Acute Effect of Two Different Hand Exercises on Vessel Size in Patients Undergoing Arteriovenous Fistula Creation

TL;DR

This study compares two hand exercises to see which better improves blood vessel size in patients with a new arteriovenous fistula.

Contribution

The study introduces tourniquet-like compression during hand exercises and shows its acute effect on blood flow rates in AVF patients.

Findings

Both hand exercises increased venous diameter, but the difference between groups was not significant.

Blood flow rates increased significantly in the compression group compared to the non-compression group.

Tourniquet-like compression during exercises may enhance AVF maturation acutely.

Abstract

Objectives: We primarily aimed to compare the acute effects of hand-squeezing exercises, with and without tourniquet-like compression, on vessel size 5 minutes post-exercise in patients after arteriovenous fistula (AVF) creation. The secondary aim was to assess differences in AVF blood flow rates between the 2 interventions.

Methods: A randomized study was conducted at a university hospital in Bangkok, Thailand, from October 2018 to September 2023. Seventy-eight participants, 2 weeks post-first-time autogenous AVF creation, were randomized into 2 groups: a non-compression group (n = 39) performing 5 minutes of hand-squeezing exercises and a compression group (n = 39) performing the same exercises with tourniquet-like compression. Ultrasound measured venous diameter and blood flow rates pre- and post-exercise.

Results: Both groups showed increased venous diameter, but the difference between the groups was not statistically significant (mean difference: 0.18 mm with compression vs. 0.12 mm without; P = 0.489). Blood flow rates increased significantly in the compression group compared to the non-compression group (mean difference: 171.49 vs. 24.44 mL/min; P = 0.002).

Conclusion: Hand-squeezing exercises with tourniquet-like compression significantly improved AVF blood flow rates acutely, supporting its potential to enhance AVF maturation. Further research is needed to assess long-term benefits.

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