Original article| Volume 70, 104480, February 2023

Effect of exergaming in people with restless legs syndrome with multiple sclerosis: A single-blind randomized controlled trial

Published:December 23, 2022DOI:


      • Exergaming effectively reduces RLS severity in RLS-positive pwMS.
      • The effects of exergaming on RLS severity were maintained during 8-week follow-up.
      • Exergaming is an effective method for sleep-related outcomes in RLS-positive pwMS.



      Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation in the lower extremity, triggered by sitting and lying positions and release with motion. There is strong evidence that RLS prevalence is higher in persons with multiple sclerosis (MS, pwMS) than in the general population. Current literature has shown that exergaming as non-pharmacological therapy may be an effective method for symptoms such as balance, walking, fatigue, cognitive functions in pwMS, but the effects on RLS are not known. Therefore, the study's main aim is to investigate the effects of exergaming in pwMS with RLS.


      Thirty-one pwMS with RLS and 34 pwMS without RLS were randomly divided as exergaming group and control group. The outcome measures were International RLS Study Group Rating Scale, Modified Fatigue Impact Scale, MS Walking Scale, Timed 25-Foot Walk Test, Hospital Anxiety and Depression Scale, Godin-Shephard Leisure-Time Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, 6 min Walk Test, Timed and Up Go, MS International Quality of Life questionnaire, MS-Related Symptom Checklist.


      26 pwMS with RLS (11 exergaming group, 15 control group) and 27 pwMS without RLS (12 exergaming group, 15 control group) were included in 8-week post-treatment analyses. After an 8-week long-term follow-up, 16 pwMS with and without RLS completed the protocol. The RLS severity (p = 0.004), anxiety level (p = 0.024), sleep quality (0.005), walking (0.004), and balance functions (0.041) were improved in pwMS with RLS exergaming group, while RLS severity increased in control group (p = 0.004). At 8-week follow-up, the effect of exergaming on RLS severity, quality of life, sleep quality, and walking capacity was preserved. There was significant improvement in gait and balance functions in pwMS without RLS exergaming group, there was no significant differences control group. In 8-week follow-up, improvement obtained in pwMS without RLS exergaming group was not preserved.


      This study suggests that exergaming training could be an effective method for managing RLS severity, anxiety, sleep quality, gait, balance, and quality of life in pwMS with RLS.


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