Impact of Virtual Reality (VR) Based Exercises on Lower Limb Lymphedema Outcomes (LELO)

The Effect of Virtual Reality-Assisted Exercises on Gait Parameters, Function, Quality of Life, and Edema Level in Patients With Lower Extremity Lymphedema

This randomized controlled study aims to investigate the effects of virtual reality (VR)-assisted gait training, in addition to Complex Decongestive Therapy (CDT), on gait parameters, physical function, quality of life, and edema levels in patients with lower extremity lymphedema. Lymphedema is a progressive condition characterized by the accumulation of protein-rich fluid due to lymphatic drainage insufficiency, leading to chronic inflammation and fibrosis. It impairs gait patterns and reduces functional mobility. VR technologies, such as the RehaWalk system, provide interactive, personalized rehabilitation environments that enhance motor learning, motivation, and adherence to treatment. The study evaluates spatiotemporal gait parameters, three-zone foot analysis (heel, midfoot, forefoot), limb circumferences, ultrasound measurements (dermis, epidermis, subcutaneous fat thickness), and patient-reported outcomes. VR-based training offers a novel, engaging approach to improve physical rehabilitation outcomes in patients with lower limb lymphedema. No significant risks are expected in this study.

Inclusion Criteria:

• Age between 18 and 65 years
• Diagnosis of unilateral lower extremity lymphedema following gynecological and/or oncological surgery
• Stage 2 or 3 lymphedema

Exclusion Criteria:

• Decompensated heart, lung, or kidney failure
• Uncontrolled hypertension
• Presence of systemic infection
• Local infections in the lower extremity such as erysipelas or cellulitis
• Venous insufficiency (e.g., deep vein thrombosis)
• Any neuromuscular or orthopedic disease affecting lower extremity walking
• Presence of balance disorders
• Bilateral lymphedema
• Presence of lipolymphedema
• Fracture in the lower extremity
• Active metastasis
• Speech or language problems
• Pregnancy
• Inability to continue treatment (5 days a week for a total of 4 weeks)