
- Acronym / sponsor ID
- PODUSG / MARPODUSG
- Conditions
- Lipedema, Obesity & Overweight
- Keywords
- Lipedema, Pedobarography, Musculoskeletal Ultrasound, Rectus Femoris, Gastrocnemius, Posterior Tibialis, Gluteus Medius, Achilles
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 100 participants (actual)
- Lead sponsor
- Marmara UniversityUniversity, hospital or other
- Study start
- 15 Jul 2026 (actual)
- Primary completion
- 31 Aug 2026 (actual)
- Study completion
- 15 Sep 2026 (actual)
- First posted
- 24 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary aim of this study is to evaluate the lower extremity muscle structure, lower extremity alignment, and foot posture in lipedema; secondly, to reveal the chain relationship and biomechanical problems that may be observed in lipedema patients. Lipedema is a condition characterized by abnormal fat accumulation that can lead to walking difficulties and joint problems. We will use ultrasonography to measure muscle thickness and tendon structures, and a pedobarography system to analyze foot pressure distribution during standing and walking. By comparing 50 women diagnosed lipedema with 50 healthy volunteers, we aim to identify the musculoskeletal causes of gait disorders in lipedema to help develop better prevention and treatment strategies
Detailed description
Lipedema is a disease affecting fat tissues. Fat accumulates abnormally, especially in the hips and lower extremities. It was first described by Worl et al. The cause of the disease is unknown at the current level of scientific knowledge. Lipedema usually occurs in women during adolescence and the third decade. Although there is usually no lymphatic flow dysfunction in these patients, they are often misdiagnosed with lymphedema, but lipedema can cause secondary lymphatic dysfunction, leading to the development of lipolymphedema.
Lipedema is a clinical diagnosis. It is evaluated with appropriate history taking and physical examination. It can be detected by symptoms such as easy bruising, difficulty in losing weight from the legs while losing weight from the trunk, the presence of women with similar conditions in the family, pain on pressure, disproportion between the upper and lower body, pearl-sized nodules on the thighs, and decreased tissue and fascia elasticity on physical examination.
Ultrasonography (USG) muscle thickness measurement is a reliable method for determining regional muscle mass. Previous studies in the literature have evaluated the rectus femoris, gastrocnemius, gluteus medius and posterior tibialis muscles with USG and appropriate measurement techniques have been determined in these studies.
Pedobarography is a technology that evaluates a person's gait, balance, and consequently their locomotor system by examining the pressure distributions on the sole of the foot. It can be used diagnostically in the evaluation of lower extremity pathologies. Pedobarographic examination can provide static, postural, and dynamic evaluation. Static evaluation assesses the plantar pressure distribution during a certain standing time, while postural evaluation examines the pressure distributions in different standing positions. Dynamic evaluation assesses the load distribution on the sole of the foot during walking.
It is known that foot mechanics are affected in patients with lipedema. Considering that the load on the foot is increased in this patient group and that the majority of this load is caused by atypically stored fat, impairment of foot function is inevitable, especially in advanced stages. This is attributed to the valgus position of the knee and the disruption of the medial arch of the foot due to weakness of the knee extensors and hip abductors, and it has also been stated that these alignment problems may be due to gait disorders. Furthermore, it is known that obesity, which may occur simultaneously with lipedema, can lead to additional problems in mobility, and this limited mobility also increases the risk of depression. In addition, predominant sarcopenia in the thigh can be observed in these patients. In this case, weakness of the gluteus medius and quadriceps femoris that may develop contributes to the development of dynamic valgus in the knee. With the development of dynamic valgus, patellar displacement may occur, and as a result, chondromalacia may develop.
Considering the walking problems frequently observed in lipedema patients, it is crucial to address the root causes of these problems, preventing them where possible and detecting them when intervention is required. To achieve this, an assessment of potential problems and identification of related muscle and tendon dysfunctions are necessary to determine their causes. The aim of this study is to evaluate musculoskeletal problems in the lower extremities of lipedema patients, particularly those related to gait and posture, and their functional implications, and to determine the relationship between these functional problems and measurements of muscles and tendons using ultrasonography.
Study Methodology:
Design: Cross-sectional case-control study. Participants: 45 female patients with lipedema and 45 healthy controls. Clinical Evaluation: BMI, waist-hip ratio, leg volume calculation, and Foot Posture Index-6.
Functional Assessment: 6-Minute Walk Test. Questionnaires: Rapprich Lipedema Symptomatic Assessment, LYMPQOL-LEG and Short Form-36 USG Protocol: Measurement of M. Rectus Femoris, Gastrocnemius, Tibialis Posterior, and Gluteus Medius thickness using Esaote MyLab Seven lineer probe [SL1543].
Pedobarography: Static and dynamic 6-phase gait analysis using ACK Medical pedogram system.
Statistical Analysis: Group comparisons and Pearson/Spearman correlation analysis will be performed using SPSS.
Study design
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Target follow-up
- 1 Day
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Lipedema | – | –Patients Diagnosed Lipedema |
| Healthy Volunteer | – | –Healthy Volunteers thoose age- and BMI-matched |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Female patients aged 18-65 years diagnosed with lipedema by a clinician and their age- and BMI-matched healthy volunteers
Key inclusion criteria (2 listed)
- Female patients aged 18-65 years and diagnosed with lipedema by a clinician.
- To agree to participate in the research.
Key exclusion criteria (11 listed)
- Positivity of Stemmer's sign (inability to compress the skin between the proximal phalanges of the 2nd and 3rd fingers)
- Patients with Heart Failure
- Patients with Chronic Kidney Disease
- Motor neuron diseases or myositis
- Diseases causing myositis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
M. Rectus Femoris Muscle Thickness
Time frame: At baseline (Day 0)
Measurement of thickness (mm) for M. Rectus Femoris with B-mode Ultrasonography (Esaote MyLab Seven). With the participant's knee fully extended and in a supine position, the transverse section of the image obtained from the midpoint of the distance between the SIAS and the upper edge of the patella was used to measure the RF thickness, excluding the fascial boundaries.
M. Gastrocnemius Medialis Muscle Thickness
Time frame: At baseline (Day 0)
Measurement of thickness (mm) for Gastrocnemius Medialis via B-mode Ultrasonography (Esaote MyLab Seven). With the participant in the prone position, muscle thickness (distance between superficial and deep fascia) was measured in a longitudinal section at the proximal 1/3 of the muscle, where it is widest.
M. Tibialis Posterior Muscle Thickness
Time frame: At Baseline (Day 0)
Measurement of thickness (mm) for M. Tibialis Posterior via B-mode Ultrasonography (Esaote MyLab Seven). With the participant in the supine position, the muscle running deep within the tibialis anterior, at approximately 30% of the lateral malleolus and between the lateral knee joint space, was identified. The thickness of the muscle was assessed at the midline in the transverse section.
M. Gluteus Medius Muscle Thickness
Time frame: At Baseline (Day 0)
Measurement of thickness (mm) for M. Gluteus Medius via B-mode Ultrasonography (Esaote MyLab Seven). The participant was positioned in the LD position, with both legs crossed and hips and knees flexed at 30°. The midpoint between the major trochanter and the crista iliaca was located and measured longitudinally. The thickness of the muscle located in the deep compartment was evaluated in the longitudinal section.
Clarke's Angle
Time frame: At baseline (Day 0).
Measurement of Clarke's angle (in degrees) derived from the plantar pressure distribution to objectively evaluate the integrity of the medial longitudinal arch.
Foot Posture Index-6 (FPI-6) Score
Time frame: At baseline (Day 0)
Assessment of foot posture (pronation, supination, or neutral) based on six clinical criteria, providing a total score for foot alignment
Genu Valgum
Time frame: At baseline (Day 0)
In genu valgum examination, the intermalleolar distance was measured while the participant had both knees together, and values greater than 8 cm were considered positive. In participants with an increase in intermalleolar distance, the tibiofemoral angle was measured, and values above 5° were considered genu valgum.
Genu Recurvatum
Time frame: At Baseline (Day 0)
In the genu recurvatum assessment, participants were placed in a supine position with a cushion under their heels, the goniometer was placed on the lateral femoral condyle, the tips of the goniometer were aligned with the greater trochanter and the lateral malleolus, and goniometric knee hyperextension was measured; values above 5° were considered positive.
8 secondary outcomes
Static Pedobarographic Weight Distribution Left& Right
Time frame: At baseline (Day 0)
Static Pedobarographic Weight Distribution Forefoot& Hindfoot
Time frame: At Baseline (Day 0)
Center of Pressure (COP) Sway Area
Time frame: At baseline (Day 0)
Center of Pressure (COP) Sway Velocity
Time frame: At baseline (Day 0)
Dynamic Peak Plantar Pressures
Time frame: At baseline (Day 0)
Patellar Tendon Cross-Sectional Area (CSA)
Time frame: At baseline (Day 0)
Achilles Tendon Cross-Sectional Area (CSA)
Time frame: At Baseline (Day 0)
Tibialis Posterior Tendon Cross-Sectional Area (CSA)
Time frame: At Baseline (Day 0)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Oct 2026.
- Background: PubMed 21166777Rapprich S, Dingler A, Podda M. Liposuction is an effective treatment for lipedema-results of a study with 25 patients. J Dtsch Dermatol Ges. 2011 Jan;9(1):33-40. doi: 10.1111/j.1610-0387.2010.07504.x. Epub 2010 Sep 7. English, German.
- Background: PubMed 38432813Yalfani A, Ahmadi M, Asgarpoor A. The effect of kinetic factors of dynamic knee valgus on patellofemoral pain: A systematic review and meta-analysis. J Bodyw Mov Ther. 2024 Jan;37:246-253. doi: 10.1016/j.jbmt.2023.11.001. Epub 2023 Nov 14.
- Background: PubMed 31559467Linsmayer D, Neidlinger PK, Braus DF. [Rheumatism and the mind-A mini review]. Orthopade. 2019 Nov;48(11):957-962. doi: 10.1007/s00132-019-03812-8. German.
- Background: PubMed 33124947Volkan-Yazici M, Yazici G, Esmer M. The Effects of Complex Decongestive Physiotherapy Applications on Lower Extremity Circumference and Volume in Patients with Lipedema. Lymphat Res Biol. 2021 Feb;19(1):111-114. doi: 10.1089/lrb.2020.0080. Epub 2020 Oct 30.
- Background: PubMed 41287673Amato AC. Chondromalacia in Lipedema: The Sarcopenic-Valgus Cascade That Keeps Getting Missed. Cureus. 2025 Oct 24;17(10):e95299. doi: 10.7759/cureus.95299. eCollection 2025 Oct.
- Background: PubMed 39188170Faerber G, Cornely M, Daubert C, Erbacher G, Fink J, Hirsch T, Mendoza E, Miller A, Rabe E, Rapprich S, Reich-Schupke S, Stucker M, Brenner E. S2k guideline lipedema. J Dtsch Dermatol Ges. 2024 Sep;22(9):1303-1315. doi: 10.1111/ddg.15513. Epub 2024 Aug 27.
- Background: PubMed 31544340Buso G, Depairon M, Tomson D, Raffoul W, Vettor R, Mazzolai L. Lipedema: A Call to Action! Obesity (Silver Spring). 2019 Oct;27(10):1567-1576. doi: 10.1002/oby.22597.
- Background: PubMed 27017452Guven M, Kocadal O, Akman B, Poyanli OS, Kemah B, Atay EF. Proximal femoral nail shows better concordance of gait analysis between operated and uninjured limbs compared to hemiarthroplasty in intertrochanteric femoral fractures. Injury. 2016 Jun;47(6):1325-31. doi: 10.1016/j.injury.2016.03.009. Epub 2016 Mar 12.
- Background: PubMed 17469520Lorkowski J, Zarzycki D. [Clinical use of pedobarographic examination--own experience and review of literature]. Przegl Lek. 2006;63 Suppl 5:28-32. Polish.
- Background: PubMed 33914289Lorkowski J, Gawronska K. Pedobarography in Physiotherapy: A Narrative Review on Current Knowledge. Adv Exp Med Biol. 2022;1375:13-22. doi: 10.1007/5584_2021_636.
- Background: PubMed 20885025Neville C, Meyers K, Hojnowski L. Ultrasound assessment of the tibialis posterior tendon. J Orthop Sports Phys Ther. 2010 Oct;40(10):667. doi: 10.2519/jospt.2010.0417. No abstract available.
- Background: PubMed 32412115Johnson AW, Bruening DA, Violette VA, Perkins KV, Thompson CL, Ridge ST. Ultrasound Imaging Is Reliable for Tibialis Posterior Size Measurements. J Ultrasound Med. 2020 Dec;39(12):2305-2312. doi: 10.1002/jum.15340. Epub 2020 May 15.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Canan Şanal, Assoc. Prof. principal investigator
Marmara University Faculty of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Lipedema and Obesity & Overweight, run by Marmara University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
M. Rectus Femoris Muscle Thickness (time frame: At baseline (Day 0)). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07724483, which also lists 19 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Oct 2026.