Objective measures of physical activity and physical capacities in lipedema - a scooping review

Abstract Background Lipedema is a chronic condition characterized by abnormal subcutaneous fat accumulation, predominantly affecting women. It is associated with pain, swelling, reduced mobility, and psychological distress, all of which may limit physical activity (PA) and impair physical function. While PA is increasingly recognized as a key component in conservative management, most existing studies rely on self-reported data, which are prone to bias. Objective assessments of PA and physical capacity are essential to better understand functional limitations and guide tailored interventions. Objective This scoping review aimed to map and summarize existing studies that have used objective methods to assess physical activity levels and physical function in women with lipedema. Methods The review is reported following the PRISMA-ScR guidelines. A systematic search was conducted in five databases (Scopus, Web of Science, MEDLINE, CINAHL, and AMED) from inception to August 13, 2025. Studies were included if they investigated lipedema and used objective measures of PA or physical capacity. After screening 5,147 records and assessing 46 full-text articles, six studies met the inclusion criteria. Results The included studies employed various objective tools, such as accelerometry, six-minute walk tests, sit-to-stand tests, and handheld dynamometry. Sample sizes ranged from 31 to 96 participants with lipedema, with a predominance of female subjects. Findings indicated that individuals with lipedema generally exhibit lower walking capacity and muscle strength compared to healthy or BMI-matched controls. Structured exercise interventions, particularly multimodal programs combining aerobic and resistance training, were associated with improvements in walking distance, muscle strength, and pain reduction. However, methodological heterogeneity and small sample sizes limit the generalizability of findings. Conclusions Objective assessments reveal that individuals with lipedema have reduced physical capacity, but structured physical activity interventions may yield functional benefits. Despite promising results, the evidence base remains limited. Future research should prioritize standardized, objective measurement protocols and larger, well-designed trials to inform evidence-based guidelines for physical activity in this population.