Progressive muscle relaxation versus manual lymphatic drainage on restless leg syndrome and sleep quality in hemodialysis patients

Restless legs syndrome (RLS) is a sensory motor disturbance with features of both neurologic and sleeps disorders. The patients complain of strong, irresistible urge to move the legs, often accompanied by uncomfortable sensations deeply in the legs. Poor sleep quality affects many hemodialysis patients and can potentially predict their morbidity, mortality, quality of life and pattern of medication use. Progressive muscle relaxation (PMR) is one way to improve physical work capacity and reduce functional limitations. Manual lymphatic drainage (MLD) is a traditional therapy in which the hands work on the tissues of the body, including tuina, acupressure, and the likes. It is beneficial to the well-being of patients both physically and mentally

Inclusion Criteria:

• Male and female adults ranging from 35- 65 years old.
• Able to communicate verbally and agree to participate in the study.
• On maintenance arteriovenous fistula (AVF) hemodialysis 3 times weekly.
• None of the research participants had a lower extremity dialysis graft, and they were all taking medication to maintain their health.
• Prior to the study procedure, all patients underwent a nephrologist assessment
• All patients had good compliance with their dialysis treatment (not missing more than 2 dialysis sessions in the prior 3 months

Exclusion Criteria:

• Peripheral neuropathy or vascular diseases of the lower limbs.
• Skin diseases including acute psoriasis or eczema.
• Recent fractures or lower limbs surgeries.
• Feet injuries including severe muscle weakness, bruises, ulcers, Open wounds or recent burns