Turkish Validation of the Rapprich Lipedema Symptomatic Assessment Questionnaire (RapprichTR)

Turkish Validity and Reliability of the Rapprich Lipedema Symptomatic Assessment Questionnaire

Lipedema is a chronic disease characterized by abnormal fat accumulation, primarily in the lower extremities, affecting women. This study aims to evaluate the validity and reliability of the Turkish version of the Rapprich Lipedema Symptomatic Assessment Questionnaire, which was originally developed by Rapprich et al. in 2010. Since a validated Turkish version is currently unavailable, this research will provide a standardized tool for clinicians to assess symptomatic severity in Turkish-speaking lipedema patients.

Study Overview

• Status: Recruiting
• Conditions: Lipedema
• Intervention / Treatment: Other: Questionnaires; Other: Physical Examination and Functional Testing

Detailed Description

This cross-sectional study will involve 180 female participants diagnosed with lipedema (Stages I, II, and III). Participants will be recruited from the Physical Medicine and Rehabilitation clinics of Marmara University and Sultan 2. Abdülhamid Han Training and Research Hospital.

Assessments will include:

• Demographic data (age, BMI).
• Physical examinations (waist-hip ratio, limb circumference, and volume calculations).
• Functional testing (6-minute walk test).
• The Turkish version of the Rapprich Lipedema Symptomatic Assessment -Questionnaire (15 items scored 0-10).
• The SF-36 Health Survey for criterion validity.

Statistical analysis will include Cronbach's alpha for internal consistency, Intraclass Correlation Coefficient (ICC) for test-retest reliability (14-day interval), and Exploratory/Confirmatory Factor Analysis for construct validity.

• Study Type: Observational
• Enrollment (Estimated): 180

Contacts and Locations

• Study Contact: Name: Canan Şanal, Assoc. Prof.; Phone Number: +90 533 138 10 32; Email: canansanal@hotmail.com
• Study Contact Backup: Name: M. Selim Eryılmaz, Res. Asst.

Study Locations

• Turkey (Türkiye)
  • Kadıköy
    • Istanbul, Kadıköy, Turkey (Türkiye)
      • Recruiting
      • Sultan 2. Abdülhamid Han Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Istanbul, Turkey.
      • Contact: Feyza Nur Yücel, Assoc. Prof.; Phone Number: +905385577059; Email: dr.fny28@gmail.com
      • Contact: İrem Lazkan, Res. Asst.; Phone Number: +90534 92 63 640
  • Pendik
    • Istanbul, Pendik, Turkey (Türkiye), 34899
      • Recruiting
      • Marmara University Pendik Training and Research Hospital, Physical Medicine and Rehabilitation Department, Istanbul, Turkey.
      • Contact: Selim Eryılmaz; Phone Number: 05424848329; Email: selimerylmz@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of 180 female patients aged 18 to 75 years diagnosed with Stage I, II, or III lipedema, recruited from the Physical Medicine and Rehabilitation clinics of the participating hospitals.

Description

Inclusion Criteria:

• Female patients aged 18-75.
• Diagnosed with lipedema by a clinician.
• Willingness to participate and sign the informed consent form.

Exclusion Criteria:

• Positive Stemmer sign or presence of advanced-stage lymphedema.
• Diagnosis of Heart Failure.
• Chronic Kidney Disease.
• Pregnancy.
• BMI > 50 kg/m².

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Stage I Lipedema; 60 female patients diagnosed with Stage I lipedema	Other: Questionnaires; Turkish version of Rapprich Lipedema Symptomatic Assessment Questionnaire: A 15-item scale used to evaluate the severity of lipedema symptoms (such as pain, tension, tenderness, bruising, and heaviness) on a 0-10 point rating scale. Short Form-36 (SF-36) Health Survey: A widely used, validated scale to assess the general health status and quality of life across eight sub-dimensions, used in this study for criterion validity; Other: Physical Examination and Functional Testing; Anthropometric and Vital Measurements: Recording of demographic data (age, height, weight, BMI), as well as arterial blood pressure and pulse rate.; Lipedema-Specific Assessment: Clinical determination of the lipedema stage (Stages I-III) and type (Types I-V).; Morphometric Measurements: Measurement of waist and hip circumferences (for waist-to-hip ratio) and actual leg length.; Lower Extremity Volume Calculation: Circular circumference measurements taken at 4 cm intervals starting from the ankle to calculate the total volume of both lower extremities.; 6-Minute Walk Test (6MWT): A functional test to evaluate the total walking distance and heart rate response, assessing the patient's functional capacity.
Stage II Lipedema; 60 female patients diagnosed with Stage II lipedema	Other: Questionnaires; Turkish version of Rapprich Lipedema Symptomatic Assessment Questionnaire: A 15-item scale used to evaluate the severity of lipedema symptoms (such as pain, tension, tenderness, bruising, and heaviness) on a 0-10 point rating scale. Short Form-36 (SF-36) Health Survey: A widely used, validated scale to assess the general health status and quality of life across eight sub-dimensions, used in this study for criterion validity; Other: Physical Examination and Functional Testing; Anthropometric and Vital Measurements: Recording of demographic data (age, height, weight, BMI), as well as arterial blood pressure and pulse rate.; Lipedema-Specific Assessment: Clinical determination of the lipedema stage (Stages I-III) and type (Types I-V).; Morphometric Measurements: Measurement of waist and hip circumferences (for waist-to-hip ratio) and actual leg length.; Lower Extremity Volume Calculation: Circular circumference measurements taken at 4 cm intervals starting from the ankle to calculate the total volume of both lower extremities.; 6-Minute Walk Test (6MWT): A functional test to evaluate the total walking distance and heart rate response, assessing the patient's functional capacity.
Stage III Lipedema; 60 female patients diagnosed with Stage III	Other: Questionnaires; Turkish version of Rapprich Lipedema Symptomatic Assessment Questionnaire: A 15-item scale used to evaluate the severity of lipedema symptoms (such as pain, tension, tenderness, bruising, and heaviness) on a 0-10 point rating scale. Short Form-36 (SF-36) Health Survey: A widely used, validated scale to assess the general health status and quality of life across eight sub-dimensions, used in this study for criterion validity; Other: Physical Examination and Functional Testing; Anthropometric and Vital Measurements: Recording of demographic data (age, height, weight, BMI), as well as arterial blood pressure and pulse rate.; Lipedema-Specific Assessment: Clinical determination of the lipedema stage (Stages I-III) and type (Types I-V).; Morphometric Measurements: Measurement of waist and hip circumferences (for waist-to-hip ratio) and actual leg length.; Lower Extremity Volume Calculation: Circular circumference measurements taken at 4 cm intervals starting from the ankle to calculate the total volume of both lower extremities.; 6-Minute Walk Test (6MWT): A functional test to evaluate the total walking distance and heart rate response, assessing the patient's functional capacity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Internal Consistency (Cronbach's Alpha)	Evaluation of the internal consistency of the 15-item Turkish Rapprich Lipedema Questionnaire.	At baseline (Day 0).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Test-Retest Reliability (ICC)	Agreement between two measurements taken 14 days apart in a subgroup of 40 patients.	Baseline and 14 days
Criterion Validity (Correlation with SF-36).	Correlation between Rapprich questionnaire scores and the 8 sub-dimensions of the SF-36 quality of life scale.	At baseline (Day 0)

Collaborators and Investigators

• Sponsor: Marmara University
• Investigators: Principal Investigator: Canan Şanal, Assoc. Prof., Marmara University Faculty of Medicine

Publications and helpful links

General Publications

• Mortada H, Alhithlool AW, AlBattal NZ, Shetty RK, Al-Mekhlafi GA, Hong JP, Alshomer F. Lipedema: Clinical Features, Diagnosis, and Management. Arch Plast Surg. 2025 May 15;52(3):185-196. doi: 10.1055/a-2530-5875. eCollection 2025 May.
• Amato ACM, Amato FCM, Benitti DA, Dos Santos RV. Translation, cultural adaptation, and validation of a lipedema symptoms questionnaire. J Vasc Bras. 2020 Aug 31;19:e20200049. doi: 10.1590/1677-5449.200049.
• van la Parra RFD, Deconinck C, Pirson G, Servaes M, Fosseprez P. Lipedema: What we don't know. J Plast Reconstr Aesthet Surg. 2023 Sep;84:302-312. doi: 10.1016/j.bjps.2023.05.056. Epub 2023 May 30.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): July 17, 2026
• Primary Completion (Estimated): February 15, 2027
• Study Completion (Estimated): March 15, 2027

Study Registration Dates

• First Submitted: July 21, 2026
• First Submitted That Met QC Criteria: July 21, 2026
• First Posted (Actual): July 24, 2026

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 21, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Quality of Life; Lipedema; Cultural Adaptation; Turkish; Symptom Assessment; Rapprich Questionnaire; Adipose Tissue Diseases
• Additional Relevant MeSH Terms: Connective Tissue Diseases; Skin and Connective Tissue Diseases; Lipedema; Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Therapeutics; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Behavior Control; Immobilization; Surveys and Questionnaires; Restraint, Physical
• Other Study ID Numbers: RapprichTR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No