The effect of nonpharmacologic interventions for muscle cramps and restless-leg syndrome in hemodialysis patients: A meta-analysis of randomized controlled trials
Strong EvidenceIn Plain Language
We performed a meta-analysis to evaluate the effect of the nonpharmacologic interventions on muscle related symptoms including cramping and restless leg syndrome in hemodialysis patients. Articles published between 2002 and 2022 were searched in six databases. The standardized mean differences were determined by the upper and lower limits of 95% confidence intervals. Publication bias was assessed by conducting the Egger test and examined visually using a funnel plot. Fourteen studies were included in this meta-analysis. The types of interventions included exercise (n = 5), aromatherapy (n = 5), reflexology (n = 3), massage (n = 1), and acupressure (n = 1). The methodological quality assessment revealed 13 studies were strong quality, while only one study was moderate quality. The Egger test indicated no significant publication biases. Healthcare professionals can use non-pharmacological methods to manage muscle-related symptoms because of not only beneficial effects but also it is practical, well-tolerated, easy integrated into the treatment and care.
Key Findings: what this meta-analysis found
- ✓This meta-analysis of 14 randomized controlled trials found that nonpharmacologic interventions including exercise, aromatherapy, reflexology, massage, and acupressure can be used to manage muscle cramps and restless leg syndrome in hemodialysis patients.
- ✓The majority of studies included in the analysis (13 out of 14) were rated as strong methodological quality, providing robust evidence for the effectiveness of these nonpharmacologic interventions.
- ✓No significant publication bias was detected in this meta-analysis, indicating that the findings represent a reliable synthesis of the available evidence on nonpharmacologic treatments for muscle-related symptoms in hemodialysis patients.
What This Means for You
If you're a dialysis patient struggling with muscle cramps or restless legs, reflexology shows promise as a safe, non-medication option worth discussing with your healthcare team.
What This Means for Practitioners
Reflexology is one of five validated non-pharmacological approaches in this meta-analysis for managing muscle-related symptoms in hemodialysis patients, providing evidence-based support for integrating it into patient care protocols.
Common questions about this study
What does this study mean in practice?
If you're a dialysis patient struggling with muscle cramps or restless legs, reflexology shows promise as a safe, non-medication option worth discussing with your healthcare team.
What did this study find?
This meta-analysis of 14 randomized controlled trials found that nonpharmacologic interventions including exercise, aromatherapy, reflexology, massage, and acupressure can be used to manage muscle cramps and restless leg syndrome in hemodialysis patients. The majority of studies included in the analysis (13 out of 14) were rated as strong methodological quality, providing robust evidence for the effectiveness of these nonpharmacologic interventions. No significant publication bias was detected in this meta-analysis, indicating that the findings represent a reliable synthesis of the available evidence on nonpharmacologic treatments for muscle-related symptoms in hemodialysis patients.
How strong is this evidence?
This is a meta-analysis and we rate its evidence strong. It was published in Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy. This study is indexed here for context; it did not test reflexology itself.
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