Treatment of Willis-Ekbom Disease (Restless Leg Syndrome); The Efficacy of Mulligan's Traction Straight Leg Raise among Paramedical Professionals.

Main Article Content

Usman Iqbal Janjua
Huma Andleeb
Rimsha Farooq
Muhammad Abdullah
Imran Rafiq
Syeda Mahnoor Hassan

Abstract

Background: Restless Leg Syndrome (RLS) is a generalized neurological sensory-motor disorder characterized by intense restlessness and discomfort in the lower extremities, leading to an urge to move the legs at sleep time. Treatment protocols for RLS may include thermotherapy, stretching exercises, and Mulligan’s traction straight leg raise (SLR). Mulligan’s traction SLR is an effective method that influences peripheral and central neural pathways through mobilization, thereby alleviating RLS symptoms.


Objective: The study aimed to compare the efficacy of stretching exercises and Mulligan traction straight leg raise in reducing RLS severity among paramedical staff.


Methods: This randomized clinical trial included a sample size of 38 paramedical staff members diagnosed with RLS using standard criteria. Participants were allocated using the Convenient Sampling Technique and randomly assigned into Group 1 (Stretching Exercises) and Group 2 (Mulligan Traction SLR) through coin tossing. Each group consisted of 19 participants. The interventions were conducted three times per week for one month. Assessments were made using the RLS Severity Scale, Numeric Pain Rating Scale, Groningen Sleep Quality Scale, and Goniometer at baseline, and after the 2nd and 4th weeks of treatment.


Results: The study indicated that both treatments were effective in treating RLS, showing a significant difference with p<0.05. However, Mulligan's TSLR exhibited remarkable results in improving sleep quality, increasing SLR range of both legs, reducing pain intensity, and improving RLS symptoms, with p-values of 0.001, 0.000, 0.012, and 0.001, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26.


Conclusion: The study concluded that both Stretching Exercises and Mulligan's TSLR are effective treatments for RLS. However, Mulligan's TSLR showed superior effectiveness in reducing pain levels, RLS symptoms, and in improving sleep quality and SLR range among paramedical staff members.

Article Details

How to Cite
Janjua, U. I., Andleeb, H., Farooq, R., Abdullah, M., Rafiq, I., & Hassan, S. M. (2023). Treatment of Willis-Ekbom Disease (Restless Leg Syndrome); The Efficacy of Mulligan’s Traction Straight Leg Raise among Paramedical Professionals. Journal of Health and Rehabilitation Research, 3(2), 1052–1057. https://doi.org/10.61919/jhrr.v3i2.248
Section
Articles
Author Biographies

Usman Iqbal Janjua, Elite College of Management Sciences-Gujranwala.

Head of Department, Department of Physical Therapy.

Huma Andleeb, Khalid Mahmood Institute of Medical Sciences-Sialkot.

Lecturer.

Imran Rafiq, Elite College of Management Sciences-Gujranwala.

Principal, Department of Physical Therapy.

Syeda Mahnoor Hassan, Elite College of Management Sciences-Gujranwala.

Lecturer, Department of Physical Therapy.

References

Kamble PA, Jadhav A, Yadav T, Chotai K. Effect of Mulligan’s traction straight leg raise in nurses with restless leg syndrome. Int J Health Sci Res. 2019;9(9):296-300.

Ameri M, Mirhosseini S, Basirinezhad MH, Ebrahimi H. Prevalence of Restless Legs Syndrome and Its Relationship with Fatigue in Critical Care Nurses. Indian J Crit Care Med. 2021;25(11):1275-9.

Jafarimanesh H, Vakilian K, Mobasseri S. Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: A randomized clinical trial. Complement Ther Med. 2020;50:102409.

Giannaki CD, Hadjigeorgiou GM, Karatzaferi C, Maridaki MD, Koutedakis Y, Founta P, et al. A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Nephrol Dial Transplant. 2013;28(11):2834-40.

Nagandla K, De S. Restless legs syndrome: pathophysiology and modern management. Postgrad Med J. 2013;89(1053):402-10.

Dinkins EM, Stevens-Lapsley J. Management of symptoms of Restless Legs Syndrome with use of a traction straight leg raise: a preliminary case series. Man Ther. 2013;18(4):299-302.

Shahgholian N, Jazi SK, Karimian J, Valiani M. The effects of two methods of reflexology and stretching exercises on the severity of restless leg syndrome among hemodialysis patients. Iran J Nurs Midwifery Res. 2016;21(3):219-24.

Aliasgharpour M, Abbasi Z, Pedram Razi S, Kazemnezhad A. The Effect of Stretching Exercises on Severity of Restless Legs Syndrome in Patients on Hemodialysis. Asian J Sports Med. 2016;7(2):e31001.

Ameri M, Ebrahimi H, Khosravi A, Mirhosseini S, Khatibi MR. Effect of Local Warm Compression on Restless Leg Syndrome and Fatigue among Critical Care Nurses: A Parallel Randomized Clinical Trial. Critical care research and practice. 2022;2022.

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Archives of internal medicine. 2005;165(11):1286-92.

Kamble PA, Jadhav AS, Yadav T, Chotai K. Effect of Mulligan’s traction straight leg raise in nurses with restless leg syndrome. Int J Health Sci Res. 2019;9(9):296-300.

Fatima A, Mehmood Z, Ahmad S. Effects of Mulligan Traction Straight Leg Raise Versus Passive Straight Leg Raise in Lumbar Radiculopathy Patients. Journal of Islamic International Medical College (JIIMC). 2022;17(2):86-90.

Çoban Ö, Ün Yıldırım N, Yaşa ME, Sonkaya AR. Effects of Different Exercise Programs on Symptoms, Sleep, and Quality of Life in Patients with Primary Restless Legs Syndrome. Movement Disorders Clinical Practice. 2023;10(9):1349-59.

Ameri M, Mirhosseini S, Basirinezhad MH, Ebrahimi H. Prevalence of restless legs syndrome and its relationship with fatigue in critical care nurses. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2021;25(11):1275.

Ergin N, Kılıç BB, Ergin A, Varlı S. Sleep quality and related factors including restless leg syndrome in medical students and residents in a Turkish university. Sleep and Breathing. 2022;26(3):1299-307.

Fauzi A, Triaswati R. The effect of intradialytic stretching training on restless legs syndrome and sleep quality in hemodialysis patients. Korean Journal of Adult Nursing. 2021;33(1):37-43.

Aliasgharpour M, Abbasi Z, Razi SP, Kazemnezhad A. The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian journal of sports medicine. 2016;7(2).

Shamekh AH, Hassan NZ, Rashwan ZI, Fathalla NF. Effect of stretching exercises versus thermotherapy on restless legs syndrome symptoms, pain, and quality of sleep among pregnant women. International Journal of Health Sciences. 2022;6(S6):11204-20.

Pawar AH, Metgud S. Comparative effectiveness of Mulligan’s traction straight leg raise and bent leg raise in low back ache with radiculopathy—a randomized clinical trial: Citeseer; 2010.

Hall T, Cacho A, McNee C, Riches J, Walsh J. Effects of the Mulligan traction straight leg raise technique on range of movement. Journal of Manual & Manipulative Therapy. 2001;9(3):128-33.