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Abstract: TH-OR046

Effectiveness of Additional Strengthening Exercises Combined with Gabapentin in Managing Restless Legs Syndrome Among Patients on Hemodialysis: An Open-Label Randomized Controlled Trial

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Sornseney, Siriwan, Phramongkutklao Hospital, Bangkok, Thailand
  • Varothai, Narittaya, Phramongkutklao Hospital, Bangkok, Thailand
Background

Restless legs syndrome (RLS) is prevalent among hemodialysis (HD) patients, leading to a significant symptom burden. Gabapentin is the main treatment, but rebound phenomena remain a concern. The efficacy of intradialytic quadriceps strengthening exercises alongside gabapentin is uncertain.

Methods

This randomized controlled trial enrolled 60 end-stage kidney disease patients undergoing HD for ≥3 months who were diagnosed with RLS (IRLSSG criteria). Participants were randomized 1:1 to receive either gabapentin alone (control) or gabapentin with intradialytic strengthening exercises (intervention) for 12 weeks. RLS severity (IRLSSG score), quality of life (KDQOL-36), and sleep quality (Epworth Sleepiness Scale) were assessed pre- and post-intervention.

Results

total of 60 participants with RLS undergoing HD (66.67% male; mean age: 53.1±13.9 years) were included. At 12 weeks, the intervention group showed a mean IRLSSG severity score reduction of -12.1 (95% CI: -15.05 to -9.23) compared to -5.4 (95% CI: -7.76 to -3.00) in the control group, with a significant mean difference of -6.6 (95% CI: -10.07 to -3.08, p < 0.001). Improvement in RLS severity grades favored the intervention group compared to the control group (3 grades: 3.3% vs. 0%, 2 grades: 23.3% vs. 3.3%, 1 grade: 50% vs. 36.7%, p = 0.035). Both the intervention and control groups positively affected quality of life in Physical Component Summary and Symptoms and Problems of Kidney Disease domains of the KDQOL-36. However, no significant differences were found in overall quality of life or sleep quality between groups. All participants completed the exercise program without any reported serious adverse events.

Conclusion

A 12-week intradialytic strengthening exercise program, when added to gabapentin, was a safe and effective intervention for reducing RLS symptom severity in patients undergoing HD compared to gabapentin alone.

Digital Object Identifier (DOI)