Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted,comprehensive occupational therapy

Objective

Work disability is a serious consequence of rheumatoid arthritis (RA). We conducted a 6‐month, prospective randomized controlled trial comparing assessments of function, work, coping, and disease activity in employed patients with RA receiving occupational therapy intervention versus usual care.

Methods

Employed patients with RA with increased perceived work disability risk were identified by the RA Work Instability Scale (WIS; score ≥10). Patients were stratified into medium‐ (score ≥10 and <17) and high‐risk (≥17) groups, then randomized into occupational therapy or usual care groups. Assessments were conducted at baseline and 6 months. The primary outcome was the Canadian Occupational Performance Measure (COPM), a standardized patient self‐report of function. Other outcomes included the disability index (DI) of the Health Assessment Questionnaire (HAQ); Disease Activity Score in 28 joints (DAS28); RA WIS; EuroQol Index; visual analog scales (VAS) for pain, work satisfaction, and work performance; and days missed/month. Independent sample t‐tests and Mann‐Whitney U tests were used.

Results

We recruited 32 employed patients with RA. At baseline the groups were well matched. At 6 months the improvement in the occupational therapy group was significantly greater than that in the usual care group for all functional outcomes (COPM performance P < 0.001, COPM satisfaction P < 0.001, HAQ DI P = 0.02) and most work outcomes (RA WIS [P = 0.04], VAS work satisfaction [P < 0.001], VAS work performance [P = 0.01]). Additionally, Arthritis Helplessness Index (P = 0.02), Arthritis Impact Measurement Scales II pain subscale (P = 0.03), VAS pain (P = 0.007), EuroQol Index (P = 0.02), EuroQol global (P = 0.02), and DAS28 (P = 0.03) scores significantly improved.

Conclusion

Targeted, comprehensive occupational therapy intervention improves functional and work‐related outcomes in employed RA patients at risk of work disability.     

Perceived stress and sleep quality before oocyte pick-up,embryo transfer,and pregnancy test in women receiving in vitro fertilization treatment

Background

Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances.

Objective

This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment.

Material and methods

This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.

Results

The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level.

Conclusion

Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased.

Trial registration

70904504/38

     

Occupational Therapy and Older Drivers: Research,Education, and Practice

ABSTRACT

Occupational therapists facilitate independence and support participation in occupations that are personally meaningful to clients to enhance well-being and quality of life. Among the occupations addressed by occupational therapists is the instrumental activity of daily living (IADL) of driving. Occupational therapists are particularly concerned with older adult engagement in driving because of the vital contributions driving and community mobility make to engagement in other activities and subsequently quality of life. This article includes the current status of occupational therapy research, education, and practice and presents the role of the occupational therapist as a member of the team with regard to older drivers.     

A Sonotrombólise Promove Melhora dos Índices de Motilidade e Perfusão do Ventrículo Esquerdo após o Infarto Agudo do Miocárdio

BackgroundIt has recently been demonstrated that the application of high-energy ultrasound and microbubbles, in a technique known as sonothrombolysis, dissolves intravascular thrombi and increases the angiographic recanalization rate in patients with ST-segment–elevation myocardial infarction (STEMI).ObjectiveTo evaluate the effects of sonothrombolysis on left ventricular wall motion and myocardial perfusion in patients with STEMI, using real-time myocardial perfusion echocardiography (RTMPE).MethodsOne hundred patients with STEMI were randomized into the following 2 groups: therapy (50 patients treated with sonothrombolysis and primary coronary angioplasty) and control (50 patients treated with primary coronary angioplasty). The patients underwent RTMPE for analysis of left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and number of segments with myocardial perfusion defects 72 hours after STEMI and at 6 months of follow-up. P < 0.05 was considered statistically significant.ResultsPatients treated with sonothrombolysis had higher LVEF than the control group at 72 hours (50% ± 10% versus 44% ± 10%; p = 0.006), and this difference was maintained at 6 months of follow-up (53% ± 10% versus 48% ± 12%; p = 0.008). The WMSI was similar in the therapy and control groups at 72 hours (1.62 ± 0.39 versus 1.75 ± 0.40; p = 0.09), but it was lower in the therapy group at 6 months (1.46 ± 0.36 versus 1.64 ± 0.44; p = 0.02). The number of segments with perfusion defects on RTMPE was similar in therapy and control group at 72 hours (5.92 ± 3.47 versus 6.94 ± 3.39; p = 0.15), but it was lower in the therapy group at 6 months (4.64 ± 3.31 versus 6.57 ± 4.29; p = 0.01).ConclusionSonothrombolysis in patients with STEMI resulted in improved wall motion and ventricular perfusion scores over time.     

The effect of acupuncture on emotional disorders in patients with insomnia: A protocol for systemic review and meta-analysis

Background:Insomnia with high incidence is usually accompanied by many other diseases, especially mental disorders with the under-diagnosis and under-treatment. Some studies demonstrated that acupuncture may be effective for emotional disorders accompanied by insomnia. The systematic review protocol is designed to guiding analysis the effectiveness and safety of acupuncture for emotional disorders in patients with insomnia.Methods:Seven databases, Cochrane central register of controlled trials, Medline, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and Wanfang database, will be searched from initial to December 2020. Randomized controlled trials (RCTs) of acupuncture for insomnia with emotional disorders (depression and anxiety) outcomes, which were reported in Chinese or English, will be included. The primary outcome is the change of degree of anxiety and depression. Study selection, data extraction and assessment of the risk of bias will be performed independently by 2 or more reviewers. Available data will be synthesized and statistically analyzed in RevMan V.5.3. The model of fixed effects will be used for the pooled data when the heterogeneity tests show little or no statistical heterogeneity (I2 < 50%). The random-effects model will be taken with heterogeneous data (50% ≤ I2 < 75%).Results:The effect of acupuncture on emotional disorders in patients with insomnia will be assessed on Hamilton anxiety Scale, Hamilton anxiety Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Self-rating Anxiety Scale, Self-rating Depressive Scale and the number of participants secede and the number of patients reported adverse events.Conclusion:the emotional disorders interaction with insomnia and the increase of risk on disease evolving and insomnia-related burden, it is so momentous to know that the role of insomnia treatment on comorbidities. We should concern about the management of emotional disorders when treat insomnia, and acupuncture treatment anxiety and depression caused by insomnia may be effective.Ethics and dissemination:Ethics approval is not be needed because the data will not contain individual patient data, and there are no concerns about privacy. The results of this meta-analysis will be disseminated through publication in a peer-reviewed academic journal or relevant conference.INPLASY registration number:INPLASY2020100115.     

Effekte einer psychologischen Gruppenintervention auf neuropsychiatrische Symptome und Kommunikation bei Alzheimer-Demenz

Background

Outcomes of a multicomponent psychological intervention designed for the treatment of neuropsychiatric symptoms, communicative and emotional deficits in patients with mild to moderate Alzheimer’s dementia were evaluated in a controlled trial. Core components of the program were milieu therapy interventions and music therapy.

Patients and methods

A total of 49 patients were involved into a pre–post design. The treatment group (n=26) received the program for 6?months, while controls (n=23) participated in standard occupational therapy. Statistical analyses included t-tests, calculation of effect sizes, and two-way analyses of variance.

Results

After 6?months, the treatment group showed clear, partly significant improvement of anxiety, agitation, aggression, and apathy as well as social communication, emotional competence and activity levels relative to controls.

Conclusion

The program has the potential to increase psychological well-being and to improve communication in patients with Alzheimer’s dementia.     

A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center

Objectives: To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. Methods: A randomized case–control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Results: Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). Conclusions: An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. Scientific Significance: This study suggests RP as a potentially effective component of treatment for heroin addicts.     

Factors burdening the caregiving relatives of community-dwelling disable Japanese people

AIM: This study examined the factors associated with burdens on the primary caregivers of community-dwelling disabled people. METHODS: Participants were 78 disabled people (40 men, 38 women; mean age 77.8+/-11.5 years) who received home-based physical therapy and/or occupational therapy, and their 78 caregivers (20 men, 58 women; mean age 66.8+/-10.2 years). The caregiver burden was assessed using the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8). In addition, the primary caregivers completed questionnaires about burdens arising from supporting the activities of daily living (ADL) using a visual analogue scale, available social support, subjective well-being, and the Motor Fitness Scale. The performance of the disabled subjects was assessed using the Bedside Mobility Scale and the Barthel Index. The disabled subjects and the caregivers were divided into higher burden (J-ZBI_8 score, 10 points and over) and lower burden groups (J-ZBI_8 score, 9 points and under) to compare the group differences in the measurements. RESULTS: The disabled participants in the lower burden group (n=41) showed significantly higher Bedside Mobility Scale scores and Barthel Index scores than those in the higher burden group (n=37). The primary caregivers in the higher burden group showed significantly higher burden due to supporting the ADL, lower subjective well-being, and lower social support as compared to those in the lower-burden group. CONCLUSION: The burden levels of the primary caregivers relating to the mobility and ADL of their recipients were assessed. The caregivers with higher burden showed less social support and low subjective well-being.     

The Promotion of Well-Being in Aging Individuals Living in Nursing Homes: A Controlled Pilot Intervention with Narrative Strategies

Objectives: The study aimed: (1) to compare levels of well-being and distress in older adults living in nursing homes with those living in community; and (2) to test the feasibility of a positive narrative intervention for improving well-being versus a control art-and-craft intervention in a nursing home setting.

Methods: Sixty older adults participated in the study (M = 77.37; SD = 5.00), Male = 20 (33.3%). In Study 1, 30 adults living in nursing homes were compared with 30 community-dwellers using the following measures: Satisfaction with Life Scale, Psychological Well-being Scale, Social Well-being Scale, Geriatric Depression Scale, and sleep quality. In Study 2, the same 30 adults living in nursing homes were allocated to a positive narrative intervention group (N = 20) or to a control group (N = 10) and assessed at post-intervention.

Results: In Study 1, older adults in nursing homes presented more depression and impairments in well-being, compared to community-dwellers. In Study 2, at post-treatment, individuals assigned to the narrative intervention reported significantly increased well-being and sleep quality.

Conclusions: Although preliminary, results showed that older adults living in nursing homes are more vulnerable than community-dwellers. These patients experienced improvement when given a short group positive narrative intervention applicable in nursing homes.

Clinical Implications: A brief group intervention based on fairy tales yielded improvements in well-being and sleep quality in nursing home residents, who enjoyed and appreciated its content. These promising results need to be confirmed by future randomized controlled trials.     

The effect of education given to type 2 diabetic individuals on diabetes self-management and self-efficacy: Randomized controlled trial

AimThis study used a randomized controlled trial design and was carried out to examine the effect of education on diabetes self-management and self-efficacy in patients with type 2 diabetes.MethodsThe study was carried out between July 2016–March 2017. Data were collected using information form, Diabetes Self-Management Questionnaire (DSMQ), self-efficacy scale for patients with type 2 diabetes (DSS).The individuals in the experimental group were given education. Both groups were reminded about the control time of their metabolic values on the phone in the 3rd and 6th months.ResultsThe average age of the individuals was 59.91 ± 8.93 (n = 78), 62.8% (n = 49) were female, 92.3% (n = 72), were married, 42.3% (n = 33) were high school graduates and their diabetes duration was 7.05 ± 3.9. There was a statistically significant difference in the 6th month metabolic values in the experimental group compared to the control group. When diabetes self-management and self-efficacy were examined, a statistically significant difference was found in the experimental group compared to the control group at 3rd and 6th months (p < 0.05, p < 0.01).ConclusionIn this study, a significant increase in diabetes self-management and self-efficacy and a significant decrease in metabolic values were observed as a result of education and phone reminders given to individuals with type 2 diabetes.     

EFFECT OF FLAMINGO EXERCISES ON BALANCE IN PATIENTS WITH BALANCE IMPAIRMENT DUE TO SENILE OSTEOARTHRITIS

ObjectiveTo investigate the effect of flamingo exercise with or without KAT 2000 device on the balance problems due to senile OA.ParticipantsNinety elderly osteoarthritic patients with balance impairment.InterventionsParticipants were randomly assigned into three groups; Kinesthetic ability trainer (KAT 2000) training group (Group 1) (n = 30), Flamingo training group (Group 2) (n = 30), Combined training group (Group 3) (n = 30) group. 45 minutes individualized training sessions as three times a week for 4 weeks were given to all participants.Main Outcome MeasuresPatients were evaluated with Berg balance scale (BBS), kinesthetic ability trainer (KAT 2000) static and dynamic scores, timed up and go test (TUGT), walking speed (WS), Activities Specific Balance Confidence (ABC) Scale and Functional Reach Test (FRT) at the baseline and at the end of 4 weeks.ResultsAt the end of the therapy, there were statistically significant improvements in KAT 2000 static and dynamic scores, TUGT scores, WS and ABC Scale in all groups (p < 0.05). At the end of the therapy there were statistically significant differences in Group 3 for KAT 2000 static and dynamic scores, TUGT scores, WS and ABC Scale than the other groups (p < 0.05). But there were no statistical difference in BBS and FRT score between the groups (p > 0.05).ConclusionsBoth flamingo and KAT2000 exercises device have positive effects on the balance problems due to senile OA. Combined with the KAT2000 device, the effects of flamingo exercises on balance disorder in senile osteoarthritis patients are more pronounced.     

Comprehensive TCM treatments combined with chemotherapy for advanced non-small cell lung cancer: A randomized,controlled trial

Objective:We conducted this study to evaluate the efficacy and safety of traditional Chinese medicine (TCM) in advanced non-small cell lung cancer (NSCLC) patients who underwent chemotherapy.Design:This was a prospective, open-label, randomized controlled trial. NSCLC patients at stage IIIA, IIIB, or IV were randomly assigned to either TCM plus chemotherapy or chemotherapy alone. The comprehensive TCM treatment consisted of Kang Ai injection, herbal decoction, and Zhenqifuzheng capsules. The primary endpoint was quality of life (QOL) measured by the Functional Assessment of Cancer Therapy-Lung version 4.0. The secondary endpoints were chemotherapy completion rate, tumor response, and adverse events. All assessments were done at baseline, the third week, and the sixth week.Results:Thirty-nine participants were randomly assigned to the treatment group and 36 to the control group. The QOL scores were significantly improved in the treatment group compared with those of the control group in social well-being (cycle 1, P = .048; cycle 2, P = .015), emotional well-being (cycle 1, P = .047; cycle 2, P = 4.29E-05), and functional well-being (cycle 1, P = .030; cycle 2, P = .003), while the QOL scores in the above 3 domains declined in the control group (P < .05). Both groups had a decline in the physical well-being score (cycle 1, P = .042; cycle 2, P = .017) and lung cancer symptom score (cycle 1, P = .001; cycle 2, P = .001) after 2 courses of intervention. The deterioration in physical well-being and lung cancer symptoms was noticeably smaller in the treatment group (P < .05). There were significant differences between the 2 groups in social well-being, emotional well-being, functional well-being, lung cancer symptom domain, and the total score (P < .05). Patients in the treatment group had a significantly lower incidence of platelet reduction than the control group (P = .028) after 2 cycles of treatment. No significant difference in nonhematological adverse events (AEs) was observed.Conclusion:This study illustrated that comprehensive TCM treatment could promote the QOL of NSCLC patients, alleviate symptoms, and reduce the AEs caused by chemotherapy, verifying the synergistic and attenuating effects of TCM in NSCLC patients undergoing chemotherapy.Trial registration:Chinese Clinical Trial Registry (www.chictr.org.cn): ChiCTR-TRC-13003637     

The role of illness uncertainty in the relationship between disease knowledge and patient-reported outcomes among adolescents and adults with congenital heart disease

BackgroundGreater general disease knowledge predicts better patient-reported outcomes (PROs) among congenital heart disease (CHD) survivors, but higher illness uncertainty is associated with elevated emotional distress and poorer well-being among patients with chronic disease.ObjectivesThis study explored the relationship of illness uncertainty and disease knowledge with emotional distress and health-related quality of life (HRQoL) among patients with CHD.MethodsIndividuals with CHD (N = 169, ages 15–39) completed self-report measures of disease knowledge (general and risk-related), illness uncertainty, depressive and anxiety symptoms, and HRQoL. Pearson correlations and regressions analyses were utilized.ResultsGreater risk-related knowledge was associated with greater anxiety (b = .41, p = .03, 95% CI = [.04, .77]) and poorer emotional HRQoL (b = -.53, p = .03, 95% CI = [-1.02, -.05]) when illness uncertainty was higher.ConclusionWhen individuals with CHD feel uncertain about their disease course and outcomes, knowledge about future cardiovascular risks may result in higher levels of distress.     

Effects of an occupational therapy program on functional outcomes in older stroke patients

BACKGROUND: During the last decade, occupational therapy has gained increasing importance as component of the rehabilitation programs in disabled patients. Objective: To evaluate the efficacy of occupational therapy programs in patients with a recent stroke. METHODS: We selected all patients with a primary diagnosis of ischemic stroke (n = 50) consecutively admitted to the two post-acute Geriatric Rehabilitation Units (CEMI 2 and 3) of the 'A. Gemelli' Hospital--Catholic University of Sacred Heart, Rome, Italy. Patients in the unit CEMI 3 (intervention group) received 8 weeks (3 h per day) of a combined rehabilitation program based on occupational therapy and physiotherapy. Patients admitted to the control unit (CEMI 2) received no input from the occupational therapist. RESULTS: Overall, patients had a moderate-to-severe impairment in basic activities of daily living; the mean ADL score was 30.8 (SD +/- 7.8) in the intervention group and 30.7 (SD +/- 6.1) in the control group (p = 0.9). After 8 weeks of treatment the mean ADL score in the intervention group was 13.2 (SD +/- 9.9) compared to 20.3 (SD +/- 11.5) in the control group (p = 0.02). Differences between the intervention and control groups were statistically significant for transfers (+2.8 vs. +1.6 points on the ADL scale, p = 0.006), locomotion (+3.4 vs. +1.7 points on the ADL scale, p = 0.01), dressing (+3.0 vs. +1.8 points on the ADL scale, p = 0.01) and self-care (+3.4 vs. +1.8 points on the ADL scale, p = 0.005). CONCLUSION: Our results show that patients with stroke who received occupational therapy had a greater level of independence in activities of daily living over a period of 8 weeks than patients who did not.     

Health-promotion interventions enhance and maintain self-efficacy for adults at cardiometabolic risk: A randomized controlled trial

ObjectivesTo investigate whether a community-based intervention program, based on self-efficacy theory, might improve older adults’ self-care behaviors as well as health outcomes related to hypertension and dyslipidemia.MethodsThis randomized controlled trial was conducted in Taipei, Taiwan, From October 16, 2011 to July 31, 2014. Residents identified during community screening for the over 50 s were invited to participate if their blood pressure was 120–139/80–89 mmHg, high-density lipoprotein cholesterol was <40 mg/dL (men) or <50 mg/dL (women), or low-density lipoprotein cholesterol was 130–159 mg/dL. The intervention group participated in a special health promotion program; the control group received conventional health education. Participants’ demographic and anthropometric data were recorded, and each completed semi-structured questionnaires about hypertension and cholesterol management, and gave blood samples for biochemical analyses before the intervention and 6 months after it ended.ResultsFrom 90/98 eligible subjects who enrolled, 84 completed the study: 41/43 and 43/47 respectively in intervention and control groups. Body mass index, blood pressure, hyperglycemia, and high-density lipoprotein cholesterol in the intervention group improved significantly from baseline. The Self-Efficacy Scale (P = 0.020), Self-Care Activities Questionnaire (P = 0.014) and Perceived Therapeutic Efficacy Scale (P = 0.023) scores improved significantly.ConclusionThis health promotion intervention program enhanced self-efficacy among older adults, with sustained effect through 6-months’ follow-up. These findings are consistent with studies that evaluated the effect of a diabetes education program on self-efficacy. The beneficial effect on a population at high-risk for hypertension and hypercholesterolemia, may serve as a model for developing and implementing such interventions.     

Perceiving control: a double-edged sword in old age

Although control beliefs are thought to be pivotal contributors to emotional well-being in old age, questions remain about the specific and long-term emotional implications of different types of control beliefs. We examined three generalized beliefs about control (personal control over desirable outcomes, personal responsibility for undesirable outcomes, perceived others' control) and their associations with emotional well-being (positive and negative affect) using cross-sectional (N = 516) and longitudinal (N = 206) samples from the Berlin Aging Study (age range = 70-103 years). Relationships between control beliefs and emotional well-being were dependent on the type of control belief and the dimension of emotional well-being considered, the sample investigated, and on whether individual differences at a given point in time or individual differences in intraindividual changes over time were examined. Despite these complexities, findings suggest that perceived control over desirable outcomes is associated with high emotional well-being, whereas perceived others' control is an emotional risk factor in old age.     

Evaluation of efficacy of fluoxetine in the management of major depression and arthritis in patients of Rheumatoid Arthritis

BackgroundPatients with chronic pain suffer significant reduction in physical, psychological, and social well-being. Anxiety and depressive disorders occur in 20%–25% of patients with Rheumatoid Arthritis (RA). Antidepressants are useful in the treatment of major depression, however the analgesic properties of this class of drugs is not clear.ObjectiveTo study the association between RA and depression along with independent effect of fluoxetine on depression and arthritis.MethodOne hundred women attending a rheumatology clinic with RA were included in the study along with controls. Hospital Anxiety Depression Rating Scale (HADS), Montgomery–Asberg Depression Rating Scale (MADRS) and Clinical Global Impression – Change Scale (CGI) were applied. Both the groups were treated with DMARD. RA with depression group also received fluoxetine.ResultsDepression is significantly associated with RA; however severity of RA has no relationship with severity of depression. Treatment outcome was better and earlier with add on fluoxetine in the RA with depression group as compared to RA without depression.ConclusionTreatment of associated depression may expedite the recovery of physical symptoms thus improving the quality of life of an individual with chronic painful conditions.     

Sequential compression devices for treatment of restless legs syndrome

Restless legs syndrome (RLS) is a common disorder that presents with irresistible urges to move the legs and motor restlessness, worsening in the evening. RLS commonly causes insomnia and associated daytime symptoms. Treatment of first choice for RLS is usually medication, but medications are often ineffective or poorly tolerated. An effective nonpharmacologic therapy would be highly desirable. Here we review RLS and its treatment and present data from a pilot study on the effect of a novel treatment for this condition. The objective of this study was to determine the therapeutic effect of pneumatic sequential compression devices (SCDs) on RLS symptoms.We performed an uncontrolled, prospective interventional study using SCDs on a convenience sample of adults reliably diagnosed with RLS. Patients were asked to wear the SCD for an hour each evening before the usual time of onset of restless legs symptoms. Before and after 1-3 months of SCD therapy, patients completed validated questionnaires to assess RLS severity, daytime sleepiness, and impact of RLS on quality of life in the domains of social function, daily task function, sleep quality, and emotional well-being. Compliance with SCD therapy was measured using patient-recorded logs.Of 10 patients (7 women; age range, 37-80 yr; mean age, 56 yr), symptomatic for a mean of 68 months (range, 12-360 mo), 1 could not tolerate wearing the SCD and withdrew from the protocol after 3 days. The remaining 9 patients complied with therapy 58%-100% of nights (mean, 82%). Three patients experienced complete resolution of RLS and 6 patients had improvement of symptoms. Group severity score improved from 24/40 to 8/40 (p = 0.001). Epworth Sleepiness Scale score improved from 12/24 to 8/24 (p = 0.05). Every quality of life score improved: social function from 74% to 96% (p = 0.04), daily task function 63% to 80% (p = 0.05), sleep quality 27% to 63% (p = 0.003), and emotional well-being from 49% to 83% (p = 0.02). In this group of patients, wearing the SCD in the evening for an hour improved symptoms of RLS and improved quality of life, with complete resolution of symptoms in 3 of 10 patients.