Clinical Efficacy and Safety of Massage for the Treatment of Restless Leg Syndrome in Hemodialysis Patients: A Meta-Analysis of 5 Randomized Controlled Trials

Abstract

AimWe conducted this meta-analysis to evaluate the clinical efficacy and safety of massage for the treatment of hemodialysis patients with restless leg syndrome (RLS).MethodsA comprehensive literature search was performed using the PubMed database, EMBASE database (via OVID), and the Cochrane Library in order to identify eligible randomized controlled trials (RCTs) published before August 31, 2021. After extracted essential data and assessed risk of bias of each eligible study, we calculated the pooled estimate of RLS score and safety after treatment. Statistical analysis was performed by using Review Manager 5.3.ResultsFive studies involving 369 hemodialysis patients with RLS were analyzed. The RLS score after treatment [mean difference (MD), −12.01; 95% confidence interval (CI), −14.91 to −9.11] and mean difference of RLS score at the beginning and end of treatment [mean difference (MD), −11.94; 95% confidence interval (CI), −15.45 to −8.43] in a massage group was significantly better than that in route care group. Subgroup analysis suggested that massage with lavender oil also significantly reduced the RLS score after treatment (MD, −14.22; 95% CI, −17.81 to −10.63) and mean difference of RLS score at the beginning and end of treatment (MD, −14.87; 95% CI, −18.29 to −11.45) compared with route care. Meanwhile, massage regime significantly relieved RLS severity compared with route care but did not increase adverse events.ConclusionMassage may be a preferred treatment modality for hemodialysis patients with RLS because it effectively reduces RLS symptoms, relieves RLS severity, and does not increase the risk of adverse events. However, future study with a larger sample size is warranted due to the fact that only limited number of eligible studies with small sample size are enrolled.

Physical Exercise Intervention In Reducing The Severity Level Of Restless Leg Syndrome In Hemodialysis Patients: Literature Review

“…Some therapies that can be given include repetitive transcranial magnetic stimulation, exercises, compression devices, counterstain manipulation, infrared therapy, and standard acupuncture (Harrison et al, 2019). Massage therapy is an intervention that can also be used for the treatment of RLS that effectively reduces the symptoms of RLS, reduces the severity of RLS, and does not increase the risk of side effects (Xia et al, 2022). The use of progressive muscle relaxation techniques also reduces the severity of RLS in the hemodialysis patients (Soleimani, 2016).…”

The effect of nonpharmacologic interventions for muscle cramps and restless‐leg syndrome in hemodialysis patients: A meta‐analysis of randomized controlled trials

“…Although aromatherapy can be applied with inhalation, compression, and bath techniques, it was applied with light pressure on the skin in the management of muscle-related symptoms in HD patients [19,21,22,25,27]. Xia et al in their meta-analysis published in 2022, stated that aromatherapy massage is effective on RLS [38]. Consequently, aromatherapy has remarkable positive effects on muscle-related symptoms.…”

Approach to restless leg syndrome in hemodialysis patients

“…35 Massage: A meta-analysis conducted in 2022 showed that massage therapy reduced the symptoms and severity of RLS due to hemodialysis. 34 In addition, in this study, the effect of massage therapy with lavender oil was examined and it was concluded that lavender oil may also be effective in the treatment of RLS due to its effect on relieving muscle pain and strengthening immunity. The minimal side effect profile is also an advantage of this treatment option.…”

“…It has been found that dopamine receptor agonists may be associated with various adverse effects such as nausea in the short term and re-exacerbation of symptoms in long-term use. 33,34 Shortterm side effects disappear after the drug is discontinued. Due to these side effects that may occur during pharmacologic treatment, non-pharmacologic treatments play an important role in the management of the disease.…”