Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury

Study design: Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). Objective: The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Setting: Centro de Estudos em Psicobiologia e Exercicio. Universidade Federal de Sao Paulo, Brazil. Methods: A total of 13 volunteers (mean age: 31.6 +/- 8.3 years) received L-DOPA ( 200 mg) and benserazide ( 50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days ( 3 times a week). Results: Both L-DOPA administration (35.11 - 19.87 PLM/h, P<0.03) and physical exercise (35.11 - 18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. Conclusions: The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.