The Effect of Acupressure on Restless Legs Syndrome and Pruritus in Patients Undergoing Hemodialysis

"Effect of Combined Traditional and Paraspinal Acupressure on Restless Legs Syndrome and Pruritus in Patients Undergoing Hemodialysis: A Randomized Controlled Trial

This randomized controlled trial aims to evaluate the effect of combined traditional and paraspinal acupressure on restless legs syndrome and pruritus among patients undergoing hemodialysis. Participants will be randomly assigned to either an intervention group receiving the acupressure intervention in addition to routine hemodialysis care or a control group receiving routine care only. The severity of restless legs syndrome and pruritus will be assessed at predetermined time points using validated assessment tools. The study aims to determine whether the combined acupressure intervention is effective in reducing restless legs syndrome and pruritus symptoms in patients undergoing hemodialysis

Participants allocated to the intervention group will receive combined traditional and paraspinal acupressure in addition to routine hemodialysis care. The intervention will involve stimulation of selected acupressure points using a vibration acupressure device.

The paraspinal component will include selected thoracic and lumbar points (BL13, BL17, BL23, BL24, and BL25) and will be applied before the hemodialysis session. Traditional peripheral acupressure points, including SP6, SP10, ST36, LI11, LR3, and BL57, will be stimulated during the hemodialysis session.The intervention will be administered according to a standardized protocol regarding point localization, application technique, duration, and frequency to ensure consistency among participants. Participants will be observed during the intervention for any discomfort or adverse events.

Participants allocated to the control group will continue to receive routine hemodialysis care without the acupressure intervention during the study period.

Restless legs syndrome severity and pruritus severity will be evaluated using validated instruments at three predetermined assessment time points. The collected data will be used to examine changes in symptoms over time and differences between the two study groups.

Inclusion Criteria

1. Patients more than 18 years old on hemodialysis treatment for more than 2 sessions per week.
2. The patients on hemodialysis for more than 3 months
3. The patients who complain of restless leg syndrome and pruritus.
4. RLS diagnosis meeting the diagnostic criteria defined by the International Restless Legs Syndrome Study Group (IRLSSG).
5. At least moderate RLS symptoms (IRLS - total score ≥ 11)
6. Patients who score more than five on the 5D Pruritus scale.
7. Patient with a history of pruritus for more than 3 months.

Exclusion Criteria

1. Patients with impaired skin integrity.
2. Patients with skin lesions in areas involved in acupressure therapy.
3. Patients with neurological deficits as perception of pain, may differ from other patients.
4. Patients with a body mass index (BMI) of more than > 30 kg/m².
5. Patients with malignancy.
6. Patients with Jaundice.