The effect of nonpharmacologic interventions for muscle cramps and restless-leg syndrome in hemodialysis patients: A meta-analysis of randomized controlled trials

Introduction: We performed a meta-analysis to evaluate the effect of the nonpharmacologic interventions on muscle related symptoms including cramping and restless leg syndrome in hemodialysis patients.Methods: Articles published between 2002 and 2022 were searched in six databases. The standardized mean differences were determined by the upper and lower limits of 95% confidence intervals. Publication bias was assessed by conducting the Egger test and examined visually using a funnel plot. Results: Fourteen studies were included in this meta-analysis. The types of interventions included exercise (n = 5), aromatherapy (n = 5), reflexology (n = 3), massage (n = 1), and acupressure (n = 1). The methodological quality assessment revealed 13 studies were strong quality, while only one study was moderate quality. The Egger test indicated no significant publication biases.Conclusion: Healthcare professionals can use non-pharmacological methods to manage muscle-related symptoms because of not only beneficial effects but also it is practical, well-tolerated, easy integrated into the treatment and care.