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Managing nocturnal leg cramps — calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial

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), pp. 186-191.

Record type: Article

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

Catalogue record

Date deposited: 29 Mar 2006
Last modified: 17 Jul 2017 16:13

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Contributors

Author: Richard J. Coppin
Author: Dorothy M. Wicke
Author: Paul S. Little

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