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The Effect of Mindfulness-Based Stress Reduction on Restless Legs Syndrome in Hemodialysis Patients: A Randomized Clinical Trial

Zahra Delshad  -  MSN, psychiatric nursing, Student Research Committee, Kashan University of Medical Sciences, Iran, Islamic Republic of
*Mohammad Aghajani orcid  -  PhD, Infectious Diseases Research Center, Department of Psychiatric Nursing, Kashan University of Medical Sciences, Iran, Islamic Republic of
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Background: There is currently no definitive cure for restless legs syndrome (RLS), and the common treatments are only used to reduce symptoms. Mindfulness-based stress reduction (MBSR) is an intervention that has shown beneficial effects in many mental and physical disorders.

Purpose: This study aimed to determine the effect of MBSR on RLS in hemodialysis patients.

Methods: This study was a randomized clinical trial involving 60 hemodialysis patients with RLS recruited by convenience sampling each group. Inclusion criteria were patients with RLS diagnosis, age 18-65, Hb>10, no cognitive disorders, ability to read and write, no vision or hearing problems, and history of hemodialysis ≥6 months. The intervention group received eight sessions of the MBSR program, and the control group received routine care in a government dialysis center. International Restless Legs Syndrome Scale and Restless Legs Syndrome Severity Scale were used to measure RLS. Statistical analyses were conducted using independent and pair t-test and ANCOVA.

Results: Significant difference was found in the severity the RLS (Mean(SD) score) between the intervention group (12.90(4.58)) and the control group (22.27(4.19)) (95% CI:-11.66 to -7.08, p<0.0001). The effect size between groups was obtained based on Cohen’s d of 2.13.

Conclusion: MBSR showed a significant reduction in the severity of RLS in hemodialysis patients. This preliminary study suggests that MBSR can be a promising treatment option in the management of RLS patients.
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Keywords: Hemodialysis; mindfulness-based stress reduction; restless legs syndrome

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  1. Bablas, V., Yap, K., Cunnington, D., Swieca, J., & Greenwood, K. M. (2016). Mindfulness-based stress reduction for restless legs syndrome: A proof of concept trial. Mindfulness, 7(2), 396-408.
  2. Basaran, S., & Tas, H. I. (2022). Evaluation of affective temperament profile and levels of depressive symptoms and anxiety in patients with restless legs syndrome. Sleep Breath, 26(1), 381-388.
  3. Batool-Anwar, S., Li, Y., De Vito, K., Malhotra, A., Winkelman, J., & Gao, X. (2016). Lifestyle factors and risk of restless legs syndrome: Prospective cohort study. Journal of Clinical Sleep Medicine, 12(2), 187-194.
  4. Chen, Z., Jiang, J., Hu, T., Luo, L., Chen, C., & Xiang, W. (2022). The effect of mindfulness-based stress reduction therapy on maternal anxiety, depression, and sleep quality: A protocol for systematic review and meta-analysis. Medicine, 101(8), e28849.
  5. Cho, I.-H., Suh, S.-R., & Jang, K.-H. (2017). Effects of the MBSR Program on stress response, psychosocial adaptation and health-related quality of life in patients undergoing hemodialysis. International Information Institute (Tokyo). Information, 20(12), 8589-8596
  6. Cochen De Cock, V. (2019). Therapies for restless legs in Parkinson’s disease. Current Treatment Options in Neurology, 21, 56.
  7. Darvishi, N., Daneshkhah, A., Khaledi-Paveh, B., Vaisi-Raygani, A., Mohammadi, M., Salari, N., Darvishi, M., Abdi, A., & Jalali, R. (2020). The prevalence of restless legs syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: A systematic review. BMC Neurology, 20, 132.
  8. de Menezes, A. F., Motta, D. R. M. d. S., Carvalho, F. O. d., Santana-Santos, E., de Andrade Júnior, M. P., Figueirôa, M. F., Farias, M. I. T., & Bastos, K. d. A. (2018). Restless legs syndrome in dialysis patients: Does the dialysis modality influence its occurrence and severity? International Journal of Nephrology, 2018, 1414568.
  9. Guay, A., Houle, M., O'Shaughnessy, J., & Descarreaux, M. (2020). Current evidence on diagnostic criteria, relevant outcome measures, and efficacy of nonpharmacologic therapy in the management of restless legs syndrome (RLS): A scoping review. Journal of Manipulative Physiological Therapeutics, 43(9), 930-941.
  10. Habibzade, H., Khalkhali, H., & Ghaneii, R. (2011). Study of the relationship between restless legs syndrome and sleep disturbance among patients in critical care units. Iranian Journal of Critical Care Nursing, 4(3), 153-158
  11. Haghshenas, M., Assarian, F., Omidi, A., Razaghof, M., & Rahimi, H. (2019). Efficacy of mindfulness-based stress reduction in hemodialysis patients with anxiety and depression: A randomized, double-blind, parallel-group trial. Electronic physician, 11(1), 7370-7377
  12. Hashemi, S. H., Hajbagheri, A., & Aghajani, M. (2015). The effect of massage with lavender oil on restless leg syndrome in hemodialysis patients: A randomized controlled trial. Nursing and Midwifery Studies, 4(4), e29617.
  13. Hemmati, Z., & Alidosti, M. (2012). Frequency of restless legs syndrome in hemodialysis patients referring to Chaharmahal and Bakhtiari province hospitals. Journal of Health and Care, 14(4), 28-34
  14. Hornyak, M., Grossmann, C., Kohnen, R., Schlatterer, M., Richter, H., Voderholzer, U., Riemann D., & Berger, M. (2008). Cognitive behavioural group therapy to improve patients’ strategies for coping with restless legs syndrome: A proof-of-concept trial. Journal of Neurology, Neurosurgery and Psychiatry, 79(7), 823-825.
  15. Innes, K. E., Selfe, T. K., Agarwal, P., Williams, K., & Flack, K. L. (2013). Efficacy of an eight-week yoga intervention on symptoms of restless legs syndrome (RLS): a pilot study. The Journal of Alternative Complementary Medicine, 19(6), 527-535.
  16. Jalali, D., & Aghaee, A. (2017). Comparing the effectiveness of Native Mindfulness-Based Cognitive Therapy (nMBCT) according to Iranian-Islamic culture and Cognitive-Behavioral Therapy (CBT) on blood pressure. Journal of Shahrekord University of Medical Sciences, 18
  17. Khoo, E. L., Small, R., Cheng, W., Hatchard, T., Glynn, B., Rice, D. B., Skidmore, B., Kenny, S., Hutton, B., & Poulin, P. A. (2019). Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis. Evidence-Based Mental Health, 22(1), 26-35.
  18. Khoshkhatti, N., Bazzazian, S., & Yazdinezhad, A. (2020). The effectiveness of mindfulness-based cognitive therapy on symptoms of anxiety, depression and stress in renal patients under hemodialysis. Iranian Journal of Nursing Research, 14(6), 9-17.
  19. Kusuma, H., Ropyanto, C. B., Widyaningsih, S., & Sujianto, U. (2018). Relating factors of insomnia among haemodialysis patients. Nurse Media Journal of Nursing, 8(1), 44-57.
  20. Mohammed, W. A., Pappous, A., & Sharma, D. (2018). Effect of Mindfulness-Based Stress Reduction (MBSR) in increasing pain tolerance and improving the mental health of injured athletes. Frontiers in Psychology, 9, 722.
  21. Mousavi, M., Soleimani, M. A., Akrami, R., & Tadayonfar, M. (2016). The effect of progressive muscle relaxation on the severity of restless leg syndrome in patients under treatment with hemodialysis. Journal of hayat, 22(3), 279-290
  22. Myc, L. A., Churnin, I. T., Jameson, M. J., & Davis, E. M. (2018). Treatment of comorbid obstructive sleep apnea by upper airway stimulation results in resolution of debilitating symptoms of restless legs syndrome. Journal of Clinical Sleep Medicine, 14(10), 1797-1800.
  23. Norouzi, E., Gerber, M., Masrour, F. F., Vaezmosavi, M., Pühse, U., & Brand, S. (2020). Implementation of a mindfulness-based stress reduction (MBSR) program to reduce stress, anxiety, and depression and to improve psychological well-being among retired Iranian football players. Psychology of Sport and Exercise, 47, 101636
  24. Omidi, A., & Zargar, F. (2014). Effect of mindfulness-based stress reduction on pain severity and mindful awareness in patients with tension headache: a randomized controlled clinical trial. Nursing and Midwifery Studies, 3(3), e21136
  25. Rikos, D., Dardiotis, E., Aloizou, A. M., Siokas, V., Zintzaras, E., & Hadjigeorgiou, G. M. (2019). Reporting quality of randomized controlled trials in restless legs syndrome based on the CONSORT statement. Tremor and Other Hyperkinetic Movement, 9, 1-6.
  26. Selfe, T. K., Wen, S., Sherman, K., Klatt, M., & Innes, K. E. (2019). Acceptability and feasibility of a 12-week yoga vs. educational film program for the management of restless legs syndrome (RLS): study protocol for a randomized controlled trial. Trials, 20(1), 134.
  27. Silber, M. H., Buchfuhrer, M. J., Earley, C. J., Koo, B. B., Manconi, M., & Winkelman, J. W. (2021). The management of restless legs syndrome: An updated algorithm. Mayo Clinic Proceedings, 96(7), 1921-1937.
  28. Sobhani, E., Babakhani, N., & Alebouyeh, M. R. (2019). The effectiveness of mindfulness-based stress reduction on the depression, anxiety, stress, and pain perception in females with obstructed labour-induced chronic low back pain. Iranian Journal of Psychiatry and Clinical Psychology, 25(3), 266-277.
  29. Song, M. L., Park, K. M., Motamedi, G. K., & Cho, Y. W. (2020). Cognitive behavioral therapy for insomnia in restless legs syndrome patients. Sleep Medicine, 74, 227-234.
  30. Turk, A. C., Ozkurt, S., Turgal, E., & Sahin, F. (2018). The association between the prevalence of restless leg syndrome, fatigue, and sleep quality in patients undergoing hemodialysis. Saudi Med J, 39(8), 792-798.
  31. Vollestad, J., Sivertsen, B., & Nielsen, G. H. (2011). Mindfulness-based stress reduction for patients with anxiety disorders: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4), 281-288.
  32. Walters, A. S., LeBrocq, C., Dhar, A., Hening, W., Rosen, R., Allen, R. P., & Trenkwalder, C. (2003). Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Medicine, 4(2), 121-132.
  33. Yang, X.-X., Chen, Y.-Y., & Meng, F.-J. (2020). Effects of mindfulness-based stress reduction therapy on anxiety and depression in patients with maintenance hemodialysis. TMR Integrative Medicine, 4, e20008.
  34. Yasaie Sokeh, M., Shafiabadi, A., & Farzad, V. (2017). Comparison of the efficacy of acceptance and commitment group therapy (ACT) with mindfulness-based cognitive therapy (MBCT) on hemodialysis patients in terms of anxiety and depression. Journal of Fundamentals of Mental Health, 19(special issue), 220-230.
  35. Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G., & Coghill, R. C. (2011). Brain mechanisms supporting the modulation of pain by mindfulness meditation. Journal of Neuroscience, 31(14), 5540-5548.
  36. Zhang, L. Y., Ma, X. Y., Lin, J., Liu, W. H., Guo, W., Yin, L., & Tuo, H. Z. (2020). Prevalence and risk factors of restless legs syndrome in hemodialysis patients. Nature and Science of Sleep, 12, 19-27.

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