Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial

Question: In adults who experience nocturnal leg cramps, does stretching of the calf and hamstring muscles each day just before sleep reduce the frequency and severity of the cramps? Design: A randomised trial with concealed allocation and intention-to-treat analysis. Participants: Eighty adults aged over 55 years with nocturnal leg cramps who were not being treated with quinine. Intervention: The experimental group performed stretches of the calf and hamstring muscles nightly, immediately before going to sleep, for six weeks. The control group performed no specific stretching exercises. Both groups continued other usual activities. Outcome measures: Participants recorded the frequency of nocturnal leg cramps in a daily diary. Participants also recorded the severity of the pain associated with nocturnal leg cramps on a 10-cm visual analogue scale. Adverse events were also recorded. Results: All participants completed the study. At six weeks, the frequency of nocturnal leg cramps decreased significantly more in the experimental group, mean difference 1.2 cramps per night (95% Cl 0.6 to 1.8). The severity of the nocturnal leg cramps had also decreased significantly more in the experimental group than in the control group, mean difference 1.3 cm (95% Cl 0.9 to 1.7) on the 10-cm visual analogue scale. Conclusion: Nightly stretching before going to sleep reduces the frequency and severity of nocturnal leg cramps in older adults. Trial registration: NCT01421628. [Hallegraeff JM, van der Schans CP, de Ruiter R, de Greet MHG (2012) Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. Journal of Physiotherapy 58: 17-22]