Author(s): MORALES PINO, V., VIARENGO, G., ROSA DA SILVA, C.E., ALMEIDA, G., FIGUEIRA JR, A., Institution: UNIVERSITY SÃO JUDAS TADEU , Country: BRAZIL, Abstract-ID: 285

INTRODUCTION:
Lipedema affects approximately 11% of women worldwide and is associated with pain, heaviness, functional limitations, and psychosocial burden, potentially impairing exercise adherence. While prescribed resistance training is commonly recommended, self-selected resistance training (greater autonomy over load, repetitions, and rest) may represent a feasible alternative to support enjoyment and adherence. Symptom severity assessed by QuASiL may also explain inter-individual variability in acute psychophysiological responses to resistance exercise. PURPOSE: To compare acute responses to prescribed versus self-selected resistance-training sessions in women with lipedema and to examine whether symptom severity (QuASiL) is associated with workload, perceived exertion, and mood responses.
METHODS:
Ten women clinically diagnosed with lipedema (37.9 ± 8.4 years) completed baseline assessments including anthropometry and body composition via bioimpedance (fat mass, skeletal muscle mass, fat-free mass, and total body water). Participants completed QuASiL, with severity classified as mild (0–33), moderate (34–66), or severe (67–100), and physical activity level was assessed using IPAQ. Two resistance-training sessions were performed on separate days: Prescribed (PR) and Self-selected (SS). Both sessions included leg press, hip thrust, abduction, adduction, lat pulldown, and dumbbell shoulder press (3 sets, 1 s concentric / 2 s eccentric). PR loads were set using a 10–15RM prediction test with 2-min rest intervals, whereas SS participants freely chose load, repetitions, and rest. Outcomes included total workload (Σ load × repetitions), Borg RPE, and mood (BRUMS) pre–post. Wilcoxon tests and Spearman correlations were applied (α = 0.05).
RESULTS:
Participants had body mass 76.7 ± 17.0 kg, height 166.0 ± 5.7 cm, and BMI 28.0 ± 6.8 kg/m². QuASiL total score was 84.1 ± 29.1 (13–114), with mild (10%), moderate (10%), and severe (80%) classifications. Total workload was similar between PR and SS (12,096 ± 4,930 vs. 11,899 ± 4,643 kg; p = 0.432), as was perceived exertion (14.0 ± 1.9 vs. 13.6 ± 2.2; p = 0.330). Mood improved post-exercise (Δ negative mood −3.0 ± 3.4; Δ vigor +1.1 ± 1.5), with no difference between sessions (p = 0.670). Higher QuASiL scores were strongly associated with smaller vigor gains (rho = −0.823; p = 0.003) and moderately associated with higher fat mass (rho = 0.669; p = 0.035), with no associations for workload or RPE.
CONCLUSION:
In women with lipedema, a self-selected resistance-training session produced workload and perceived exertion comparable to a prescribed session. Higher symptom burden was associated with a blunted vigor response after exercise. QuASiL appears useful for characterizing symptom severity and interpreting affective responses, and self-selected resistance training warrants further investigation as a practical strategy to support autonomy without reducing training volume.