Effect of Dumbbell Exercise on Arteriovenous Fistula in Patients Undergoing Maintenance Haemodialysis: A Prospective Randomized Controlled Trial

Abstract

Background: Arteriovenous fistulas (AVF) have been the main vascular accesses for haemodialysis patients, but the maintenance after maturation poses serious challenges. Arm exercises promote the maturation of AVFs. However, few studies have evaluated the effect of arm exercise on matured AVF and addressed the intervention for late fistula failure. Objectives: The study was conducted to explore the effect of dumbbell exercise on mature AVF. Methods: 86 participants undergoing haemodialysis with AVFs were randomized into the control group and experimental group. The experimental group held 6-pound dumbbells on non-dialysis days for 3 months, while the control group squeezed rubber balls. Results: For blood flow of draining vein (DV; primary outcome), the between-group effects, interaction effect and time effect showed significant differences. A significant increase in blood flow of DV was observed in the dumbbell group at the 3rd month (mean difference, 359.50 [111.90–829.05] mL/min; p = 0.001). The difference in blood flow of AVF proximal artery, blood flow of brachial artery, the diameter of DV and the incidence of adverse events at 3 months (secondary outcomes) between the 2 groups was insignificant. Conclusion: Prolonged training with arm exercises is essential for patients with AVFs though the fistula has matured. The designed dumbbell exercise is an economical, effective intervention to maintain the function of AVF, especially for patients with potential reduction of access blood flow and no percutaneous transluminal angioplasty indication.

Effects of upper limb exercise programs on the arteriovenous fistula in patients on hemodialysis: A systematic review and meta-analysis

“…Although our results demonstrated that experimental upper limb exercise programs did not increase DVD in patients with AVF, they indicated a significant improvement in DVBFR. These findings were supported by Mo et al, 12 who demonstrated that 3 months of an experimental exercise program using dumbbells for the upper limb with a functional AVF significantly improved blood flow when compared to the usual care group. We decided to maintain Mo et al 12 study in this analysis due to the exclusion of AVF with a diameter of the aneurysm >2 cm and due to exercises are performed on non-dialysis days at home, disregarding the dilation and increased blood flow mediated by hemodialysis and anticoagulant drugs.…”

Research on the Effect of 5Why-Based Nursing Intervention in Blood Purification Nursing

“…Doctors, nurses, and researchers themselves supervise and guide patients during exercise intervention during dialysis and deal with emergencies when necessary. The graduate students themselves participate in the whole process of this research, including the signing of the informed consent form, the collection, sorting, and entry of various patient information and data [ 20 ].…”

Expert consensus on the establishment and maintenance of native arteriovenous fistula

“…Dumbbell exercise is an economical and effective intervention that can maintain the function of AVF, especially in patients who may have reduced blood flow and have no indications for PTA. 91 …”

“…Dumbbell exercise is an economical and effective intervention that can maintain the function of AVF, especially in patients who may have reduced blood flow and have no indications for PTA. 91 The European nursing guidelines indicated that allowing patients to prepare for HD more actively can improve their self-management ability, improve the sense of gain, and even prognosis. The guidelines state that simple exercises (such as pinching hands) are unlikely to produce any harmful results.…”