title: Intradialytic Massage for Leg Cramps Among Hemodialysis Patients: a Pilot Randomized Controlled Trial.
abstract: BACKGROUND
  Patients on hemodialysis often experience muscle cramps that result in discomfort, shortened treatment times, and inadequate dialysis dose. Cramps have been associated with adversely affecting sleep and health-related quality of life, depression and anxiety. There is limited evidence available about massage in dialysis; however, massage in cancer patients has demonstrated decreases in pain, inflammation, and feelings of anxiety. These correlations indicate massage may be an effective treatment modality for hemodialysis-related lower extremity cramping.
  
  
  OBJECTIVE
  To determine the effectiveness of intradialytic massage on the frequency of cramping among hemodialysis patients prone to lower extremity cramping.
  
  
  METHODS
  26 maintenance hemodialysis patients with frequent lower extremity cramps.
  
  
  METHODS
  three outpatient hemodialysis centers in Northeast Ohio.
  
  
  METHODS
  randomized controlled trial.
  
  
  METHODS
  The intervention group received a 20-minute massage of the lower extremities during each treatment (three times per week) for two weeks. The control group received usual care by dialysis center staff.
  
  
  METHODS
  change in frequency of lower leg cramping.
  
  
  RESULTS
  Patient reported cramping at home decreased by 1.3 episodes per week in the intervention group compared to 0.2 episodes per week in the control group (p=.005). Patient reported cramping during dialysis decreased by 0.8 episodes in the intervention group compared to 0.4 episodes in the control group (p=0.44).
  
  
  CONCLUSIONS
  Intradialytic massage appears to be an effective way to address muscle cramping. Larger studies with longer duration should be conducted to further examine this approach.
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Mastnardo
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Janice M
authors.initials: JM
authors.lastname: Lewis
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Kristi
authors.initials: K
authors.lastname: Hall
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Sullivan
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Katrice
authors.initials: K
authors.lastname: Cain
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Theurer
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Huml
authors.affiliation: Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Ashwini R
authors.initials: AR
authors.lastname: Sehgal
keywords: dialysis; massage; muscle cramping