Managing nocturnal leg cramps — calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial
Managing nocturnal leg cramps — calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial
Background: quinine is a common treatment for nocturnal leg cramps but has potential side effects. An uncontrolled study suggested that calf-stretching exercises could prevent nocturnal leg cramps (night cramps) but these findings have never been confirmed.
Aim: to assess the effect of calf-stretching exercises and cessation of quinine treatment for patients with night cramps taking quinine.
Design of study: randomised controlled trial.
Setting: twenty-eight general practices in southern England.
Method: one hundred and ninety-one patients prescribed quinine for night cramps were randomised to one of four groups defined by two 'advice' factors: undertake exercises and stop quinine. After 6 weeks they were advised that they could take quinine and undertake the exercises freely. Documentation of cramp at 12 weeks was achieved in 181 (95%) patients. Main outcome measures were: symptom burden score, and frequency of night cramps and quinine usage.
Results: at 12 weeks there was no significant difference in number of cramps in the previous 4 weeks (exercise = 1.95, 95% confidence interval [CI] = -3.01 to 6.90; quinine cessation = 3.45, 95% CI = -1.52 to 8.41) nor symptom burden or severity of cramps. However, after 12 weeks 26.5% (95% CI = 13.3% to 39.7%) more patients who had been advised to stop quinine treatment reported taking no quinine tablets in the previous week (odds ratio [OR] = 3.32, 95% CI = 1.37 to 8.06), whereas advice to do stretching exercises had no effect (OR = 0.73, 95% CI = 0.27 to 1.98).
Conclusions: calf-stretching exercises are not effective in reducing the frequency or severity of night cramps. Advising those on long-term repeat prescriptions to try stopping quinine temporarily will result in no major problems for patients, and allow a significant number to stop medication.
exercise therapy, muscle cramp, nocturnal leg cramps, primary health care, quinine, ransomised controlled, trials
186-191
Coppin, Richard J.
4be9cd55-a3f2-406b-8b32-5e461e6cf06d
Wicke, Dorothy M.
1501d861-4f31-4a41-a26d-158b7c7ec490
Little, Paul S.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
March 2005
Coppin, Richard J.
4be9cd55-a3f2-406b-8b32-5e461e6cf06d
Wicke, Dorothy M.
1501d861-4f31-4a41-a26d-158b7c7ec490
Little, Paul S.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Coppin, Richard J., Wicke, Dorothy M. and Little, Paul S.
(2005)
Managing nocturnal leg cramps — calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial.
British Journal of General Practice, 55 (512), .
Abstract
Background: quinine is a common treatment for nocturnal leg cramps but has potential side effects. An uncontrolled study suggested that calf-stretching exercises could prevent nocturnal leg cramps (night cramps) but these findings have never been confirmed.
Aim: to assess the effect of calf-stretching exercises and cessation of quinine treatment for patients with night cramps taking quinine.
Design of study: randomised controlled trial.
Setting: twenty-eight general practices in southern England.
Method: one hundred and ninety-one patients prescribed quinine for night cramps were randomised to one of four groups defined by two 'advice' factors: undertake exercises and stop quinine. After 6 weeks they were advised that they could take quinine and undertake the exercises freely. Documentation of cramp at 12 weeks was achieved in 181 (95%) patients. Main outcome measures were: symptom burden score, and frequency of night cramps and quinine usage.
Results: at 12 weeks there was no significant difference in number of cramps in the previous 4 weeks (exercise = 1.95, 95% confidence interval [CI] = -3.01 to 6.90; quinine cessation = 3.45, 95% CI = -1.52 to 8.41) nor symptom burden or severity of cramps. However, after 12 weeks 26.5% (95% CI = 13.3% to 39.7%) more patients who had been advised to stop quinine treatment reported taking no quinine tablets in the previous week (odds ratio [OR] = 3.32, 95% CI = 1.37 to 8.06), whereas advice to do stretching exercises had no effect (OR = 0.73, 95% CI = 0.27 to 1.98).
Conclusions: calf-stretching exercises are not effective in reducing the frequency or severity of night cramps. Advising those on long-term repeat prescriptions to try stopping quinine temporarily will result in no major problems for patients, and allow a significant number to stop medication.
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More information
Published date: March 2005
Keywords:
exercise therapy, muscle cramp, nocturnal leg cramps, primary health care, quinine, ransomised controlled, trials
Identifiers
Local EPrints ID: 24311
URI: http://eprints.soton.ac.uk/id/eprint/24311
ISSN: 0960-1643
PURE UUID: c6e7b12d-0958-4252-b832-862214201c68
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Date deposited: 29 Mar 2006
Last modified: 11 Jul 2024 01:34
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Contributors
Author:
Richard J. Coppin
Author:
Dorothy M. Wicke
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