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Kim HJ, Yoon KB, Kang M, Lee HW, Kim SH. Use of Baclofen as a Treatment for Nocturnal Calf Cramps in Individuals With Lumbar Spinal Stenosis: A Prospective Randomized Study. Am J Phys Med Rehabil 2024; 103:384-389. [PMID: 38063320 DOI: 10.1097/phm.0000000000002364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
OBJECTIVE This study aimed to compare the efficacy and safety of baclofen and gabapentin in reducing leg pain from nocturnal calf cramps in lumbar spinal stenosis patients. DESIGN In a randomized clinical trial, the patients with lumbar spinal stenosis who commonly experienced nocturnal calf cramps were included. Patients were randomly assigned to either the baclofen or gabapentin group. Overall leg pain intensity, nocturnal calf cramp frequency and severity, sleep disturbances and functional disability were assessed at baseline and after 4 and 12 wks. RESULTS Thirty-six patients completed the 3-mo study. Both gabapentin and baclofen groups showed a significant reduction in overall leg pain, calf cramp frequency and intensity, and insomnia severity index scores from baseline to the endpoint. However, there were no significant differences between the two groups in terms of symptom reduction at different time points. The baclofen group also demonstrated a significant decrease in Oswestry Disability Index scores ( P < 0.001), while the gabapentin group did not ( P = 0.344). No adverse effects were reported in either group. CONCLUSIONS Baclofen seems to be as effective and as safe as gabapentin in treating nocturnal calf cramps in lumbar spinal stenosis patients and even shows superiority in enhancing functional outcomes.
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Affiliation(s)
- Hee Jung Kim
- From the Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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2
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Tanizaki R, Miyamatsu Y. Nocturnal Leg Cramping Caused by Carnitine Deficiency Due to Long-Term Pivalate Antibiotics Administration in a Patient With Chronic Kidney Disease. Cureus 2023; 15:e48927. [PMID: 38106710 PMCID: PMC10725522 DOI: 10.7759/cureus.48927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Carnitine deficiency is a known cause of leg cramps and is sometimes observed in patients taking certain medications such as pivalate-containing antibiotics. A 69-year-old Japanese woman presented with a progression of painful involuntary nocturnal leg cramping. She had been taking cefcapene-pivoxil for six months. Serum-free carnitine (FC) and acylcarnitine levels were decreased. Then, carnitine deficiency due to long-term pivalate-containing antibiotics administration was diagnosed. After initiating oral L-carnitine treatment, her symptoms improved. It should be aware of carnitine deficiency if a patient taking pivalate-containing antibiotics presents with leg cramping.
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Affiliation(s)
- Ryutaro Tanizaki
- Internal Medicine and General Medicine, Ise Municipal General Hospital, Mie, JPN
| | - Yayoi Miyamatsu
- Internal Medicine and General Medicine, Ise Municipal General Hospital, Mie, JPN
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3
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Wong SG, Vorakunthada Y, Lee-Iannotti J, Johnson KG. Sleep-related motor disorders. HANDBOOK OF CLINICAL NEUROLOGY 2023; 195:383-397. [PMID: 37562879 DOI: 10.1016/b978-0-323-98818-6.00012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Sleep-related motor disorders include non-rapid-eye movement (NREM) sleep parasomnias, rapid-eye movement (REM), sleep parasomnias including REM sleep behavior disorder (RBD), isolated motor phenomena in sleep, and periodic limb movement disorder. Restless legs syndrome (RLS) occurs while awake but is closely related to sleep and has a circadian pattern. The pontine sublaterodorsal tegmental nucleus has an important role in aligning motor control with sleep states, and dysfunction in this region can explain motor activities including cataplexy and loss of REM atonia seen in REM sleep behavior disorder. This chapter begins with a review of motor control in sleep. The rest of the chapter summarizes the clinical presentation, epidemiology, differential and treatment of NREM, REM, and isolated sleep-related motor disorders as well as restless legs syndrome.
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Affiliation(s)
- Stephanie G Wong
- Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Yuttiwat Vorakunthada
- Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Joyce Lee-Iannotti
- Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Karin G Johnson
- Department of Neurology, University of Massachusetts Chan School of Medicine-Baystate, Springfield, MA, United States; Institute for Healthcare Delivery and Population Science, University of Massachusetts Chan School of Medicine-Baystate, Springfield, MA, United States.
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4
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Jadidi A, Rezaei Ashtiani A, Khanmohamadi Hezaveh A, Aghaepour SM. Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial. BMC Complement Med Ther 2022; 23:1. [PMID: 36587225 PMCID: PMC9804944 DOI: 10.1186/s12906-022-03814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/30/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Restless legs syndrome/Willis-Ekbom Disease (RLS/WED) is one of the most prevalent sleep disorders. There are contradicting data about the effectiveness of magnesium and vitamin B6 in alleviating the symptoms of this condition. Therefore, this study aimed to assess the efficacy of magnesium and vitamin B6 in alleviating the symptoms of RLS/WED. METHODS A single-blind study was conducted on individuals with this illness for at least three months. Randomly, 75 patients were assigned into three groups: magnesium, vitamin B6, and placebo. The experimental group received daily doses of 40 mg vitamin B6 or 250 mg magnesium oxide. While others in the control group merely received a placebo. Patients' disease severity and sleep quality were evaluated three times using standard questionnaires (at the beginning of the study, one and two months after therapy). Utilizing SPSS22 software and the ANOVA, t-test, and repeated measure tests, statistical analysis was conducted. RESULTS The mean and standard deviation of sleep quality and disease severity at the beginning of the trial and throughout the first month following the intervention did not differ statistically between the three groups. In the second month following the intervention, the mean and standard deviation of sleep quality and disease severity were significantly different (P = 0.001). CONCLUSION Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.
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Affiliation(s)
- Ali Jadidi
- grid.468130.80000 0001 1218 604XSchool of Nursing, Arak University of Medical Sciences, Arak, Iran ,grid.468130.80000 0001 1218 604XTraditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Alireza Rezaei Ashtiani
- grid.468130.80000 0001 1218 604XSchool of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Ali Khanmohamadi Hezaveh
- grid.468130.80000 0001 1218 604XStudent Research Committee, Arak University of Medical Sciences, Arak, Iran
| | - Seyed Mohamad Aghaepour
- grid.468130.80000 0001 1218 604XStudent Research Committee, Arak University of Medical Sciences, Arak, Iran
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5
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Sebo P, Haller DM, Kaiser C, Zaim A, Heimer O, Chauveau N, Maisonneuve H. Health-related quality of life associated with nocturnal leg cramps in primary care: a mixed methods study. Fam Pract 2022; 39:85-91. [PMID: 34278417 DOI: 10.1093/fampra/cmab082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although nocturnal leg cramps are common, little research is available about their impact on quality of life. This mixed-methods study explored the impact of nocturnal leg cramps on health-related quality of life (HRQoL). METHODS The study included primary care patients (>50 years) who reported suffering from nocturnal leg cramps (2016-2017). In the quantitative phase, patients completed a questionnaire about their HRQoL (SF-36) and the frequency of their cramps, and we computed the SF-36 scores. Then, we conducted a qualitative study using semi-structured interviews with patients with various levels of HRQol to explore their perception of the impact of cramps on their lives. RESULTS A total of 114 patients (49%) agreed to participate in the quantitative study (mean age: 71, women: 62%) and 15 patients were included in the qualitative study (mean age: 69, women: 67%). The number of cramps in the previous week was low (mean: 1.6 (SD 1.5)). The SF-36 mean physical and mental summary scores were 43 and 50, respectively, and the domain scores were similar to a comparative general population. Whilst some patients reported little interference with their daily lives, others reported a major decrease in their HRQoL. SF-36 scores were not sufficient to describe the cramp-related impairment, as patients from all levels of SF-36 scores reported major impacts of NLC in the interviews. CONCLUSIONS Some patients describe a specific impact of cramps on their lives, regardless of their HRQoL. These patients should be the target of future intervention trials.
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Affiliation(s)
- Paul Sebo
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Dagmar M Haller
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland.,Department of Community, Primary Care and Emergency Medicine, Geneva, Switzerland.,Department of Paediatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Céline Kaiser
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Armita Zaim
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Olivier Heimer
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Chauveau
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
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6
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Duncan ADS, Hapca S, De Souza N, Morales D, Bell S. Quinine exposure and the risk of acute kidney injury: a population-based observational study of older people. Age Ageing 2020; 49:1042-1047. [PMID: 32463438 PMCID: PMC7583521 DOI: 10.1093/ageing/afaa079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives to establish and quantify any observable association between the exposure to community prescriptions for quinine and acute kidney injury (AKI) events in a population of older adults. Design two observational studies using the same dataset, a retrospective longitudinal cohort study and a self-controlled case series (SCCS). Setting NHS health board in Scotland. Participants older adults (60+ years) who received quinine prescriptions in Tayside, Scotland, between January 2004 and December 2015. The first study included 12,744 individuals. The SCCS cohort included 5,907 people with quinine exposure and more than or equal to one AKI event. Main outcome measured in the first study, multivariable logistic regression was used to calculate odds ratios (ORs) for AKI comparing between episodes with and without recent quinine exposure after adjustment for demographics, comorbidities and concomitant medications. The SCCS study divided follow-up for each individual into periods ‘on’ and ‘off’ quinine, calculating incidence rate ratios (IRRs) for AKI adjusting for age. Results during the study period, 273,596 prescriptions for quinine were dispensed in Tayside. A total of 13,616 AKI events occurred during follow-up (crude incidence 12.5 per 100 person-years). In the first study, exposure to quinine before an episode of care was significantly associated with an increased probability of AKI (adjusted OR = 1.27, 95% confidence interval (CI) 1.21–1.33). In the SCCS study, exposure to quinine was associated with an increased relative incidence of AKI compared to unexposed periods (IRR = 1.20, 95% CI 1.15–1.26), with the greatest risk observed within 30 days following quinine initiation (IRR = 1.48, 95% CI 1.35–1.61). Conclusion community prescriptions for quinine in an older adult population are associated with an increased risk of AKI.
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Affiliation(s)
- Andrew D S Duncan
- Renal Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - Simona Hapca
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Division of Computing Science and Mathematics, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
| | - Nicosha De Souza
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Daniel Morales
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Samira Bell
- Renal Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
- Division of Population Health and Genomics, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Address correspondence to: Samira Bell.
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7
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Pilot testing a stretching regimen for prevention of night time nocturnal leg cramps. Geriatr Nurs 2020; 41:105-109. [DOI: 10.1016/j.gerinurse.2019.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/13/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022]
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8
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Delacour C, Chambe J, Lefebvre F, Bodot C, Bigerel E, Epifani L, Granda C, Haller DM, Maisonneuve H. Association between physical activity and Nocturnal Leg Cramps in patients over 60 years old: a case-control study. Sci Rep 2020; 10:2638. [PMID: 32060316 PMCID: PMC7021766 DOI: 10.1038/s41598-020-59312-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/24/2020] [Indexed: 11/09/2022] Open
Abstract
Nocturnal Legs Cramps are a frequent disorder, which have a negative impact on quality of life, particularly among patients over 60 years old. Lifestyle factors such as alcohol consumption have been shown to be associated with Nocturnal Leg Cramps. This study aimed to explore the association between nocturnal leg cramps and a sedentary lifestyle among elderly patients. A case-control study was conducted with a Bayesian approach for sensitivity analysis. Patients over 60 years old consulting their family doctor were recruited in the Alsace region, France. Cases were matched with controls free from cramps for age, sex, medical history and medications known to trigger cramps. The level of physical activity was assessed using the Dijon Physical Activity Score (DPAS). We performed univariate and multivariate analyses adjusting for alcohol consumption. 272 participants were matched into 136 pairs. 11% of all were sedentary persons. Adjusting for alcohol consumption, we observed an association between Nocturnal Leg Cramps and a sedentary lifestyle OR = 9.84 (95% credibility interval [1.74; 101.9]; posterior probability 99.68%). Our findings represent an additional argument to promote physical activity to patients over 60 years old. They also highlight the need to develop and evaluate physical activity interventions in the treatment of Nocturnal Legs Cramps.
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Affiliation(s)
- Chloé Delacour
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France.
| | - Juliette Chambe
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - François Lefebvre
- Public Health Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Claire Bodot
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Elodie Bigerel
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Laetitia Epifani
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Céline Granda
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, 1211, Switzerland
| | - Hubert Maisonneuve
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, 67000, France.,Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, 1211, Switzerland
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9
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[Tolerability, compliance, quality of life, and clinical outcome during treatment with quinine sulfate in patients with nocturnal calf cramps. A multicenter non-interventional study (NIS) in adults]. MMW Fortschr Med 2019; 161:24-31. [PMID: 31587167 DOI: 10.1007/s15006-019-0921-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 07/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Frequent and painful nocturnal leg cramps (NLC) require an effective therapy to improve quality of life and sleep performance in patients. METHOD In a multicenter, prospective, non-interventional study (NIS) data on the effectiveness, tolerability and safety of quinine sulfate were collected in daily medical management in adult patients with frequent and painful nocturnal leg cramps. RESULTS In total 596 patients were included into the study. Of these, 568 patients finished the study as planned (95.3%). Number, duration and pain intensity of NLC were reduced in the majority of patients after 2 weeks of therapy with quinine sulfate 200 mg OD. Physicians rated global assessment of treatment effect as "good" and "very good" in 535 patients (92.4%) which was concurrent with the patients' rating ("good" and "very good" by 534 patients = 92.2%), based on the full analysis set of 579 patients. Furthermore, quality of life and sleep were improved. Adverse drug reactions were reported in 35/592 patients (5.9%). Severe adverse events were not observed. The total incidence of therapy-associated adverse effects was comparable in the subgroup of patients with concomitant ß-blocker therapy (149/592 patients, 25.2%; totally 10%, subgroup 10.1%). Efficacy and tolerability of quinine sulfate were evaluated as "very good" or "good" by the majority of physicians and patients. CONCLUSIONS The present NIS confirms effectiveness and tolerability of the therapy with quinine sulfate in daily clinical routine for adult patients with frequent and painful nocturnal leg cramps.
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10
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Delacour C, Chambe J, Lefebvre F, Bodot C, Bigerel E, Epifani L, Granda C, Haller DM, Maisonneuve H. Association Between Alcohol Consumption and Nocturnal Leg Cramps in Patients Over 60 Years Old: A Case-Control Study. Ann Fam Med 2018; 16:296-301. [PMID: 29987076 PMCID: PMC6037509 DOI: 10.1370/afm.2238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 12/21/2017] [Accepted: 03/06/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Nocturnal leg cramps are a specific kind of cramps affecting almost one-half of patients aged 60 years and older. They reduce patients' quality of sleep and have a negative impact on their quality of life. The aim of this study was to evaluate the association between nocturnal leg cramps and the consumption of alcoholic beverages in patients aged 60 years and older attending general practices. METHODS Case-control study with a Bayesian approach for sensitivity analysis. Participants were voluntary ambulatory patients aged 60 years and older consulting their family doctor. They were recruited in 67 general practices across the Alsace region. Cases (patients having cramps), were matched with controls (patients free from cramps) for age, sex, medical history, and medications known to trigger cramps. Alcohol consumption was assessed through a standardized food frequency questionnaire. RESULTS We found an association between the global consumption of alcoholic beverages and nocturnal leg cramps (OR = 6.5, 95% credibility interval, 1.68-38.05; posterior probability 99.82%). CONCLUSION We identified an association between alcohol consumption and nocturnal leg cramps among patients aged 60 years and older attending general practices. These findings have implications for the prevention of cramps.
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Affiliation(s)
- Chloé Delacour
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Juliette Chambe
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - François Lefebvre
- Public Health Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Claire Bodot
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Elodie Bigerel
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Laetitia Epifani
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Céline Granda
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France.,Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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11
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Breen DP, Högl B, Fasano A, Trenkwalder C, Lang AE. Sleep-related motor and behavioral disorders: Recent advances and new entities. Mov Disord 2018; 33:1042-1055. [PMID: 29756278 DOI: 10.1002/mds.27375] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 12/30/2022] Open
Abstract
Patients with sleep-related motor and behavioral disorders present to a variety of subspecialty clinics (neurology, sleep medicine, respiratory medicine, psychiatry). Diagnosing these disorders can be difficult, and sometimes they have a significant impact on quality of life. Alongside a number of common and well-recognized conditions, several new disease entities have been described in recent years that present with abnormal nocturnal motor phenomena (such as ADCY5-associated disease and anti-IgLON5 disease). Our understanding of the neural basis and prognostic significance of other sleep-related disorders has also grown, particularly rapid eye movement sleep behavior disorder. This review (along with a collection of previously unpublished videos) is intended to aid in the recognition and treatment of these patients. The recent change in terminology from nocturnal frontal lobe epilepsy to sleep-related hypermotor epilepsy is also discussed. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- David P Breen
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
| | - Claudia Trenkwalder
- Centre of Parkinsonism and Movement Disorders, Paracelsus-Elena Hospital, Kassel, Germany.,Department of Neurosurgery, University Medical Center, Göttingen, Germany
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
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12
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Lorenzo M, Schaeffer M, Haller DM, Maisonneuve H. Treatment of nocturnal leg cramps by primary care patients over the age of 60. Fam Pract 2018; 35:29-33. [PMID: 28985304 DOI: 10.1093/fampra/cmx062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Approximately one out of two individuals over the age of 60 suffers from nocturnal leg cramps. These often have an important impact on the person's quality of life. Different drug and non-drug treatments are proposed to treat these cramps, but none to date have been shown to be both safe and effective. The objective of this study was to describe the drug and non-drug treatments used by primary care patients suffering from cramps. METHODS We used data collected as part of two cross-sectional surveys of patients aged 60 years and older attending general practices in the French region of Alsace. We asked the participants suffering from cramps if they were currently using a treatment for their cramps. We distinguished potentially harmful from unharmful treatments. RESULTS Overall, 632 patients suffering from cramps were included in our study. Only 133 patients (19.5%) were taking a treatment for cramps. 82 patients used one or several of 17 different drug treatments. 58 patients used one or several of 13 different types of non-drug treatments. Potentially harmful treatments, mostly Quinine made up 16,7% (n = 25) of all treatments used for cramps. CONCLUSIONS This study sheds light on the great diversity of therapeutic practices for cramps in outpatient care. Many of the treatments reported by patients have not previously been described in the medical literature. We recommend GPs to ask their patients about the treatments they take for cramps in order to make sure that they are safe.
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Affiliation(s)
- Mathieu Lorenzo
- Department of General Practice, Faculty of Medicine, University of Strasbourg, Strasbourg, France - Clinical Investigation Unit INSERM - CIC 1434, Strasbourg, France
| | - Mickaël Schaeffer
- Public Health Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Dagmar M Haller
- Primary care unit, University of Geneva, Geneva, Switzerland
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13
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Behringer M, Harmsen JF, Fasse A, Mester J. Effects of Neuromuscular Electrical Stimulation on the Frequency of Skeletal Muscle Cramps: A Prospective Controlled Clinical Trial. Neuromodulation 2017; 21:815-822. [PMID: 29164749 DOI: 10.1111/ner.12728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 09/14/2017] [Accepted: 10/03/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We investigated if neuromuscular electrical stimulation (NMES) of calf muscles prevents spontaneous calf cramps. MATERIALS AND METHODS In 19 individuals affected by more than or equal to one calf cramp per week the gastrocnemius of the predominantly affected leg was stimulated twice a week (intervention leg, IL) over six weeks (3 × 6 stimulation trains at 30 Hz above the individual cramp threshold frequency). The other leg served as control (CL). The participants were advised to record all spontaneous muscle cramps from two weeks before the intervention until two weeks after the last NMES session. RESULTS The number of spontaneous calf cramps in the two weeks after the intervention was 78% lower (2.1 ± 6.8 cramps) in the stimulated (p < 0.001) and 63% lower (2.0 ± 6.9 cramps) in the unstimulated calves (p < 0.001), when compared to the two weeks prior to the intervention (IL: 9.6 ± 12.4 cramps; CL: 5.5 ± 12.7 cramps). Only in the IL, this improvement was accompanied by an increase in the cramp threshold frequency from 15.5 ± 8.5 Hz before the NMES intervention to 21.7 ± 12.4 Hz after the intervention. The severity of the remaining calf cramps tended to be lower in both legs after the intervention. CONCLUSIONS The applied stimulation protocol seems to provide an effective prevention strategy in individuals affected by regular calf cramps.
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Affiliation(s)
- Michael Behringer
- Institute of Sports Sciences, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan-Frieder Harmsen
- German Research Center for Elite Sports-momentum, German Sport University Cologne, Cologne, Germany
| | | | - Joachim Mester
- German Research Center for Elite Sports-momentum, German Sport University Cologne, Cologne, Germany
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14
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O'Keeffe ST. Summertime blues? A re-examination of the seasonality of web searches for restless legs and leg cramps. Sleep Med 2017; 37:119-123. [DOI: 10.1016/j.sleep.2017.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/21/2017] [Accepted: 06/24/2017] [Indexed: 10/19/2022]
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Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One 2017; 12:e0178465. [PMID: 28586374 PMCID: PMC5460850 DOI: 10.1371/journal.pone.0178465] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 05/13/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Nocturnal leg cramps (NLC) are common and poorly understood. OBJECTIVE To determine the prevalence of NLC and associations with cardiometabolic, sleep, and behavioral risk factors in the US population. DESIGN Cross-sectional epidemiology. PARTICIPANTS National Health and Nutrition Examination Survey, 2005-2006 and 2007-2008 waves. MAIN OUTCOME(S) AND MEASURE(S) NLC were assessed with, "In the past month, how often did you have leg cramps while trying to sleep?" Responses were categorized as None, Mild, or Moderate-Severe. Demographics, medical history, sleep disturbances, and cardiometabolic risk factors were evaluated using the 2005-2006 dataset. Variables that demonstrated significant relationships to NLC after adjusting for age, sex, education, and BMI were assessed in the 2007-2008 dataset. Variables that were still significant were entered into a forward stepwise regression model combining both waves, to determine which variables best explained the variance in NLC. RESULTS Prevalence was 24-25% reporting mild and 6% reporting moderate-severe NLC. NLC increased with age, lower education, unemployment, shorter sleep duration, all assessed sleep symptoms (nocturnal "leg jerks", snoring, snorting/gasping, difficulty falling asleep, difficulty maintaining sleep, non-restorative sleep, sleepiness, use of sleep medications), higher BMI, smoking, medical history (hypertension, heart failure, angina, stroke, arthritis, respiratory disease, and cancer), depression symptoms, and biomarkers (CRP, HbA1c, calcium, cadmium, red blood cells). Stepwise analysis showed that moderate-severe nocturnal leg cramps were associated with (in decreasing order of partial R2): leg jerks, poor overall health, arthritis, difficulty falling asleep, age, nonrestorative sleep, red blood cell count, lower education, angina, and difficulty maintaining sleep. CONCLUSIONS AND RELEVANCE Based on this first large, representative study, NLC occurring >5x per month are reported by 6% of the adult US population. Sleep disturbance symptoms and health conditions are associated with higher frequency of NLC, suggesting that NLC is a marker, and possibly contributor, to poor sleep and general health.
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Affiliation(s)
- Michael A. Grandner
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States of America
| | - John W. Winkelman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
- Department Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America
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