Non-pharmacological interventions for improving restless legs syndrome in hemodialysis patients:a network Meta-analysis

CHANG Zhongwen; ZHAO Qian; HE Yapeng; XU Huize; ZHAO Jian; ZHU Dongge; HAN Minghua

doi:10.12102/j.issn.1009-6493.2025.08.009

Abstract：Objective:To evaluate the effect of different non-pharmacological interventions on restless legs syndrome in hemodialysis patients by network meta-analysis,and to provide evidence for clinical nursing.Methods:The relevant randomized controlled trials in PubMed,CINAHL,the Cochrane Library,EMbase,Web of Science,CNKI,WanFang database,VIP,and CBM databases were searched by computer.The retrieval time was from database establishment to November 30,2023.The quality of the included literatures was evaluated using the Cochrane handbook.A network Meta-analysis was performed using StataSE 15.0 software to rank interventions by cumulative ranking of areas under the probability curve.Funnel plot was drawn for publication bias test.Results:A total of 33 articles were included,involving 2 065 patients,including 22 non-pharmacological interventions.Network Meta-analysis results showed,cool dialysate,lavender essential oil massage,glycerin massage,sweet orange essential oil massage,acupoint application,Chinese medicine foot bath combined with acupuncture,reflexology,Chinese medicine foot bath and point massage,bicycle exercise and Chinese medicine foot bath were superior to the control group in improving the symptoms of restless legs in dialysis patients,SUCRA values were 99.6％,92.2％,75.4％,72.1％,67.9％,67.4％,65.6％,57.2％,47.7％,and 41.9％,respectively.Stretching exercises were the most effective in improving sleep,followed by reflexology and aerobic exercise,SUCRA values were 84.0％,80.7％and 79.4％,respectively.Conclusion:Non-pharmacological intervention has obvious effect on the improvement of restless legs syndrome in hemodialysis patients.Low temperature dialysis is the best intervention measure to improve restless leg symptoms in hemodialysis patients.And stretching exercise is the best intervention measure to improve sleep conditions.In the future,evidence-based non-pharmacological interventions could be used in clinical practice.