The present study focused on reducing the level of muscle cramps of patients undergoing haemodialysis by providing intradialytic stretching exercises during the third and fourth hour of a haemodialysis. Literatures related to the intradialytic stretching exercises on reduction of muscle cramps were reviewed. It revealed that intradialytic exercise every 20 minutes during the last two hours of dialysis helped to reduce and even prevent muscle cramps.
Some of the other studies revealed that stretching before sleep reduces the nocturnal leg cramps. There were many studies tested the level of muscle cramps by performing resistance exercises than the stretching exercises. Most of the studies were focused on the muscle loss, functional performance, and the efficacy of the haemodialysis. Hence this study was focused on the reduction of muscle cramps and incorporated this intradialytic stretching exercises as an evidenced based nursing practice.
The design adopted for this study is pre-test post-test with control group, which is a type of quasi-experimental research design. The study was conducted on 30 samples those who had muscle cramps during the haemodialysis, during a period of 4 weeks in Dialysis unit Sundaram hospital, Trichy. After obtaining an informed consent, Demographic data was collected by an interview method, level of muscle cramps was assessed using the self made muscle cramp questionnaire chart (0-13 scores) which is comprehensively scored with the various features of muscle cramps.
The intradialytic stretching exercises were given passively to the samples during the third and fourth hour of haemodialysis for a period of 20 minutes twice per sitting. Data were categorized and analyzed using descriptive (mean, percentage, and standard deviation) and inferential statistics (independent paired "t" test, chi-square analysis).
Major Findings of the Study:
Thirty demographic variables were assessed the distribution of demographic variables among the patient undergoing Haemodialysis with muscle cramps. This study revealed that according to their demographic variables majority of the subjects 16 (53.3%) were in the age group of 51-60 years,Gender 20 (66.7%) were Male, Religion 26 (86.7%) were Hindu, Education 10 (33.3%) were collegiate, Occupation 09(30.0%) were of Home maker and 09 (30.0%) were of Government employee.
According to Family income 10 (33.3%) were between 5001-10000, Marital status 30(100%) were married, Locality 20 (66.7%) were urban, Duration of treatment 17 (56.7%) were of less than one year and food habits 13 (43.3%) were of non-vegetarian.
The study shows the level of muscle cramps before and after the intradialytic stretching exercise. It shows that majority of the patients undergoing haemodialysis had severe 26 (86.67%) muscle cramps before the intradialytic stretching exercise and 4 (13.33%) patients had moderate muscle cramps. But after the intervention of intradialytic stretching exercise 18(60%) had severe muscle cramps. 12 (40%) had moderate muscle cramps. And this value shows that there is a significant improvement in the reduction of muscle cramps after the intervention of intradialytic stretching exercises.
Assessment of pre-test and post-test levels of muscle cramps among the patients undergoing haemodialysis. The value of t is -10.074721. The value of p is < 0.00001. The result is significant at p ≤ 0.05.
Assessment of association between the post test scores of muscle cramps among the patients undergoing haemodialysis with demographic variables shows that there is a significant association such as gender, education and locality. But there is no any significance association between age, religion, occupation, family income, marital status, duration of treatment, Food habits.
* Significant at P< 0.05.
CONCLUSION:
Muscle cramps are the most prevalent intradialytic complication and it is a subjective feeling that can be expressed by all the patients. There are many pharmacological and non pharmacological measures are adopted to treat the muscle cramps but the data from various studies revealed that there were no complete relief from the cramps. This study was taken up to assess the effectiveness of intradialytic stretching exercises on the reduction of muscle cramps among patients undergoing haemodialysis at Sundaram hospital, Trichy. Intradialytic stretching exercises is an effective method which can be used as a preventive therapy in the treatment of muscle cramps. By conclusion intradialytic stretching exercises helps to reduce the level of muscle cramps. Regular stretching exercises during the haemodialysis prevents the occurrence of muscle cramps and improves the quality of life among the patients undergoing haemodialysis
