Aerobic Exercise in Individuals with Restless Legs Syndrome: A Case Series Study

Abstract

Project Number

2020.KB.SAG.015

Aerobic Exercise in Individuals with Restless Legs Syndrome: A Case Series Study

Abstract

Purpose: Exercise has been demonstrated to alleviate restless legs syndrome (RLS) symptoms in individuals with RLS, but little studies are available on the physical health of primary RLS. This case series aim to describe outcome after the training of supervised aerobic exercise training in individuals with RLS. Case Report: Five individuals with RLS were received with a supervised aerobic exercise training 2 days per week for 12 weeks. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) was used to detect the severity of RLS. The Turkish version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The functional effect of fatigue was evaluated with Fatigue Impact Scale (FIS). The Six-Minute Walk test (6MWT) were used to determine the functional exercise capacity. All assessments took place at baseline and post-intervention. Conclusion: Following aerobic exercise, clinically meaningful changes in the severity of RLS, PSQI, and 6MWT were reported in all individuals with severe RLS. Four of 5 patients improved their FIS at post-intervention. These results suggest that 24-session supervised aerobic exercise training might help to improve RLS severity, sleep quality, fatigue, and exercise capacity in an individual with RLS.

Keywords

• aerobic exercise
• restless legs syndrome
• sleep
• fatigue
• six-minute walk test

Supporting Institution

Department of Scientific Research Projects of Dokuz Eylul University

Project Number

2020.KB.SAG.015

Thanks

This study was funded by the Department of Scientific Research Projects of Dokuz Eylul University (Grant ID: 2020.KB.SAG.015). The funding body had no involvement in the data collection, analysis or interpretation, the writing of the manuscript or the decision to submit the manuscript for publication.

References

1. Allen RP, Picchietti DL, Garcia-Borreguero D, et al. Restless legs syndrome/Willis–Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Med 2014; 15:860-873.
2. Manconi M, Garcia-Borreguero D, Schormair B, et al. Restless legs syndrome. Nat Rev Dis Primers 2021;7:80.
3. Trenkwalder C, Winkelmann J, Inoue Y, Paulus W. Restless legs syndrome—current therapies and management of augmentation. Nat Rev Neurol 2015;11:434-445.
4. Akbaş P, Yaman Sözbir Ş. Non-pharmacological methods used in coping with restless leg syndrome (RLS): a systematic review. Sleep Biol Rhythms 2021; 19:215-225.
5. Harrison EG, Keating JL, Morgan PE. Non-pharmacological interventions for restless legs syndrome: a systematic review of randomised controlled trials. Disabil Rehabil 2019;41:2006-2014.
6. Pescatello LS, Arena R, Riebe D, Thompson PD. ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2014.
7. Walters AS, LeBrocq C, Dhar A, et al. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 2003;4:121-132.
8. Ay E, Helvacı Yılmaz N, Arıcı Düz Ö, Özer FF. Validity and reliability of the Turkish version of the International Restless Legs Syndrome Study Group Rating Scale. Acta Medica Alanya 2019; 3:105-110.

9. Agargun MY, Kara H, Anlar O. The validity and reliability of Pittsburgh Sleep Quality Index. Turkish Journal of Psychiatry 1996;7:107-115.
10. Armutlu K, Keser I, Korkmaz N, et al. Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients. J Neurol Sci 2007;255:64-68.
11. Lanza G, Bachmann CG, Ghorayeb I, Wang Y, Ferri R, Paulus W. Central and peripheral nervous system excitability in restless legs syndrome. Sleep Med 2017;31:49-60.
12. Koh SY, Kim MS, Lee SM, Hong JM, Yoon JH. Impaired vascular endothelial function in patients with restless legs syndrome: a new aspect of the vascular pathophysiology. J. Neurol Sci. 2015; 359:207-210.
13. Bertisch SM, Muresan C, Schoerning L, Winkelman JW, Taylor JA. Impact of restless legs syndrome on cardiovascular autonomic control. Sleep 2016;36:565-571.
14. Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Neurochemical features of idiopathic restless legs syndrome. Sleep Med. Rev. 2019;45:70–87.
15. Ehrman, J.K., D. Kerrigan, and S. Keteyian, Advanced Exercise Physiology: Essential Concepts and Applications. Human Kinetics; 2018.
16. Salminen AV, Rimpilä V, Polo O. Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease). Neurology 2014;82:1856-1861.
17. Mitchell UH. Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome. Neuropsychiatric Disease and Treatment 2011; 7:251-257.
18. Aukerman MM, Aukerman D, Bayard M, Tudiver F, Thorp L, Bailey B. Exercise and restless legs syndrome: a randomized controlled trial. J Am Board Fam Med 2006; 19:487-493.
19. Harrison EG, Keating JL, Morgan P. Novel exercises for restless legs syndrome: a randomized, controlled trial. J Am Board Fam Med 2018; 31:783-794.
20. Grandner MA. Sleep, health, and society. Sleep Med Clin 2017; 12:1-22.
21. Zhan Q, Zhao J, Guo Q, et al. Association of Sleep Duration with Physical Performance in Hemodialysis Patients: A Multicenter Cross-Sectional Study. Nephron 2023;147(5):260-265.
22. Song Y-Y, Hu R-J, Diao Y-S, Chen L, Jiang X-L. Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: a systematic review and meta-analysis. J Pain Symptom Manage 2018; 55:1184-95.