# Objective Assessment of the Cardiorespiratory Fitness Among Individuals With Lymphedema and Lipedema: A Systematic Review and Meta-Analysis

## TL;DR

This study reviews evidence on how well people with lymphedema and lipedema perform in tests of heart and lung fitness, finding differences in a 6-minute walk test.

## Contribution

The study provides a systematic review and meta-analysis comparing cardiorespiratory fitness measures in lymphedema and lipedema populations.

## Key findings

- The 6-minute walk test (6MWT) was significantly lower in individuals with lipedema compared to those with lymphedema.
- There was no correlation between limb volume and VO2 peak in breast cancer-related lymphedema.
- 6MWT results correlated with subjective CRF measures like the SF-36 physical function score in one study.

## Abstract

Background: One of the main challenges in managing lymphedema and lipedema is the lack of valid and reliable objective measures for diagnosis and follow-up. This study was aimed at gathering evidence regarding the objective measures of cardiorespiratory fitness (CRF) among these populations.

Methods: Scopus, PubMed, and Embase were searched for observational studies investigating the objective measures of CRF among individuals with lipedema and lymphedema. Both primary and secondary lymphedema were included. Different CRF measures reported by the included articles were determined, and the main outcomes regarding these measurements were extracted. The meta-analysis was performed to compare the pooled mean 6-min walk test (6MWT) between individuals with lower limb lymphedema and lipedema using STATA software (Version 17.0).

Results: Eight articles were included, and the majority of participants were female. Four distinct objective measures of CRF were reported among the included articles, including hemodynamic indices, spirometry indices, VO2 peak, and 6MWT. The mean VO2 peak was significantly lower among women with breast cancer–related lymphedema; however, there was no correlation between affected limb volumes and the VO2 peak. The meta-analysis revealed a lower mean 6MWT among individuals with lipedema compared to lymphedema (pooled difference: 37.71 [confidence interval (CI): 5.19–70.22], p value: 0.02, I2: 0%). Also, there was a significant relationship between 6MWT and subjective measures of CRF, such as the Short Form 36 (SF-36) physical function score, in one included article.

Conclusion: While limited evidence exists on the objective measures of CRF among individuals with lymphedema and lipedema, there might be a significant difference in 6MWT between these two groups.