Effect of Lower Limb Strengthening Exercises on Severity of Restless Leg Syndrome among Diabetic Patients: A Time Series Study: Restless Leg Syndrome among Diabetic Patients

Amina  Sadaqat; Kainat  Ahmar; Hafiza Rabia  Javed; Ayesha  Hamid; Hira  Shahid

doi:10.54393/pjhs.v4i06.888

Authors

Amina Sadaqat Department of Physiotherapy, Life Care Hospital, Lahore, Pakistan
Kainat Ahmar University of South Asia, Lahore, Pakistan
Hafiza Rabia Javed Life Care Institute of Pharmacy and Medical Sciences, Daska, Pakistan
Ayesha Hamid Muhammadi Eyecare Hospital, Lahore, Pakistan
Hira Shahid Abasyn University, Islamabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i06.888

Keywords:

Restless Legs Syndrome, Diabetes, Diabetic Polyneuropathy, International Restless Leg Syndrome Criterion

Abstract

A disorder characterized by aching or burning sensations in the lower and rarely the upper extremities that occur prior to sleep or may awaken the patient from sleep. Objective: To evaluate the effect of lower limb strengthening exercises on the severity of restless leg syndrome (RLS) symptoms among diabetic patients. Methods: The time series Quasi experimental study design was conducted in the government sector (Services hospital) of Lahore for a sample size of 77 diabetic patients who were also suffering from RLS. In order to compensate dropout’s data were collected from 150 patients, from March 2018 to September 2019. IRRLSG Criterion was used to screen out presence of RLS in diabetic patients. After taking written informed consent, baseline data were collected through a questionnaire of close ended questions and proformas with pictures of lower limb muscle strengthening exercises was given to all patients. Follow-ups were taken twice through phone calls after every four weeks and the difference in the scores was noted down in both groups. Results: Patients who performed strengthening exercises reported reduced symptoms of RLS whereas those who didn’t perform exercises were excluded from the study. 96% patients reported reduced symptoms. While 4 patients did not have any improvement in their symptoms. At the end of 8 weeks majority had a significant improvement in the severity of their symptoms. Conclusions: It is concluded that an exercise program consisting of different strengthening exercises was effective in improving symptoms of RLS. No effort was made to discontinue medications that may aggravate RLS symptoms.

References

Klingelhoefer L, Bhattacharya K, Reichmann H. Restless legs syndrome. Clinical Medicine (Lond). 2016 Aug; 16(4): 379-82. doi: 10.7861/clinmedicine.16-4-379. DOI: https://doi.org/10.7861/clinmedicine.16-4-379

Samara D. Restless legs syndrome and impact on work performance. Universa Medicina. 2009 Feb; 28(1): 42-8. doi: 10.18051/UnivMed.2009.v28.42-48. DOI: https://doi.org/10.18051/UnivMed.2009.v28.42-48

Hanewinckel R, Maksimovic A, Verlinden VJ, van der Geest JN, Hofman A, van Doorn PA, et al. The impact of restless legs syndrome on physical functioning in a community-dwelling population of middle-aged and elderly people. Sleep Medicine. 2015 Mar; 16(3): 399-405. DOI: https://doi.org/10.1016/j.sleep.2014.11.013

Healthline. Exercises and Stretches to Alleviate Restless Leg Syndrome (RLS). [Last Cited: 15th Feb 2018]. Available at: https://www.healthline.com/health/restless-leg-syndrome/exercises-to-alleviate-rls.

Aliasgharpour M, Abbasi Z, Razi SP, Kazemnezhad A. The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian Journal of Sports Medicine. 2016 Jun; 7(2): e31001. doi: 10.5812/asjsm.31001. DOI: https://doi.org/10.5812/asjsm.31001

Kim KW, YOON IY, Chung S, SHIN YK, Lee SB, Choi EA, et al. Prevalence, comorbidities and risk factors of restless legs syndrome in the Korean elderly population–results from the Korean Longitudinal Study on Health and Aging. Journal of Sleep Research. 2010 Mar; 19(1‐Part‐I): 87-92. doi: 10.1111/j.1365-2869.2009.00739.x. DOI: https://doi.org/10.1111/j.1365-2869.2009.00739.x

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Archives of Internal Medicine. 2005 Jun; 165(11): 1286-92. doi: 10.1001/archinte.165.11.1286. DOI: https://doi.org/10.1001/archinte.165.11.1286

Trenkwalder C and Paulus W. Restless legs syndrome: pathophysiology, clinical presentation and management. Nature Reviews Neurology. 2010 Jun; 6(6): 337-46. doi: 10.1038/nrneurol.2010.55. DOI: https://doi.org/10.1038/nrneurol.2010.55

Memon MD, Faiz S, Zaveri MP, Perry JC, Schuetz TM, Cancarevic I. Unraveling the mysteries of restless leg syndrome. Cureus. 2020 Oct; 12(10): 1-7. doi: 10.7759/cureus.10951. DOI: https://doi.org/10.7759/cureus.10951

Shahgholian N, Jazi SK, Karimian J, Valiani M. The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients. Iranian Journal of Nursing and Midwifery Research. 2016 May; 21(3): 219. doi: 10.4103/1735-9066.180381. DOI: https://doi.org/10.4103/1735-9066.180381

Becker PM and Novak M. Diagnosis, comorbidities, and management of restless legs syndrome. Current Medical Research and Opinion. 2014 Aug; 30(8): 1441-60. doi: 10.1185/03007995.2014.918029. DOI: https://doi.org/10.1185/03007995.2014.918029

Li Y, Walters AS, Chiuve SE, Rimm EB, Winkelman JW, Gao X. Prospective study of restless legs syndrome and coronary heart disease among women. Circulation. 2012 Oct; 126(14): 1689-94. doi: 10.1161/CIRCULATIONAHA.112.112698. DOI: https://doi.org/10.1161/CIRCULATIONAHA.112.112698

Fereshtehnejad SM, Rahmani A, Shafieesabet M, Soori M, Delbari A, Motamed MR, et al. Prevalence and associated comorbidities of restless legs syndrome (RLS): Data from a large population-based door-to-door survey on 19176 adults in Tehran, Iran. PloS One. 2017 Feb; 12(2): e0172593. doi: 10.1371/journal.pone.0172593. DOI: https://doi.org/10.1371/journal.pone.0172593

Dayton daily news. Restless leg syndrome can significantly impact quality of life. [Last Cited: 16th Mar 2015]. Available at: https://www.daytondailynews.com/lifestyles/health/restless-leg- syndrome-can-significantly-impact-quality-life/2TOYj6KUhp0U6o9pfMIZhK/.

Marelli S, Galbiati A, Rinaldi F, Giora E, Oldani A, Strambi LF, et al. Restless legs syndrome/Willis Ekbom disease: new diagnostic criteria according to different nosology. Archives Italiennes de Biologie. 2015 Sep; 153(2-3): 184-93. doi: 10.12871/0003982920152343. DOI: https://doi.org/10.12871/0003982920152343

Mitchell UH. Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome. Neuropsychiatric Disease and Treatment. 2011 May; 7: 251-7. doi: 10.2147/NDT.S19177. DOI: https://doi.org/10.2147/NDT.S19177

Gjevre JA and Taylor-Gjevre RM. Risk Factors and Treatment of Restless Legs Syndrome in Adults. InSleep Disorders. IntechOpen. 2012 Mar.

Aukerman MM, Aukerman D, Bayard M, Tudiver F, Thorp L, Bailey B. Exercise and restless legs syndrome: a randomized controlled trial. The Journal of the American Board of Family Medicine. 2006 Sep; 19(5): 487-93. doi: 10.3122/jabfm.19.5.487. DOI: https://doi.org/10.3122/jabfm.19.5.487

Song YY, Hu RJ, Diao YS, Chen L, Jiang XL. Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: a systematic review and meta-analysis. Journal of Pain and Symptom Management. 2018 Apr; 55(4): 1184-95. doi: 10.1016/j.jpainsymman.2017.12.472. DOI: https://doi.org/10.1016/j.jpainsymman.2017.12.472

Daniele TM, de Bruin VM, e Forte AC, de Oliveira DS, Pompeu CM, de Bruin PF. The relationship between physical activity, restless legs syndrome, and health-related quality of life in type 2 diabetes. Endocrine. 2013 Aug; 44: 125-31. doi: 10.1007/s12020-012-9841-6. DOI: https://doi.org/10.1007/s12020-012-9841-6

Dinkins EM and Stevens-Lapsley J. Management of symptoms of Restless Legs Syndrome with use of a traction straight leg raise: a preliminary case series. Manual Therapy. 2013 Aug; 18(4): 299-302. doi: 10.1016/j.math.2012.11.002. DOI: https://doi.org/10.1016/j.math.2012.11.002