A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome
A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome
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DOI：
10.1093/ndt/gft288
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发表时间：
2013-11-01
影响因子：
6.1
通讯作者：
Sakkas, Giorgos K.
中科院分区：
文献类型：
--
作者：
Giannaki, Christoforos D.;Hadjigeorgiou, Georgios M.;Sakkas, Giorgos K.
背景尿毒症性不宁腿综合征（RLS）影响很大一部分接受血液透析（HD）治疗的患者。运动训练已被证明可以改善尿毒症RLS患者的RLS症状;然而，运动诱导的RLS严重程度变化的机制仍不清楚。目前的随机对照运动试验的目的是调查RLS严重程度的降低，通常在训练后看到，是由于预期的全身运动适应，还是主要是由于在自行车测力计上进行运动训练期间腿部运动带来的缓解。这是第一个在尿毒症RLS患者中进行的随机对照运动研究，24例RLS HD患者被随机分为两组：渐进式运动训练组（n 12）和无阻力对照运动组（n 12）。两组的运动包括以50 rpm的速度进行45 min的透析内循环。然而，仅在渐进式运动训练组中施加阻力，在6065的最大运动能力下，每4周重新评估一次，以说明患者的改善。RLS症状的严重程度使用IRLSSG严重程度量表进行评估，功能能力通过一系列测试进行评估，而睡眠质量，抑郁水平和每日嗜睡状态通过有效的问卷进行评估，在干预期间之前和之后。渐进式运动训练组的RLS症状严重程度下降了58（P 0.003），而对照组未观察到统计学显著性下降（17变化，P 0.124）。运动训练在改善HD患者的功能能力（P 0.04）、睡眠质量（P 0.038）和抑郁评分（P 0.000）方面也有效，而对照组未观察到显著变化。在6个月的干预后，渐进式运动组的RLS严重程度（P 0.017）、抑郁评分（P 0.002）和每日嗜睡状态（P 0.05）均明显优于对照组。6个月的透析中渐进式运动训练计划似乎是降低HD患者RLS症状严重程度的安全有效的方法。运动诱导的全身适应似乎是RLS严重程度评分降低的主要原因，因为未应用阻力方案的运动未能改善患者的RLS严重程度状态。
Background. Uraemic restless legs syndrome (RLS) affects a significant proportion of patients receiving haemodialysis (HD) therapy. Exercise training has been shown to improve RLS symptoms in uraemic RLS patients; however, the mechanism of exercise-induced changes in RLS severity is still unknown. The aim of the current randomized controlled exercise trial was to investigate whether the reduction of RLS severity, often seen after training, is due to expected systemic exercise adaptations or it is mainly due to the relief that leg movements confer during exercise training on a cycle ergometer. This is the first randomized controlled exercise study in uraemic RLS patients.Twenty-four RLS HD patients were randomly assigned to two groups: the progressive exercise training group (n 12) and the control exercise with no resistance group (n 12). The exercise session in both groups included intradialytic cycling for 45 min at 50 rpm. However, only in the progressive exercise training group was resistance applied, at 6065 of maximum exercise capacity, which was reassessed every 4 weeks to account for the patients improvement. The severity of RLS symptoms was evaluated using the IRLSSG severity scale, functional capacity by a battery of tests, while sleep quality, depression levels and daily sleepiness status were assessed via validated questionnaires, before and after the intervention period.All patients completed the exercise programme with no adverse effects. RLS symptom severity declined by 58 (P 0.003) in the progressive exercise training group, while a no statistically significant decline was observed in the control group (17 change, P 0.124). Exercise training was also effective in terms of improving functional capacity (P 0.04), sleep quality (P 0.038) and depression score (P 0.000) in HD patients, while no significant changes were observed in the control group. After 6 months of the intervention, RLS severity (P 0.017), depression score (P 0.002) and daily sleepiness status (P 0.05) appeared to be significantly better in the progressive exercise group compared with the control group.A 6-month intradialytic progressive exercise training programme appears to be a safe and effective approach in reducing RLS symptom severity in HD patients. It seems that exercise-induced adaptations to the whole body are mostly responsible for the reduction in RLS severity score, since the exercise with no applied resistance protocol failed to improve the RLS severity status of the patients.NCT00942253.