By Howard Brody
In an old joke, when a patient says, "My head hurts when I bang it against the wall," the doc replies: "Then stop banging your head against the wall."
Could it be that, if the patient says, "I feel like I want to move my legs," the doc should say: "Maybe you should move your legs"?
Few people had heard of restless legs syndrome a while ago, but now it is well known, thanks to a profusion of TV ads. I'm sure it is only a coincidence that an expensive brand-name drug, specifically approved for restless legs, was recently released on the market.
In its more severe form, RLS is no joke; it usually occurs at night and can be a serious disrupter of sleep. But, of course, many people have a mild form, not the really bad kind.
A group at Penn State and East Tennessee State University noticed that, while a number of research studies had been done showing that drugs could help RLS, no one so far had yet tested exercise - even though there was some preliminary evidence that people who exercised more had less RLS.
So they did a controlled trial in which people with RLS symptoms were randomly assigned for 12 weeks to no exercise, or to a program that included treadmill work, for aerobic exercise, and lower-body weight-resistance training. The group went to a facility for their exercises three times a week.
The study had a problem with numbers. They started out with 43 patients enrolled but ended up with data on only 23.
Most of the dropouts occurred with the no-exercise group.
If you start with low numbers, and if you have so many drop-outs, your results cannot be seen as very reliable evidence.
Nevertheless, what the researchers found sounded promising. They measured RLS symptoms on a standard scale, on which 40 points is as bad as you can get. Everyone at the start of the study had about 21 points on the scale.
The no-exercise group did not budge throughout the 12 weeks.
The exercise folks had gone down from 21 points to 12 points by the sixth week and stayed at that level through 12 weeks.
What's the take-home message? Given the low-risk nature of the exercise program, it would seem reasonable that, while waiting for more evidence, anyone with mild RLS should give some thought to trying out this type of exercise program.
Even if it did not help their RLS, it ought to improve their health in other ways. It's hard to see how they could lose and, if their RLS got a lot better, they could be big winners.
Dr. Howard Brody, a family physician, is director of the Institute for Medical Humanities at the University of Texas Medical Branch at Galveston. This column is not intended to replace the advice of a physician.
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