Harder Workout Keeps the Legs At Ease

Restless legs syndrome improved more than 50 percent with resistance exercise training

With restless legs, maybe the key is just to keep them moving with exercise. But movement alone is not quite what the legs need to keep them from being restless at night.

Symptoms of restless legs syndrome (RLS) declined more among kidney failure patients who engaged in resistance exercise training compared to those who exercised without resistance, a recent study showed. Resistance exercise also improved function and depression levels among patients.

The researchers of the study said that the results are the first of their kind to show that body adaptations caused by resistance exercise were specifically tied to improvements in restless legs syndrome compared to exercise that just allowed for leg movement.

"When your workout gets easy, add some resistance!"

A small study led by Christoforos Giannaki, from the Department of Life & Health Sciences at the University of Nicosia in Greece, aimed to see whether restless legs syndrome improved with resistance exercise or with exercise that moves the legs without adding weight.

The study included 24 patients undergoing dialysis for kidney disease and who had restless legs syndrome, which can disrupt sleep at night. Restless legs syndrome is more common among hemodialysis patients than people without the condition.

The participants were recruited from dialysis units at a hospital in Greece where they had undergone at least three months of dialysis treatment.

The participants were randomly assigned to one of two groups with different bike exercise programs. The program covered a six-month period with participants engaging in 45 minutes of cycling at 50 revolutions per minute three times a week. Participants continued their dialysis treatment through the study period.

The first group was given a progressive exercise training regimen that added resistance or weight to their cycling routine throughout the course of the study.

Resistance was applied each time participants reached 60 to 65 percent of their maximum exercise capacity, which is how hard individuals can exercise. The second group was assigned to exercise without added resistance to compare results.

The researchers reassessed participants' exercise capacity every month to track their improvement. They also tracked the severity of participants' restless legs symptoms and their functional capacity.

Participants also completed surveys on their level of sleep quality, depression, and average sleepiness on a daily basis before and after completing the exercise programs. 

By the end of the exercise program, the researchers found that restless legs symptoms declined 58 percent in the progressive exercise group. At the same time, symptoms decreased 17 percent on average in the regular exercise group.

Sleep quality, functional capacity and depression also improved in the progressive exercise group, but the regular exercise group had no significant changes.

"It seems that exercise-induced adaptations to the whole body are mostly responsible for the reduction in RLS severity score, since the exercise with no applied resistance protocol failed to improve the RLS severity status of the patients," the researchers wrote in their report.

The authors noted that a few of the exercise sessions were incomplete when patients were unable to complete the full 45-minute cycling sessions.

In addition, they did not measure the severity of restless legs symptoms throughout the course of the exercise program. 

The study was published online August 8 in the journal Nephrology Dialysis Transplantation. No conflicts of interest were declared.

Review Date: 
October 3, 2013