Document Detail

Managing nocturnal leg cramps--calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial.
MedLine Citation:
PMID:  15808033     Owner:  NLM     Status:  MEDLINE    
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.
Richard J Coppin; Dorothy M Wicke; Paul S Little
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of general practice : the journal of the Royal College of General Practitioners     Volume:  55     ISSN:  0960-1643     ISO Abbreviation:  Br J Gen Pract     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-04-05     Completed Date:  2005-09-30     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9005323     Medline TA:  Br J Gen Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  186-91     Citation Subset:  IM    
The Surgery, Station Road, Overton, Basingstoke, Hants RG25 3DZ, UK.
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MeSH Terms
Data Collection
Exercise Therapy*
Family Practice
Middle Aged
Muscle Cramp / prevention & control*
Muscle Relaxants, Central / adverse effects*
Quinine / adverse effects*
Sleep-Wake Transition Disorders / prevention & control*
Treatment Outcome
Reg. No./Substance:
0/Muscle Relaxants, Central; 130-95-0/Quinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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