Abstract
Restless leg syndrome (RLS) disrupts sleep, affecting the quality of life of patients with various chronic diseases. We assessed the prevalence of RLS in peripheral artery disease (PAD) patients and the effects of a pain-free exercise program. A total of 286 patients with claudication were enrolled in a home-based low-intensity exercise program prescribed at the hospital. RLS was determined through standardized questions. Hemodynamics, degree of calf deoxygenation, and mobility were assessed using the ankle-brachial-index, a treadmill test assisted by near-infrared spectroscopy and the 6-min walk test, respectively. During hospital visits, persistence of RLS, adherence to exercise, hemodynamics, and mobility were assessed. At the enrollment, 101 patients (35%) presented RLS, with higher prevalence among females (p = 0.032). Compared to RLS-free patients, they showed similar hemodynamics but more severe calf deoxygenation (p < 0.001) and lower mobility (p = 0.040). Eighty-seven RLS patients (83%) reported the disappearance of symptoms after 39 (36−70) days of exercise. This subgroup, compared to nonresponders, showed higher adherence (p < 0.001), hemodynamic (p = 0.041), and mobility improvements (p = 0.003). RLS symptoms were frequent in PAD but were reduced by a pain-free walking exercise aimed at inducing peripheral aerobic adaptations. The concomitant recovery of sleep and mobility may represent a synergistic action against the cardiovascular risk in PAD.
Highlights
Restless legs syndrome (RLS), a common sensory-motor disorder with a relatively high prevalence in older people and females, causes unpleasant sensations in patients’ limbs and induces patients to move their legs [1,2,3,4]
A total of 286 patients were evaluated upon enrollment in the rehabilitation program
All of the patients presented with nighttime symptoms, and the majority of the patients had intermittent RLS (n = 90)
Summary
Restless legs syndrome (RLS), a common sensory-motor disorder with a relatively high prevalence in older people and females, causes unpleasant sensations in patients’ limbs and induces patients to move their legs [1,2,3,4]. RLS symptoms exhibit a distinct circadian pattern, with an increase in both sensory and motor symptoms in the evening and at night [5]. Immobility plays an important role, and a worsening of RLS symptoms by nocturnal immobility is closely linked to intrinsic circadian variations [6]. Periodic limb movements during sleep show a nocturnal pattern, with most of the movements peaking at the beginning of the night, preceding the evening melatonin rise [7]. An association between RLS and a high risk of suicide and self-harm, independent of comorbidities and conditions, has been recently reported [11]
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