Intradialytic Massage for Leg Cramps Among Hemodialysis Patients: a Pilot Randomized Controlled Trial

Background: Patients on hemodialysis often experience muscle cramps that result in discomfort, shortened treatment times, and inadequate dialysis dose. Cramps have been associated with adversely affecting sleep and health-related quality of life, depression and anxiety. There is limited evidence available about massage in dialysis; however, massage in cancer patients has demonstrated decreases in pain, inflammation, and feelings of anxiety. These correlations indicate massage may be an effective treatment modality for hemodialysis-related lower extremity cramping.Purpose: To determine the effectiveness of intradialytic massage on the frequency of cramping among hemodialysis patients prone to lower extremity cramping.Participants: 26 maintenance hemodialysis patients with frequent lower extremity cramps.Setting: three outpatient hemodialysis centers in Northeast Ohio.Research Design: randomized controlled trial.Intervention: The intervention group received a 20-minute massage of the lower extremities during each treatment (three times per week) for two weeks. The control group received usual care by dialysis center staff.Main Outcome Measure: change in frequency of lower leg cramping.Results: Patient reported cramping at home decreased by 1.3 episodes per week in the intervention group compared to 0.2 episodes per week in the control group (p=.005). Patient reported cramping during dialysis decreased by 0.8 episodesin the intervention group compared to 0.4 episodes in the control group (p=0.44).Conclusion: Intradialytic massage appears to be an effective way to address muscle cramping. Larger studies with longer duration should be conducted to further examine this approach

Language endangerment and language documentation in Africa

Non peer reviewe

African Linguistics in Central and Eastern Europe, and in the Nordic Countries

Non peer reviewe

State of the world’s plants and fungi 2020

Kew’s State of the World’s Plants and Fungi project provides assessments of our current knowledge of the diversity of plants and fungi on Earth, the global threats that they face, and the policies to safeguard them. Produced in conjunction with an international scientific symposium, Kew’s State of the World’s Plants and Fungi sets an important international standard from which we can annually track trends in the global status of plant and fungal diversity

Book Review: Questioning Protocol

In her review of Questioning Protocol by Randi Redmond Oster, Barbara Lewis shares how this new and award winning book takes the reader on Randi Oster\u27s harrowing journey of navigating the healthcare system while helping her teenage son’s battle with Crohn’s disease. Seventeen chapters build a chronological story of success, frustration and failure in dealing with modern medicine and a healthcare industry that may appear foreign to the outsider

Book Review: Questioning Protocol

In her review of Questioning Protocol by Randi Redmond Oster, Barbara Lewis shares how this new and award winning book takes the reader on Randi Oster\u27s harrowing journey of navigating the healthcare system while helping her teenage son’s battle with Crohn’s disease. Seventeen chapters build a chronological story of success, frustration and failure in dealing with modern medicine and a healthcare industry that may appear foreign to the outsider