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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 Exercício. Universidade Federal de São 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.Spinal Cord (2004) 42, 218-221. doi:10.1038/sj.sc.3101575 [ABSTRACT FROM AUTHOR]