Effect of stretching exercises versus thermotherapy on restless legs syndrome symptoms, pain, and quality of sleep among pregnant women
Keywords:
stretching exercises, thermotherapy, restless legs syndrome, pain, sleep quality, pregnant womenAbstract
Background: Restless legs syndrome (RLS) is a sensory-motor disorder affecting up to one in three pregnant women, which peaks during the third trimester and is linked to poor pregnancy outcomes. Symptoms typically worsen during a period of inactivity, especially at night, resulting in sleep disruption or deprivation. This study aimed to compare the effects of stretching exercises versus thermotherapy on RLS symptoms and sleep quality among pregnant women. Study design: A quasi-experimental study was carried out at the antenatal outpatient clinic of Maternity University Hospital. A sample of 60 pregnant women was randomly assigned to two groups. One group was instructed to perform leg stretching exercises daily for one week, and the other group applied thermotherapy. They rated their RLS symptoms, pain level, and sleep quality at baseline and after receiving interventions. Results: the severity of RLS symptoms declined to a mild level among pregnant women immediately and after one week of performing stretching exercises (53.3%, 93.3%), compared to 6.7% and 63.3% of those who applied thermotherapy (p=0.001, p= 0.02).
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Abetz, L., Arbuckle, R., Allen, R. P., Garcia-Borreguero, D., Hening, W., Walters, A. S., Mavraki, E., & Kirsch, J. M., 2006. The reliability, validity and responsiveness of the International Restless Legs Syndrome Study Group rating scale and subscales in a clinical-trial setting. Sleep medicine, 7(4), 340-349. https://doi.org/10.1016/j.sleep.2005.12.011.
Akbaş, P., & Yaman Sözbir, Ş., 2021. Non-pharmacological methods used in coping with restless leg syndrome (RLS): A systematic review. Sleep and Biological Rhythms, 19, 215–225. https://doi.org/10.1007/s41105-021-00322-z.
Aliasgharpour, M., Abbasi, Z., Pedram Razi, S., & Kazemnezhad, A., 2016. The Effect of Stretching Exercises on Severity of Restless Legs Syndrome in Patients on Hemodialysis. Asian journal of sports medicine, 7(2), e31001. https://doi.org/10.5812/asjsm.31001.
Allen, R. P., Picchietti, D., Hening, W. A., Trenkwalder, C., Walters, A. S., & Montplaisi, J., 2003. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep medicine, 4(2), 101-119. https://doi.org/10.1016/s1389-9457(03)00010-8.
Augustina, S., Kaviya, M., & Indrani, D., 2020. Effect of transcutaneous electrical nerve stimulation with stretching and exercises in restless leg syndrome among pregnant women. Obstetrics & Gynecology International Journal, 11, 101-105. https://doi.org/10.15406/ogij.2020.11.00495.
Becker, B. E., Hildenbrand, K., Whitcomb, R. K., & Sanders, J. P., 2009. Biophysiologic effects of thermotherapy. International Journal of Aquatic Research and Education, 3(1), 4.
Cochrane, D. J., 2004. Alternating hot and cold water immersion for athlete recovery: a review. Physical Therapy in Sport, 5(1), 26-32. https://doi.org/10.1016/j.ptsp.2003.10.002.
Darvishi, N., Daneshkhah, A., Khaledi-Paveh, B., Vaisi-Raygani, A., Mohammadi, M., Salari, N., Darvishi, F., Abdi, A., & Jalali, R., 2020. The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review. BMC neurology, 20(1), 132. https://doi.org/10.1186/s12883-020-01709-0.
Finan, P. H., & Smith, M. T., 2013. The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism. Sleep medicine reviews, 17(3), 173-183. https://doi.org/10.1016/j.smrv.2012.03.003.
Goecke, T. W., Schnakenberg, P., Frensch, M., & Chechko, N., 2020. Restless Legs Syndrome During Pregnancy and 12 Weeks Postpartum and its Links to Cardiovascular Diseases, Stressful Life Events, and Psychiatric History. Journal of clinical medicine, 9(9), 3046. https://doi.org/10.3390/jcm9093046.
Gupta, R., Dhyani, M., Kendzerska, T., Pandi-Perumal, S. R., BaHammam, A. S., Srivanitchapoom, P., Pandey, S., & Hallett, M., 2016. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta neurologica Scandinavica, 133(5), 320-329. https://doi.org/10.1111/ane.12520.
Hanafy H. & Gbr A. (2018). Effect of Continuous Therapeutic Ultrasound and Stretching Exercise on Calf Muscle Cramp during Pregnancy. The Medical Journal of Cairo University, 86(3), 791–797. https://doi.org/10.21608/mjcu.2018.55563
Jafarimanesh, H., Vakilian, K., & Mobasseri, S., 2020a. Effects of Warm and Cold Footbath on Sleep Quality in Pregnant Women with Restless Legs Syndrome. Iranian Journal of Obstetrics, Gynecology and Infertility, 23, 51-60.
Jafarimanesh, H., Vakilian, K., & Mobasseri, S., 2020b. Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: A randomized clinical trial. Complementary therapies in medicine, 50, 102409. https://doi.org/10.1016/j.ctim.2020.102409.
Jahani Kondori, M., Kolla, B. P., Moore, K. M., & Mansukhani, M. P., 2020. Management of Restless Legs Syndrome in Pregnancy and Lactation. Journal of primary care & community health, 11, 2150132720905950. https://doi.org/10.1177/2150132720905950.
Kaplan, O., Başer, M., & Müderris, İ., 2021. The effect of hot water application in pregnant women with restless legs syndrome: A randomised controlled study. Authorea. https://doi.org/10.22541/au.162935801.10999591/v1.
Kim, G., Kim, H., Kim, W. K., & Kim, J., 2018. Effect of stretching-based rehabilitation on pain, flexibility and muscle strength in dancers with hamstring injury: a single-blind, prospective, randomized clinical trial. The Journal of sports medicine and physical fitness, 58(9), 1287-1295. https://doi.org/10.23736/s0022-4707.17.07554-5.
Lee, K. A., & Gay, C. L., 2004. Sleep in late pregnancy predicts length of labor and type of delivery. American journal of obstetrics and gynecology, 191(6), 2041-2046. https://doi.org/10.1016/j.ajog.2004.05.086.
Lorena, S. B., Lima Mdo, C., Ranzolin, A., & Duarte Â, L., 2015. Effects of muscle stretching exercises in the treatment of fibromyalgia: a systematic review. Revista brasileira de reumatologia, 55(2), 167-173. https://doi.org/10.1016/j.rbr.2014.08.015.
McCaffery, M., & Beebe, A., 1993. Numeric Rating Scale. Pain: Clinical manual for nursing practice. VV Mosby Company, Baltimore.
Meesters, Y., Jansen, J. H., Lambers, P. A., Bouhuys, A. L., Beersma, D. G., & van den Hoofdakker, R. H., 1993. Morning and evening light treatment of seasonal affective disorder: response, relapse and prediction. Journal of affective disorders, 28(3), 165-177. https://doi.org/10.1016/0165-0327(93)90102-p.
Minár, M., Valková, P., & Valkovič, P., 2013. Prevalence and impact of restless legs syndrome in university students. Movement disorders, 28(8), 1157-1158. https://doi.org/10.1002/mds.25312.
Mitchell, U. H., 2011. Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome. Neuropsychiatric disease and treatment, 7, 251-257. https://doi.org/10.2147/ndt.s19177.
Mooventhan, A., & Nivethitha, L., 2014. Scientific evidence-based effects of hydrotherapy on various systems of the body. North American journal of medical sciences, 6(5), 199-209. https://doi.org/10.4103/1947-2714.132935.
Nasiriani, K., & Eftekhari, A., 2016. Effect of hot water bag on severity of restless legs syndrome in hemodialysis patients. Journal of Mazandaran University of Medical Sciences, 26, 23-30.
Picchietti, D. L., Hensley, J. G., Bainbridge, J. L., Lee, K. A., Manconi, M., McGregor, J. A., Silver, R. M., Trenkwalder, C., & Walters, A. S., 2015. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep medicine reviews, 22, 64-77. https://doi.org/10.1016/j.smrv.2014.10.009.
Ramirez, J. O., Cabrera, S. A., Hidalgo, H., Cabrera, S. G., Linnebank, M., Bassetti, C. L., & Kallweit, U., 2013. Is preeclampsia associated with restless legs syndrome? Sleep medicine, 14(9), 894-896. https://doi.org/10.1016/j.sleep.2013.03.013.
Schuh-Hofer, S., Wodarski, R., Pfau, D. B., Caspani, O., Magerl, W., Kennedy, J. D., & Treede, R. D., 2013. One night of total sleep deprivation promotes a state of generalized hyperalgesia: a surrogate pain model to study the relationship of insomnia and pain. Pain, 154(9), 1613-1621. https://doi.org/10.1016/j.pain.2013.04.046.
Shahgholian, N., Jazi, S. K., Karimian, J., & Valiani, M., 2016. 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, 21(3), 219-224. https://doi.org/10.4103/1735-9066.180381.
Silvestri, R., & Aricò, I., 2019. Sleep disorders in pregnancy. Sleep science (Sao Paulo, Brazil), 12(3), 232-239. https://doi.org/10.5935/1984-0063.20190098.
Sönmez, A., & Aksoy Derya, Y., 2018. Effects of sleep hygiene training given to pregnant women with restless leg syndrome on their sleep quality. Sleep & breathing, 22(2), 527-535. https://doi.org/10.1007/s11325-018-1619-5.
Tuna Oran, N., Yuksel, E., & Ruzgar, S., 2021. Prevalence of restless leg syndrome and effects on quality of life during pregnancy. Sleep & breathing, 25(4), 2127-2134. https://doi.org/10.1007/s11325-021-02311-5.
Whitney, M. S., Shemery, A. M., Yaw, A. M., Donovan, L. J., Glass, J. D., & Deneris, E. S., 2016. Adult Brain Serotonin Deficiency Cases Hyperactivity, Circadian Disruption, and Elimination of Siestas. The Journal of neuroscience, 36(38), 9828-9842. https://doi.org/10.1523/jneurosci.1469-16.2016.
World Medical Association. (2022). WMA declaration of Helsinki – ethical principles for medical research involving human subjects. from https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/. Accessed Jan 27, 2022
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