Assessment of Effects of Upper Extremity Exercise with Arm Tourniquet on Maturity of Arteriovenous Fistula in Hemodialysis Patients

Abstract

Objective This study was designed to investigate the effects of hand exercise using a tourniquet on arteriovenous fistula (AVF) maturity in patients with end stage renal disease. Methods Fifty patients were randomly allocated to 2 groups with 25 patients. After creating an AVF, in the control group, patients were asked to start doing simple hand exercise- opening and closing the fingers. In the second groups, patients underwent a structured isometric exercise program. The pre exercise and post exercise ultrasound examination were performed in the first 24 hours and 2 weeks after the operation respectively. Patients were also clinically evaluated at the end of the study. Results Post exercise ultrasound showed significant difference in the draining vein diameter, vein wall thickness, vein area and blood flow rate (BFR) (p-value: 0.009, 0.04, 0.02 and 0.02 respectively). The number of patients who had clinically mature AVFs in the case group was significantly more than the control group (13 vs. 5; p-value: 0.008). Conclusion We conclude that hand exercise using arm tourniquet affects most sonographic parameters which are associated with AVF maturity, and could be beneficial for acceleration of AVF clinical maturation.