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Zamanifard M, Nasiri M, Yarahmadi F, Zonoori S, Razani O, Salajegheh Z, Imanipour M, Mohammadi SM, Jomehzadeh N, Asadi M. Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta-analysis of randomized controlled trials. Int Wound J 2024; 21:e14760. [PMID: 38356150 PMCID: PMC10867296 DOI: 10.1111/iwj.14760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
This systematic review aimed to qualitatively synthesize recent randomized controlled trials (RCTs) regarding the effect of topical application and oral intake of herbal products on the healing of diabetic foot ulcer (DFU). Also, we sought to pool the obtained findings in a meta-analysis using a random-effects model, if RCTs were relatively comparable and homogenous. A comprehensive search was performed on five electronic data sources from their inception through 23 January 2024. The RCTs, without restriction on the country of origin, were included if they compared the effect of administering standard treatments and/or placebo (i.e. control condition) to applying standard treatments and/or herbal products in topical or oral routes (i.e. experimental condition). Out of 1166 retrieved records, 28 RCTs were included. Studies used different poly and single herbal formulations. Based on the meta-analysis, administration of standard care plus daily dressing of the ulcer site with olive oil for 28 days significantly increased the total ulcer healing score (3 RCTs; weighted mean difference [WMD] = 89.30; p < 0.001), raised frequency of complete ulcer healing (2 RCTs; risk ratio [RR] = 12.44; p = 0.039) and declined ulcer degree (3 RCTs; WMD = -22.28; p = 0.002). Also, daily use of the bitter melon leaf extract in oral form for 28 days significantly increased the total ulcer healing score (2 RCTs; WMD = 0.40; p = 0.001). Additionally, based on qualitative synthesis, the adjuvant use of herbal agents seems an intriguing choice to manage DFU. Nonetheless, considering the undesirable methodological quality of most studies and the high heterogeneity in administered herbal formulations, more robust trials are required to build a solid conclusion regarding the use of herbal products for healing DFU.
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Affiliation(s)
- Mina Zamanifard
- Department of Nursing, School of Nursing and MidwiferyJahrom University of Medical SciencesJahromIran
| | - Morteza Nasiri
- Department of Anesthesiology, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Fatemeh Yarahmadi
- Department of Nursing, Broujerd School of NursingLorestan University of Medical SciencesKhorramabadIran
| | - Sahar Zonoori
- Department of Nursing, Broujerd School of NursingLorestan University of Medical SciencesKhorramabadIran
| | - Omolbanin Razani
- Department of Nursing, Doroud BranchIslamic Azad UniversityDoroudIran
| | - Zahra Salajegheh
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyKerman University of Medical SciencesKermanIran
| | - Mohammad Imanipour
- Department of Medical‐Surgical Nursing, Faculty of NursingAja University of Medical SciencesTehranIran
| | | | - Nabi Jomehzadeh
- Department of Medical Bacteriology, School of MedicineAbadan University of Medical SciencesAbadanIran
| | - Masoomeh Asadi
- Department of Operating Room NursingAbadan University of Medical SciencesAbadanIran
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Salahi P, Nasiri M, Yazdanpanah L, Khosravi S, Amini MR. Short-term effect of dressing with Dermaheal ointment in the treatment of diabetic foot ulcer: A double-blinded randomized controlled clinical trial. Health Sci Rep 2024; 7:e1868. [PMID: 38357487 PMCID: PMC10864714 DOI: 10.1002/hsr2.1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/10/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024] Open
Abstract
Background and Aims Diabetic foot ulcers, a major cause of amputations in diabetics, could benefit from natural products as adjuncts to standard care, given the costs and adverse effects of typical therapies. This study aims to evaluate the short-term effects of dressing with Dermaheal ointment in the treatment of DFUs through a double-blinded randomized controlled clinical trial. Methods This double-blinded, placebo-controlled trial included 50 patients with Wagner's ulcer grade I or II, randomly assigned to Dermaheal and placebo groups (received standard treatment and placebo ointment). The ulcer site was dressed daily for four consecutive weeks with either Dermaheal or placebo ointment. Ulcer healing score (using DFU healing checklist), ulcer size with transparent ruler and largest dimension of ulcer, and pain severity using numerical pain rating score (were recorded at five-time points, including baseline, and on weeks 1, 2, 3, and 4). Also, ulcer healing status was investigated at the trial ended in November 2021. Results Both groups showed significant improvement in ulcer healing over 4 weeks (p time < 0.001), with more remarkable progress in the Dermaheal group (p group = 0.03). At the trial end, complete ulcer healing was also significantly higher in the Dermaheal group compared to the placebo group (56% vs. 12%, p = 0.002). Both groups exhibited a decrease in ulcer size (p time < 0.001). Considering the baseline ulcer size as a covariate, substantial changes in mean ulcer size were noted in the initial (p = 0.01), second (p = 0.001), third (p = 0.002), and fourth (p = 0.002) weeks of the intervention, showing a preference for the Dermaheal group. However, no significant between-group difference was observed in pain severity levels. Conclusion Dressing with Dermaheal as a topical treatment shows promise in improving healing and reducing the size of diabetic foot ulcers. Further research is needed to confirm these findings' long-term efficacy.
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Affiliation(s)
- Pouya Salahi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Morteza Nasiri
- Department of Operating Room Nursing, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Leila Yazdanpanah
- Health Research Institute, Diabetes Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Sepehr Khosravi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad Reza Amini
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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Zhang X, Liang F, Lau CT, Chan JC, Wang N, Deng J, Wang J, Ma Y, Zhong LLD, Zhao C, Yao L, Wu T, Lyu A, Tian G, Shang H, Miao J, Bian Z. STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM): Extending the CONSORT statement. J Evid Based Med 2023; 16:68-81. [PMID: 36918992 DOI: 10.1111/jebm.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES Massage is a common therapy of nonpharmacological treatments, particularly in Tuina (Chinese massage) as its most common style, detailed guidance in reporting the intervention is warranted for its evaluation and replication. Based on the CONSORT (Consolidated Standards of Reporting Trials), we aimed to develop an Extension for Tuina/Massage, namely "The STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM)." METHODS A group of professional clinicians, trialists, methodologists, developers of reporting guidelines, epidemiologists, statisticians, and editors has developed this STRICTOTM checklist through a standard methodology process recommended by the EQUATOR (Enhancing the QUAlity and Transparency of Health Research) Network, including prospective registration, literature review, draft of the initial items, three rounds of the Delphi survey, consensus meeting, pilot test, and finalization of the guideline. RESULTS A checklist of seven items (namely Tuina/Massage rationale, details of Tuina/Massage, intervention regimen, other components of the intervention, Tuina/Massage provider background, control or comparator interventions, and precaution measures), and 16 subitems were developed. Explanations and examples (E&E) for each item are also provided. CONCLUSIONS The working group hopes that the STRICTOTM, in conjunction with both the CONSORT statement and extension for nonpharmacologic treatment, can improve the reporting quality and transparency of Tuina/Massage clinical research.
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Affiliation(s)
- Xuan Zhang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Feng Liang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Chung Tai Lau
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Jacky Cp Chan
- HKBU Faculty of Science, Department of Computer Science, Hong Kong Baptist University, Hong Kong, China
| | - Nana Wang
- Department of Brain and Behavioural Sciences, University of Pavia, Lombardy, Italy
| | - Jiashuai Deng
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Wang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Yanfang Ma
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Linda L D Zhong
- School of Biological Sciences, Nanyang Technological University Singapore, Nanyang Ave, Singapore
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Taixiang Wu
- Chinese Cochrane Centre, West China Hospital, Sichuan University, China Trial Registration Center, Chengdu, China
| | - Aiping Lyu
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Guihua Tian
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiangxia Miao
- School of Chinese medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhaoxiang Bian
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
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Chu SWF, Ng WJ, Yeam CT, Khan RQ, Low LL, Quah JHM, Foo WYM, Seng JJB. Manipulative and body-based methods in chronic kidney disease patients: A systematic review of randomized controlled trials. Complement Ther Clin Pract 2022; 48:101593. [DOI: 10.1016/j.ctcp.2022.101593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 04/10/2022] [Accepted: 04/10/2022] [Indexed: 12/21/2022]
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Matar SG, El-Nahas ZS, Aladwan H, Hasanin M, Elsayed SM, Nourelden AZ, Benmelouka AY, Ragab KM. Restless Leg Syndrome in Hemodialysis Patients: A Narrative Review. Neurologist 2022; 27:194-202. [PMID: 35442939 DOI: 10.1097/nrl.0000000000000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Restless legs syndrome (RLS) is a clinical entity characterized by sensory-motor manifestations commonly observed in end-stage renal illness. Evidence suggests that RLS is a multifactorial phenomenon that can be influenced by many critical factors, including genetic predisposition, dietary patterns, and deficiency in some vitamins. Iron metabolism disorders and metabolic derangements have been generally accepted as predisposing elements in RLS. Furthermore, both pharmacological and neuroimaging studies demonstrated dopamine deficiency and dopamine receptors decrease in basal ganglia during RLS. REVIEW SUMMARY A literature search was done in three databases (PubMed, Google Scholar, and Cochrane) to identify the pertinent articles discussing the epidemiology, pathogenesis, and management of RLS in hemodialysis patients. RLS can affect the morbidity and mortality of patients treated with dialysis. It also has significant impacts on the quality of life since it can lead to insomnia, increased fatigue, mental health troubles, and other movement problems. Appropriate measures should be considered in this particular population so to prevent and treat RLS. Many drugs and other nonpharmacological methods have been investigated to attenuate the disease's severity. No treatment, however, could offer long-term effects. CONCLUSION Further efforts are still required to improve the understanding of RLS pathogenic trends to find more specific and efficient therapies. A wide range of treatment options is available. However, it can be individualized according to the patients' several factors.
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Affiliation(s)
- Sajeda G Matar
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
- International Medical Student's Research Association (IMedRA)
| | - Zeinab S El-Nahas
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Menoufia University, Menoufia
| | - Hala Aladwan
- Faculty of Pharmacy, University of Jordan, Amman, Jordan
- International Medical Student's Research Association (IMedRA)
| | - Menna Hasanin
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Al-Azhar University, Cairo
| | - Sarah M Elsayed
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, October 6 University, Giza
| | - Anas Z Nourelden
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Al-Azhar University, Cairo
| | - Amira Y Benmelouka
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, University of Algiers, Algiers, Algeria
| | - Khaled M Ragab
- International Medical Student's Research Association (IMedRA)
- Faculty of Medicine, Minia University, Minia, Egypt
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Tsai LH, Chen CM, Lin LM, Tsai CC, Han Y, See LC. Acupressure reduces the severity of restless legs syndrome in hemodialysis patients: A cluster-randomized crossover pilot study. Biomed J 2022; 45:533-541. [PMID: 35835685 PMCID: PMC9421980 DOI: 10.1016/j.bj.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 04/09/2021] [Accepted: 05/13/2021] [Indexed: 11/28/2022] Open
Abstract
Background Restless legs syndrome (RLS), a neurological disorder, often affects sleep quality in hemodialysis patients. This study aimed to evaluate acupressure's effect on the severity of RLS symptoms and sleep quality in hemodialysis patients with RLS. Methods This study is a cluster-randomized crossover pilot study. Patients were randomized to two sequences: acupressure for one month and observation for another month (AC); and observation for one month and acupressure for another month (CA). For the four-week acupressure intervention, patients received 36 min of acupressure three times weekly during their hemodialysis sessions. The acupoints were on the bilateral lower limbs, including Zusanli (ST36), Yanglingquan (GB34), Sanyinjiao (SP6), Xuanzhong (GB39), Chengshan (BL57), and Taichong (LR3). RLS severity and sleep quality (measured with the Pittsburgh sleep quality index, PSQI) were measured at baseline, month 1, and month 2. Results AC sequence (n = 14) was similar to the CA sequence (n = 9) in terms of gender, age, education, employment, marital status, comorbid disease, BMI, duration of dialysis, medication for RLS and insomnia, RLS severity, and PSQI. The general linear mixed model revealed no significant carryover effect on RLS severity, PSQI, and the seven subscales of PSQI. A significant treatment effect (acupressure) was only observed in RLS severity (p = 0.0013) but not in PSQI and the seven subscales. The significant period effect was observed in RLS severity (p = 0.0250) and the subscale of sleep disturbance (p = 0.0021). Conclusion In hemodialysis patients with RLS, acupressure can alleviate the severity of RLS but cannot improve sleep quality.
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Affiliation(s)
- Li-Hung Tsai
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chuan-Mei Chen
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Li-Mei Lin
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ching-Ching Tsai
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Cardiology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi Han
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan; Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Effects of light stroking massage with olive oil on acute pain severity and number of taken non-steroidal anti-inflammatory drugs among outpatients with extremities trauma: A double-blind, placebo-controlled superiority trial. Int J Orthop Trauma Nurs 2022; 46:100953. [DOI: 10.1016/j.ijotn.2022.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
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Xia M, He Q, Ying G, Fei X, Zhou W, He X. Clinical Efficacy and Safety of Massage for the Treatment of Restless Leg Syndrome in Hemodialysis Patients: A Meta-Analysis of 5 Randomized Controlled Trials. Front Psychiatry 2022; 13:843263. [PMID: 35479488 PMCID: PMC9035587 DOI: 10.3389/fpsyt.2022.843263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
AIM We conducted this meta-analysis to evaluate the clinical efficacy and safety of massage for the treatment of hemodialysis patients with restless leg syndrome (RLS). METHODS A comprehensive literature search was performed using the PubMed database, EMBASE database (via OVID), and the Cochrane Library in order to identify eligible randomized controlled trials (RCTs) published before August 31, 2021. After extracted essential data and assessed risk of bias of each eligible study, we calculated the pooled estimate of RLS score and safety after treatment. Statistical analysis was performed by using Review Manager 5.3. RESULTS Five studies involving 369 hemodialysis patients with RLS were analyzed. The RLS score after treatment [mean difference (MD), -12.01; 95% confidence interval (CI), -14.91 to -9.11] and mean difference of RLS score at the beginning and end of treatment [mean difference (MD), -11.94; 95% confidence interval (CI), -15.45 to -8.43] in a massage group was significantly better than that in route care group. Subgroup analysis suggested that massage with lavender oil also significantly reduced the RLS score after treatment (MD, -14.22; 95% CI, -17.81 to -10.63) and mean difference of RLS score at the beginning and end of treatment (MD, -14.87; 95% CI, -18.29 to -11.45) compared with route care. Meanwhile, massage regime significantly relieved RLS severity compared with route care but did not increase adverse events. CONCLUSION Massage may be a preferred treatment modality for hemodialysis patients with RLS because it effectively reduces RLS symptoms, relieves RLS severity, and does not increase the risk of adverse events. However, future study with a larger sample size is warranted due to the fact that only limited number of eligible studies with small sample size are enrolled.
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Affiliation(s)
- Min Xia
- Department of Nephrology, Beilun People's Hospital, Ningbo, China
| | - Qien He
- Department of Nephrology, Beilun People's Hospital, Ningbo, China
| | - Guanghui Ying
- Department of Nephrology, Beilun People's Hospital, Ningbo, China
| | - Xiapei Fei
- Department of Nephrology, Beilun People's Hospital, Ningbo, China
| | - Wenjing Zhou
- Department of Nephrology, Beilun People's Hospital, Ningbo, China
| | - Xuelin He
- Department of Nephrology, Beilun People's Hospital, Ningbo, China.,Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration of Traditional Chinese Medicine of China, Hangzhou, China
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Döner A, Taşcı S. Effect of massage therapy with lavender oil on severity of restless legs syndrome and quality of life in hemodialysis patients. J Nurs Scholarsh 2021; 54:304-314. [PMID: 34779137 DOI: 10.1111/jnu.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 10/12/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE This study assessed the effects of massage therapy using 5% lavender oil on the severity of restless legs syndrome (RLS) and the quality of life (QoL) of patients on hemodialysis (HD). DESIGN AND METHODS This is a randomized placebo-controlled study with a pretest-posttest design. This study was conducted from January 30, 2019, to May 6, 2019, at HD centers in Turkey, and it includes 58 participants-31 study patients and 27 controls. Data were collected using patient identification form, RLS severity rating scale, Kidney Disease Quality of Life Scale (KDQOLTM -36) and patient follow-up charts. As per the massage therapy protocol, the patients in the study and control groups received massage therapy with lavender oil and baby oil, respectively. FINDINGS RLS severity significantly decreased in all follow-up weeks in the study group and in the first, second, and third follow-up weeks in the control group. There were significant differences between the groups in terms of KDQOLTM -36 subscales and total scores at the initial and final follow-ups. CONCLUSION In HD patients, massage with lavender oil lessened the severity of RLS and improved the QoL. Accordingly, this therapy can be recommended to HD patients. CLINICAL RELEVANCE Massage therapy during HD sessions is easy, inexpensive, and patient-friendly with no side effects. It is known to reduce symptoms and enable the patients to easily perform daily activities of living. Massage therapy with lavender oil is effective and can be easily applied to patients with RLS by nurses. TRIAL REGISTRATION This study was registered under the Clinical Trials protocol registration system (NCT04630470) upon completion.
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Affiliation(s)
- Ayser Döner
- Department of Internal Nursing, Erciyes University Faculty of Health Science, Kayseri, Turkey
| | - Sultan Taşcı
- Department of Internal Nursing, Erciyes University Faculty of Health Science, Kayseri, Turkey
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Aromatherapy Massage vs. Foot Reflexology on the Severity of Restless Legs Syndrome in Female Patients Undergoing Hemodialysis. Geriatrics (Basel) 2021; 6:geriatrics6040099. [PMID: 34698176 PMCID: PMC8544351 DOI: 10.3390/geriatrics6040099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/12/2023] Open
Abstract
This study aimed to compare the effects of reflexology and aromatherapy massage on the severity of restless legs syndrome (RLS) in 105 female patients undergoing hemodialysis. A randomized placebo-controlled clinical trial was conducted in a hemodialysis center with 48 beds in a high turnover hospital in an urban area of Iran. Intervention groups received reflexology (n = 35) and aromatherapy massage using lavender essential oil (n = 35) for 24 sessions, and the placebo group (n = 35) received simple foot massage. The restless legs syndrome rating scale was used to assess RLS severity in the groups before the intervention and after 4 and 8 weeks of the interventions. Results obtained by the mixed model analysis 3 * 3 (3 groups * 3 times) revealed the significant effect of time, group, and the time-group interrelationship (p = 0.001). Aromatherapy massage reduced the RLS severity, but reflexology did not appear to cause any significant reduction in it. Therefore, we suggest that aromatherapy massage be incorporated into routine care for relieving the ailment and suffering of patients undergoing hemodialysis.
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Chen JJ, Lee TH, Tu YK, Kuo G, Yang HY, Yen CL, Fan PC, Chang CH. Pharmacological and Nonpharmacological Treatments for Restless Legs Syndrome in End Stage Kidney Disease: A Systematic Review and Component Network Meta-Analysis. Nephrol Dial Transplant 2021; 37:1982-1992. [PMID: 34612498 PMCID: PMC9494057 DOI: 10.1093/ndt/gfab290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Restless legs syndrome (RLS) is common among patients with end stage kidney disease (ESKD) and is associated with poor outcomes. Several recently published studies had focused on pharmacological and nonpharmacological treatments of RLS, but an updated meta-analysis has not been conducted. METHODS The study population was adult ESKD patients on dialysis with RLS. Randomized controlled trials were selected. The primary outcome was reduction in RLS severity. The secondary outcomes were improvement in sleep quality and treatment-related adverse events. Frequentist standard network meta-analysis and additive component network meta-analysis was performed. The evidence certainty was assessed using Confidence in NMA (CINeMA) framework. RESULTS A total of 24 RCTs with 1,252 participants were enrolled and 14 interventions were compared. Cool dialysate produced the largest RLS severity score reduction (MD: 16.82, 95% CI: 10.635-23.02) and high level of confidence. Other potential non-pharmacologic interventions including intradialytic stretching exercise (MD: 12.00, 95% CI: 7.04-16.97) and aromatherapy massage (MD: 10.91, 95% CI: 6.96-14.85) but all with limited confidence of evidence. Among the pharmacological interventions, gabapentin was the most effective (MD: 8.95, 95% CI: 1.95-15.85), which also improved sleep quality (SMD: 2.00, 95% CI: 0.47-3.53). No statically significant adverse events were detected. CONCLUSIONS The NMA supports that cool dialysate is appropriate to apply to treat patients with ESKD and RLS. Gabapentin is most effective pharmacologic intervention which also might improve sleep quality. Further parallel RCTs with sufficient sample sizes are required to evaluate these potential interventions and long-term effects.
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Affiliation(s)
- Jia-Jin Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tao Han Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - George Kuo
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
| | - Huang-Yu Yang
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
| | - Chieh-Li Yen
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Chun Fan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
| | - Chih-Hsiang Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Taiwan
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Akbaş P, Yaman Sözbir Ş. Non-pharmacological methods used in coping with restless leg syndrome (RLS): A systematic review. Sleep Biol Rhythms 2021. [DOI: 10.1007/s41105-021-00322-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Lazarus ER, Deva Amirtharaj A, Jacob D, Chandrababu R, Isac C. The effects of an olive-oil massage on hemodialysis patients suffering from fatigue at a hemodialysis unit in southern India - a randomized controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:397-403. [PMID: 34187126 DOI: 10.1515/jcim-2019-0338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/07/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To determine the effects that an olive oil massage has on fatigue among patients undergoing hemodialysis, and the associated sociodemographic factors that can reduce fatigue. METHODS The study used true experimental pre- and post-test research design. A total of 200 patients were recruited in a selected hemodialysis unit in southern India and were allocated to either a study or control group by randomization, with 100 patients in each group. All the patients in the intervention group were given a lower back and lower leg massage using olive oil at the beginning, and after every hour, of their hemodialysis using olive oil for a period of eight weeks. In contrast, the control group continues to receive routine care. The level of fatigue was measured using the Fatigue Severity Scale both before and after massage therapy. RESULTS Between 73 and 80% of patients were suffering from severe fatigue and the mean fatigue score was 5.53 (SD 1.82) and 5.56 (SD 1.57) for the study and control group, respectively. After eight weeks of massage therapy, the results showed that 53% of patients in the study group showed borderline fatigue, with a mean score of 4.39 (SD 2.37), whereas in the control group 73% patients showed severe fatigue, with a mean score of 5.17 (SD 2.00). The independent t-test between the study and the control group showed a statistically significant reduction in fatigue in the study group with a mean difference (MD) of 3.56 (t=-1.24; p=0.000). There were also statistically significant changes noted in gender and in the duration of the hemodialysis (χ 2 = 6.043; p=0.049) and (χ 2 = 6.611; p=0.046) respectively. CONCLUSION The study concluded that patients undergoing hemodialysis experienced moderate to severe levels of fatigue. In patients with no or mild anemia, massage has been shown to decrease fatigue and increase energy levels among patients undergoing hemodialysis for chronic kidney disease.
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Affiliation(s)
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Oman
| | - Ramesh Chandrababu
- Department of Medical-Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Chandrani Isac
- Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Oman
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Hu S, He X, Zhang Y, Hu S, He F, Zhao F, Zhang Q, Liu T, Wang C. Effectiveness and safety of massage in the treatment of restless legs syndrome: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e23239. [PMID: 33235081 PMCID: PMC7710177 DOI: 10.1097/md.0000000000023239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Restless legs syndrome (RLS), known as a kind of neurological disease, is prevalent but easy to be ignored. Studies have demonstrated that massage therapy can effectively reduce the symptoms of patients with RLS and improve their quality of life. However, the efficacy of massage therapy for RLS is still controversial. Therefore, this protocol aims to evaluate the reliability of massage therapy in treating RLS in a thorough way. METHODS We will search relevant randomized controlled trials from Chinese Biomedical Literature Database, Chongqing VIP, CNKI, Wanfang, Web of Science, Cochrane Library, PubMed, and EMBASE, when publication status and language are not considered and the time limit ends with September 6, 2020. Two experienced researchers will use RevMan V.5.3 software to perform the selection of literature, data collection, data analysis and synthesis separately. Besides, the quality of trials involved in this study will be measured with the Cochrane bias risk assessment tool. RESULTS This protocol will be applied to carry out a systematic evaluation of the massage therapy purposed to treat RLS for its effectiveness and safety. CONCLUSION The review will provide a credible evidence suggesting whether massage therapy is a reliable intervention for RLS. INPLASY REGISTRATION NUMBER INPLASY202090038.
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Affiliation(s)
- Shasha Hu
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Xingwei He
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yajing Zhang
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Songfeng Hu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Fan He
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Fenfen Zhao
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Qin Zhang
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Tingping Liu
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Changkang Wang
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Salib M, Memon AN, Gowda AS, Rallabhandi B, Bidika E, Fayyaz H, Cancarevic I. Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering? Cureus 2020; 12:e10053. [PMID: 32999776 PMCID: PMC7520405 DOI: 10.7759/cureus.10053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Restless leg syndrome (RLS), also called Willis Ekbom disease, can be described as an unpleasant feeling that intensely urges the patients to move their lower limbs. RLS is classified into primary and secondary. It is one of the common complications in hemodialysis patients, and it impairs patients’ quality of life. Unfortunately, it is an underdiagnosed and undertreated disorder. In this review article, we performed a literature search using the PubMed database to compare different treatment modalities for RLS in patients with end-stage renal disease (ESRD) on regular hemodialysis. Many of the non-pharmacologic modalities of treatment are cost-effective and safer than pharmacologic therapy. Given the small sample size of the studies and short follow up duration, we should consider conducting studies on a larger number of patients and for longer periods of time to assess the efficacy and safety of different treatment patterns for RLS in hemodialysis patients. We hope to raise awareness about this neurologic condition in hemodialysis patients.
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Affiliation(s)
- Marina Salib
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Areeba N Memon
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asavari S Gowda
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bhavana Rallabhandi
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Erjola Bidika
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Hafsa Fayyaz
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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