Département des Sciences de l'Activité Physique, University of Quebec at Trois-Rivieres, Trois-Rivières, Québec, Canada.
Département de Chiropratique, University of Quebec at Trois-Rivieres, Trois-Rivières, Québec, Canada.
J Manipulative Physiol Ther. 2020 Nov-Dec;43(9):930-941. doi: 10.1016/j.jmpt.2020.05.004. Epub 2020 Sep 6.
The aim of this scoping review is to outline the current evidence regarding the management of restless legs syndrome (RLS) with nonpharmacologic approaches. To categorize the efficacy of conservative approaches in reducing symptoms of RLS, we have identified and summarized the current data regarding diagnostic criteria and relevant outcome measures, to inform future research and to guide clinical practice.
A scoping review was conducted using the National Center for Biotechnology Information; EBSCO; the Manual, Alternative and Natural Therapy Index System; the Cumulative Index to Nursing & Allied Health Literature; and Scopus. All literature related to RLS was extracted, screened, and reviewed based on titles and abstract contents. The authors then extracted data from the 24 admissible studies, that is, the ones about manual therapy, exercises, and alternative treatments for RLS. The Physiotherapy Evidence Database scale was used to rate the methodological quality of the included randomized controlled trials by 2 independent readers.
In the 24 articles fulfilling the selection criteria, there was a consistent trend in the findings showing positive results in lowering RLS symptom severity. Most clinical studies based their diagnosis on the International Restless Legs Syndrome Study Group diagnostic criteria; the International Restless Legs Syndrome Study Group rating scale was the most often used outcome measure. The efficacy of exercise, yoga, massage, acupuncture, traction straight leg raise, cryotherapy, pneumatic compression devices, whole-body vibration, transcranial and transcutaneous stimulation, and near-infrared lights showed different effects on RLS symptom severity, and the level of evidence was evaluated.
Our results showed clinically significant effects for exercises, acupuncture, pneumatic compression devices, and near-infrared light. Short-lasting effects were identified with whole-body cryotherapy, repetitive transcranial stimulation, and transcutaneous stimulation. More studies are necessary to investigate efficacy of yoga, massage, traction straight leg raise, and whole-body vibration. No adverse effects were identified for moderate-intensity exercise, yoga, massage, and pneumatic compression devices.
本范围综述旨在概述目前使用非药物方法治疗不宁腿综合征（RLS）的证据。为了对保守方法缓解 RLS 症状的疗效进行分类，我们确定并总结了有关诊断标准和相关结局测量的现有数据，以为未来的研究提供信息并指导临床实践。
使用美国国家生物技术信息中心、EBSCO、手册、替代和自然疗法索引系统、护理学和联合健康文献累积索引以及 Scopus 进行了范围综述。提取、筛选并根据标题和摘要内容审查了所有与 RLS 相关的文献。然后，作者从 24 项可接受的研究中提取数据，这些研究涉及手法治疗、运动和 RLS 的替代治疗。两位独立读者使用物理治疗证据数据库量表对纳入的随机对照试验的方法学质量进行评分。
在符合选择标准的 24 篇文章中，研究结果一致表明，降低 RLS 症状严重程度的效果较好。大多数临床研究根据国际不宁腿综合征研究组的诊断标准进行诊断；国际不宁腿综合征研究组评分量表是最常使用的结局测量方法。运动、瑜伽、按摩、针灸、直腿抬高牵引、冷冻疗法、气动压迫装置、全身振动、经颅和经皮刺激以及近红外光对 RLS 症状严重程度的疗效不同，评估了证据水平。
我们的结果表明，运动、针灸、气动压迫装置和近红外光具有临床显著疗效。全身冷冻疗法、重复经颅刺激和经皮刺激具有短暂疗效。需要进一步研究瑜伽、按摩、直腿抬高牵引和全身振动的疗效。中等强度运动、瑜伽、按摩和气动压迫装置没有不良反应。
