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DOI: 10.1055/a-0658-0360
Effekt von körperlichem Training auf den Schweregrad des Restless-Legs-Syndroms
Systematischer Review und MetaanalyseEffect of Exercise Training on the Severity of the Restless Legs SyndromeSystematic Review and Meta-AnalysisPublikationsverlauf
10. Juli 2017
02. Oktober 2017
Publikationsdatum:
11. September 2018 (online)
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Zusammenfassung
Hintergrund Das Restless-Legs-Syndrom (RLS) ist eine häufige neurologische Erkrankung, die durch einen starken Bewegungsdrang der Beine und Missempfindungen einen hohen Leidensdruck auf die betroffenen Patienten ausübt. Die in der Regel medikamentöse Therapie ist mit zahlreichen Nebenwirkungen verbunden. Über die Wirkung körperlichen Trainings als risikoarme Alternative existiert bisher nur wenig Forschung.
Ziel Diese Übersichtsarbeit untersuchte die Effekte körperlichen Trainings auf den Schweregrad des RLS.
Methode Die systematische Literaturrecherche in den Datenbanken PubMed, PEDro, The Cochrane Library und Embase schloss kontrollierte Studien über Ausdauer- oder Krafttraining zur Verbesserung der Erkrankungsschwere von RLS. Die interne Validität der Studien wurde mit der PEDro-Skala bewertet und die Effekte der Trainingsverfahren auf den Schweregrad des RLS metaanalytisch zusammengefasst.
Ergebnisse In die Arbeit wurden 5 Studien mit insgesamt 124 Teilnehmern eingeschlossen. Basierend auf der Metaanalyse verbesserte körperliches Training im Vergleich zur Kontrollintervention signifikant die Symptomatik von RLS auf der International RLS Severity Scale (durchschnittliche Verbesserung: 8,53 Punkte; 95 %-Konfidenzintervall: 10,42 bis 6,63 Punkte). Es fand sich kein signifikanter Publikationsbias. Die methodische Qualität der Studien war gering (Median PEDro-Score: 5).
Schlussfolgerung Die Ergebnisse weisen auf die Verringerung des Schweregrads des RLS durch körperliches Training hin. Da die aktuell schwache Studienlage jedoch die Übertragbarkeit limitiert, sind weitere klinische Studien erforderlich.
Abstract
Background Restless legs syndrome (RLS) is a common neurological movement disorder. It is characterised by a compelling urge to move the legs and is accompanied by painful paresthesia. Although medication is the treatment of choice, side effects, such as augmentation phenomena in particular, have been reported frequently. So far, little research has been conducted on exercise training as a low-risk alternative.
Objective The aim of this review was to investigate the effects of exercise training on the severity of symptoms in patients with RLS.
Method A systematic literature research was performed using the databases PubMed, PEDro, The Cochrane Library and Embase. Included were controlled trials that examined aerobic or resistance exercise for improving severity of symptoms in patients with RLS. The methodical quality of the retrieved studies was rated using the PEDro scale. The found data were assessed regarding the effects on the severity of RLS symptoms by means of a meta-analysis.
Results Five studies with a total of 124 subjects were included in this review. Based on the meta-analysis, exercise training decreased the severity of symptoms significantly in patients with RLS compared to the control group (average improvement: 8.53 points; 95% prediction interval: 10.42 to 6.63 points). No significant publication bias was found. The methodical quality of the included studies was low (median PEDro score: 5).
Conclusions This review suggests that exercise training can decrease the severity of symptoms in patients with RLS. However, due to the lack of high quality studies, generalizability is limited. Further randomised controlled trials investigating exercise training as therapy in patients with RLS are necessary.
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Literatur
- 1 Deutsche Gesellschaft für Neurologie (DGN). Restless-Legs-Syndrom (RLS) und Perodic Limb Movement Disorder (PLMD). 2012 www.dgn.org/leitlinien/2386-ll-06-2012-restless-legs-syndrom-rls-und-periodic-limb-movement-disorder-plmd (29.06.2018)
- 2 Yeh P, Walters AS, Tsuang JW. Restless legs syndrome: a comprehensive overview on its epidemiology, risk factors, and treatment. Sleep Breath 2012; 16: 987-1007 . doi: 10.1007/s11325-011-0606-x
- 3 Allen RP, Picchietti D, Hening WA. et al. 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 Med 2003; 4: 101-119
- 4 Garcia-Borreguero D, Kohnen R, Silber MH. et al. The long-term treatment of restless legs syndrome/Willis-Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: A Report from the International Restless Legs Syndrome Study Group. Sleep Med 2013; 14: 675-684 . doi: 10.1016/j.sleep.2013.05.016
- 5 Hanewinckel R, Maksimovic A, Verlinden VJA. et al. The impact of restless legs syndrome on physical functioning in a community-dwelling population of middle-aged and elderly people. Sleep Med 2015; 16: 399-405 . doi: 10.1016/j.sleep.2014.11.013
- 6 Allen RP. Restless Leg Syndrome/Willis-Ekbom Disease Pathophysiology. Sleep Med Clin 2015; 10: 207-214 . doi: 10.1016/j.jsmc.2015.05.022
- 7 Hornyak M, Scholz H, Kohnen R. et al. Coping strategies in restless legs syndrome. Somnologie – Schlafforschung und Schlafmedizin 2010; 14: 61-66 . doi: 10.1007/s11818-009-0442-4
- 8 Aurora RN, Kristo DA, Bista SR. et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults – an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep 2012; 35: 1039-1062 . doi: 10.5665/sleep.1988
- 9 Dodel R, Happe S, Peglau I. et al. Health economic burden of patients with restless legs syndrome in a German ambulatory setting. Pharmacoeconomics 2010; 28: 381-393 . doi: 10.2165/11531030-000000000-00000
- 10 Giannaki CD, Hadjigeorgiou GM, Karatzaferi C. et al. 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. Nephrol Dial Transplant 2013; 28: 2834-2840 . doi: 10.1093/ndt/gft288
- 11 Giannaki CD, Sakkas GK, Karatzaferi C. et al. Effect of exercise training and dopamine agonists in patients with uremic restless legs syndrome: a six-month randomized, partially double-blind, placebo-controlled comparative study. BMC Nephrol 2013; 14: 194 . doi: 10.1186/1471-2369-14-194
- 12 Mortazavi M, Vahdatpour B, Ghasempour A. et al. Aerobic exercise improves signs of restless leg syndrome in end stage renal disease patients suffering chronic hemodialysis. Scientific World Journal 2013; 2013: 628142 . doi: 10.1155/2013/628142
- 13 Sakkas GK, Hadjigeorgiou GM, Karatzaferi C. et al. Intradialytic aerobic exercise training ameliorates symptoms of restless legs syndrome and improves functional capacity in patients on hemodialysis: a pilot study. ASAIO J 2008; 54: 185-190 . doi: 10.1097/MAT.0b013e3181641b07
- 14 Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100: 126-131
- 15 World Health Organization (WHO). Global recommendations on physical activity for health. 2010 www.who.int/dietphysicalactivity/factsheet_recommendations/en (29.06.2018)
- 16 Ohayon MM, Roth T. Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res 2002; 53: 547-554
- 17 Phillips B, Young T, Finn L. et al. Epidemiology of restless legs symptoms in adults. Arch Intern Med 2000; 160: 2137-2141
- 18 Daniele TM, de Bruin VM, eForte AC. et al. The relationship between physical activity, restless legs syndrome, and health-related quality of life in type 2 diabetes. Endocrine 2013; 44: 125-131 . doi: 10.1007/s12020-012-9841-6
- 19 Sherrington C, Herbert RD, Maher CG. et al. PEDro. A database of randomized trials and systematic reviews in physiotherapy. Man Ther 2000; 5: 223-226 . doi: 10.1054/math.2000.0372
- 20 Borenstein M, Hedges LV, Higgins JPT. et al. Introduction to meta-analysis. Chichester: Wiley; 2009
- 21 Schwarzer G, Carpenter JR, Rücker G. Use R! – Meta-Analysis with R. Berlin: Springer; 2015
- 22 Aukerman MM, Aukerman D, Bayard M. et al. Exercise and restless legs syndrome: a randomized controlled trial. JABFM 2006; 19: 487-493
- 23 Schulz KF, Chalmers I, Hayes RJ. et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273: 408-412
- 24 Egger M, Juni P, Bartlett C. et al. How important are comprehensive literature searches and the assessment of trial quality in systematic reviews? Empirical study. Health Technol Assess 2003; 7: 1-76
- 25 Schulz KF, Grimes DA. Reihe Epidemiologie 8: Verblindung in randomisierten Studien: Wie man verdeckt, wer was erhalten hat. Zeitschrift für ärztliche Fortbildung und Qualität im Gesundheitswesen 2007; 101: 630-637 . doi: https://doi.org/10.1016/j.zgesun.2007.09.024
- 26 Berger K, Kurth T. RLS epidemiology – frequencies, risk factors and methods in population studies. Mov Disord 2007; 22 (Suppl. 18) S420-S423 . doi: 10.1002/mds.21589
- 27 Giannaki CD, Sakkas GK, Karatzaferi C. et al. Combination of Exercise Training and Dopamine Agonists in Patients with RLS on Dialysis: A Randomized, Double-Blind Placebo-Controlled Study. ASAIO 2015; 61: 738-741 . doi: 10.1097/mat.0000000000000271
- 28 World Health Organization (WHO). Physical activity strategy for the WHO European Region 2016–2025. 2016 www.euro.who.int/en/publications/abstracts/physical-activity-strategy-for-the-who-european-region-20162025 (29.06.2018)
- 29 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359 . doi: 10.1249/MSS.0b013e318213fefb