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Evidence for preventive, nurse-led strategies is limited. This study evaluated whether a standardized intradialytic stretching protocol reduces cramp burden compared to usual care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single-center, parallel-group randomized controlled trial was conducted. Adults on maintenance HD with a history of leg cramps were randomized 1:1 to nurse-led stretching (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) or usual care (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930). The intervention included supervised lower-limb stretches, twice weekly for ~\u20098 weeks, with fidelity monitoring. Outcomes were assessed using the Arabic Muscle Cramp Severity and Characteristics Questionnaire. The primary outcome was post-intervention cramp intensity category.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Groups were comparable at baseline. Post-intervention, the study group showed significantly lower cramp intensity: no cramps in 83.3% vs. 30.0% of controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Cramp frequency, duration, pain, and discomfort all favored the intervention (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Leg temperature perception did not differ. No serious adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A brief, nurse-led stretching protocol produced large reductions in cramp burden without disrupting workflow. Integrating standardized stretching into routine nursing care is a feasible, low-cost strategy for proactive symptom management, empowering nurses and enhancing patient comfort. Multicenter, longer-term evaluations are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trials<\/jats:title>\n                    <jats:p>The trial is registered at ClinicalTrials.gov under identifier NCT07262879.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration date<\/jats:title>\n                    <jats:p>12\/02\/2025.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12912-026-04430-4","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:34:34Z","timestamp":1773048874000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of nurse-led intradialytic stretching exercises on muscle cramp burden among patients undergoing maintenance hemodialysis: a randomized controlled trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Ahmed Mostafa","family":"Shehata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaa Eid","family":"Zaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdya Ahmed","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheir Mohamed","family":"Weheida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"6","key":"4430_CR1","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1053\/j.ajkd.2003.08.025","volume":"42","author":"SN Davison","year":"2003","unstructured":"Davison SN. 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The study adhered to the Declaration of Helsinki and local regulatory requirements. Written informed consent was obtained from all participants prior to enrollment and data collection. The participants were informed that participation was voluntary and that withdrawal would not affect their clinical care. Privacy and confidentiality were maintained through coded identifiers, restricted access to linkage files, and secure data storage.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.This manuscript does not contain any individual person\u2019s data in any form (including images, videos, or quotations) that would require explicit consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"333"}}