EFFECTIVENESS OF ADDITIONAL STRENGTHENING EXERCISES COMBINED WITH GABAPENTIN IN MANAGING RESTLESS LEGS SYNDROME AMONG HEMODIALYSIS PATIENTS: AN OPEN-LABEL RANDOMIZED CONTROLLED TRIAL

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https://storage.unitedwebnetwork.com/files/1099/12ee7781d5f5b0db9afa24cc3f2e19b2.pdf

Abstract Title *

EFFECTIVENESS OF ADDITIONAL STRENGTHENING EXERCISES COMBINED WITH GABAPENTIN IN MANAGING RESTLESS LEGS SYNDROME AMONG HEMODIALYSIS PATIENTS: AN OPEN-LABEL RANDOMIZED CONTROLLED TRIAL

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Co-author 1

Siriwan Sornseney siriwansornseney@gmail.com Phramongkutklao hospital Department of medicine Bangkok Thailand *

Co-author 2

Narittaya Varothai nvarothai@pcm.ac.th Phramongkutklao hospital Department of medicine Bangkok Thailand -

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Introduction

Restless legs syndrome (RLS) is prevalent among hemodialysis (HD) patients, leading to a significant symptom burden. Gabapentin is the main treatment, but rebound phenomena remain a concern. The efficacy of intradialytic quadriceps strengthening exercises alongside gabapentin is uncertain.

Methods

This randomized controlled trial enrolled 60 end-stage kidney disease patients undergoing HD for ≥3 months who were diagnosed with RLS (IRLSSG criteria). Participants were randomized 1:1 to receive either gabapentin alone (control) or gabapentin with intradialytic strengthening exercises (intervention) for 12 weeks. RLS severity (IRLSSG score), quality of life (KDQOL-36), and sleep quality (Epworth Sleepiness Scale) were assessed pre- and post-intervention.

Results

A total of 60 participants with RLS undergoing HD (66.67% male; mean age: 53.1±13.9 years) were included. At 12 weeks, the intervention group showed a mean IRLSSG severity score reduction of -12.1 (95% CI: -15.05 to -9.23) compared to -5.4 (95% CI: -7.76 to -3.00) in the control group, with a significant mean difference of -6.6 (95% CI: -10.07 to -3.08, p < 0.001). Improvement in RLS severity grades favored the intervention group compared to the control group (3 grades: 3.3% vs. 0%, 2 grades: 23.3% vs. 3.3%, 1 grade: 50% vs. 36.7%, p = 0.035). Both the intervention and control groups positively affected quality of life in Physical Component Summary and Symptoms and Problems of Kidney Disease domains of the KDQOL-36. However, no significant differences were found in overall quality of life or sleep quality between groups. All participants completed the exercise program without any reported serious adverse events.

Conclusion

A 12-week intradialytic strengthening exercise program, when added to gabapentin, was a safe and effective intervention for reducing RLS symptom severity in patients undergoing HD compared to gabapentin alone. Originally presented as an Oral Presentation at ASN Kidney Week 2025 (encore presentation permitted by ASN).

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