Highlights
- •Patients with restless legs syndrome often experience relief by cold.
- •Cold chamber treatment (−60 °C) resulted in symptom relief in these patients.
- •Cryotherapy might be used as an additional treatment option in restless legs syndrome.
Abstract
Objective
Treatment of restless legs syndrome (RLS) is primarily based on drugs. Since many
patients report improvement of symptoms due to cooling their legs, we examined the
efficacy of cryotherapy in RLS.
Patients and methods
35 patients (28 women, 60.9 ± 12.5 years) with idiopathic RLS and symptoms starting not later than 6 pm were randomized into three groups: cold air chamber at −60 °C (n = 12); cold air chamber at −10 °C (n = 12); local cryotherapy at −17 °C (n = 11). After a two week baseline, the different therapies were applied three minutes
daily at 6 pm over two weeks, followed by a four week observation period. The patients completed
several questionnaires regarding RLS symptoms, sleep, and quality of life on a weekly
basis (IRLS, ESS), VAS and sleep/morning protocol were completed daily, MOSS/RLS-QLI
were completed once in each period. Additionally, the PLM index was measured by a
mobile device at the end of baseline, intervention, and follow-up. The IRLS score
was chosen as primary efficacy parameter.
Results
At the end of follow-up, significant improvement of RLS symptoms and quality of life
could be observed only in the −60 °C group as compared to baseline (IRLS: p = 0.009; RLS-QLI: p = 0.006; ESS: p = 0.020). Local cryotherapy led to improvement in quality of life (VAS4: p = 0.028; RLS-QLI: p = 0.014) and sleep quality (MOSS: p = 0.020; MOSS2: p = 0.022) but not in IRLS and ESS. In the −10 °C group, the only significant effect was shortening of number of wake phases per
night. Serious side-effects were not reported.
Conclusions
Whole body cryotherapy at −60 °C and, to a less extent, local cryotherapy seem to be a treatment option for RLS
in addition to conventional pharmacological treatment. However, the exact mode of
cryotherapy needs to be established.
Keywords
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Article info
Publication history
Published online: September 08, 2016
Accepted:
September 6,
2016
Received in revised form:
August 8,
2016
Received:
June 7,
2016
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
