(563) Nocturnal leg cramps

  I read a study about nocturnal leg cramps, which was done by University Medical Center Groningen, Groningen University the Netherlands. The answer to this question, "Does stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults?" was yes. Nightly stretching before going to sleep reduces the frequency and severity of nocturnal leg cramps in older adults.

Stretches used in the experimental group; (a) calf stretch in standing, (b) hamstring stretch in standing, (c) hamstring and calf stretch in sitting.

  I tried stretches before sleep, but I did Makkouhou　（真向法） stretching instead. I did it for less than 3 minutes.

So far, I have done these stretches before sleep for about a week. It works, I think.

Introduction

Nocturnal leg cramps are suddenly occurring, episodic1), painful, sustained, involuntary muscle contractions of the calf muscles, hamstrings2), or foot muscles. During the cramp, the involved muscles are tender and hard on palpation3). The pain that occurs with these contractions is sharp and intense and may last from seconds to several minutes. Although they are otherwise benign4), nocturnal leg cramps can cause substantial5) distress6) and can disrupt7) sleep. In 20% of people who experience nocturnal leg cramps, cramps also occur during the daytime (Monderer et al 2010). The cramps sometimes occur in episodes a few days a week, during which they repeat themselves (Kanaan and Sawaya, 2001, Stewart et al 1993, Mondere et al 2010). Although the insults8) generally persist for no longer than ten minutes, in exceptional situations they can continue for several hours. In approximately 2% of cases, nocturnal leg cramps occur weekly (Abkulla et al 1999). Nocturnal leg cramps occur more commonly with advancing age, affecting between 38% and 50% of the elderly (Butler et al 2002, Abulla et al 1999, Sotag and Wanner, 1988). Nocturnal leg cramps are more prevalent9) among women and among people with comobidities10), especially those with neurological11) and cardiovascular12) diseases (Butler et al 2002, Stewart et al 1993).
1) episodic: 時折起こる
2) hamstring: 人間のひざの後ろの腱
3) palpation: 触診
4) benign: [bɪnάɪn] 良性の
5) substantial: plentiful　相当な
6) distress: suffering 苦悩
7) disrupt: 中断する
8) insults: 発作
9) prevalent: はやっている
10) comorbidity: 共存症
11) neurological: 神経性の
12) cardiovascular: 循環器系の

Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults. A randomized 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 concealed13) allocation14) and intention-to-treat analysis15). 
13) concealed: 隠した
14) allocation: 割り当て、配置
15) intention-to-treat: ITT分析、包括解析

Participants
Eighty adults aged over 55 years with nocturnal leg cramps who were not being treated with quinine16).
16) quinine: kwάɪnɑɪn(米国英語), kwɪníːn(英国英語)、キニーネ剤（マラリア特効薬）

Intervention17)
The experimental group performed stretches of the calf and hamstring muscles nightly, immediately before going to sleep, for six weeks. The control group18) performed no specific stretching exercises. Both groups continued other usual activities.
17) intervention: 治療介入
18) control group: 操作を加えないままにしてあるグループ

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% CI19) 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 difference20) 1.3 cm (95% CI 0.9 to 1.7) on the 10-cm visual analogue scale.
19) 95% CI: 95%confidence interval 95%信頼区間20) mean difference: 治療群の数値の平均値とコントロール群の数値の平均値の差

Conclusion
Nightly stretching before going to sleep reduces the frequency and severity of nocturnal leg cramps in older adults.
Trial registration
NCT01421628
*