The Effect of Two Different Hand Exercises on Grip Strength, Forearm Circumference, and Vascular Maturation in Patients Who Underwent Arteriovenous Fistula Surgery

Abstract

ObjectiveTo compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery.MethodsWe recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb.ResultsAll of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups.ConclusionThe results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball.

Strength Training Induces Greater Increase in Handgrip Strength than Wrestling Training per se

“…), have recently gained popularity in sports and rehabilitation settings for promotion of handgrip strength and for prevention and rehabilitation of hand-related injuries [9,10]. Previous studies that investigated the efficacy of various specialized handgrip strength training programs have been performed either in diseased individuals or in healthy untrained and physically active adults (young, middle-aged and elderly individuals), reporting either increases or no change on maximal handgrip strength [9][10][11][12][13]. However, the subjects' characteristics including age, training experience and health status are important contributing factors that could influence the efficacy of strength training program on improving indices of neuromuscular performance.…”

Addressing myths about exercise in hemodialysis patients

“…In one of the few published guidelines related to this topic, a position statement out of Australia suggests that “Hemodialysis patients should avoid upper limb activity with temporary or healing arterio‐venous fistulas.” However, there is no timeframe put on this recommendation, and it is likely that clinical practice varies significantly. Light forearm exercises (eg, ball squeezing) begun as early as 24 hours after the AVF surgery has been shown to improve fistula maturation . However, in clinical practice it is common to commence forearm exercises 2 weeks after the AVF surgery.…”

“…Light forearm exercises (eg, ball squeezing) begun as early as 24 hours after the AVF surgery has been shown to improve fistula maturation. 17,18 However, in clinical practice it is common to commence forearm exercises 2 weeks after the AVF surgery. Handgrip exercises also have been shown to improve forearm endothelial function in the nonaccess arm, 19 though no data appears to exist demonstrating analogous benefits in the AVF arm.…”

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

“…Moreover, the cardiovascular benefits of both resistance and aerobic exercise training were reflected in improvements in lipid profile [57,66], in echogardiography indices [37], in cardiac autonomic function [58], in arterial stiffness [67], in vessels diameters [68] and size [69] and in blood pressure [68]. The cardiovascular response to exercise training induces changes and accordingly increases heart rate and stroke volume but also reduces the peripheral vascular resistance.…”