Progressive muscle relaxation versus manual lymphatic drainage on restless leg syndrome and sleep quality in hemodialysis patients: Randomized Controlled Trial.

BACKGROUND: Restless leg syndrome (RLS) is a prevalent sensory disturbance experienced by those undergoing hemodialysis (HD), leading to mental illnesses and sleep disruption. OBJECTIVES: This study compared the effect of Progressive muscle relaxation (PMR) versus Manual lymphatic drainage (MLD) on Restless leg syndrome (RLS) and sleep quality in HD patients. METHODS: double-blinded, Randomized controlled trial (RCT), patients with HD (N = 117) were randomly assigned to three equal groups: group A (PMR with medical care), group B (MLD with medical care), and group C (control, received medical care only). For three months, all patients were evaluated using the International restless legs syndrome rating scale (IRLSS) and Pittsburgh Sleep Quality Index (PSQI), which also measured leg cramp severity and patient quality of life. RESULTS: No statistically significant difference was found between the three groups at baseline measurement; however, a treatment effect was observed after 12 weeks of treatment (p = 0.001 and f-value = 11.39). Additionally, comparing the pre- and post-treatment periods in groups A and B, a time-treatment interaction was found to be statistically significant (p = 0.001 and f-value = 17.76). However, in group B, it was clear and obvious. CONCLUSION: PMR and MLD affect IRLSS, PSQI, leg cramps, and Patient Health Questionnaire (PHQ-9) by reducing IRLS scores and leg cramp, additionally enhancing sleep quality, depression, and anxiety, the preference is for MLD intervention.