# Effects of rhythmic dumbbell upper limb rehabilitation training based on the multi-process action control framework on vascular access function and quality of life in hemodialysis patients

## TL;DR

A study found that rhythmic dumbbell exercises based on a specific control theory improved vascular function and quality of life in hemodialysis patients.

## Contribution

This study introduces a novel rehabilitation approach using rhythmic dumbbell exercises based on the M-PAC framework for hemodialysis patients.

## Key findings

- The intervention group showed significantly better AVF maturation and blood flow outcomes compared to the control group.
- Quality of life scores improved more in the intervention group after the rehabilitation program.
- Single-needle puncture success rates were higher in the intervention group post-exercise.

## Abstract

To investigate the effects of rhythmic dumbbell upper limb rehabilitation exercise based on multi-process action control (M-PAC) theory on the function and quality of life of autogenous arteriovenous fistula in hemodialysis patients.

A total of 72 patients who underwent autologous arteriovenous fistula (AVF) angioplasty and had stable and regular dialysis in the hemodialysis center of Cangzhou Central Hospital from January 2025 to April 2025 were selected as the research subjects, and were randomly divided into control group (n = 36) and intervention group (n = 36). Both groups were given routine rehabilitation management. The control group was given routine ball-holding rehabilitation exercise on the upper limb of the AVF side, and the intervention group was given rhythmic dumbbell rehabilitation exercise based on M-PAC theory. The intervention began 2 weeks after the operation, and the total intervention lasted for 3 months. Doppler ultrasound was used to measure the physiological maturation of AVF in both intervention and control groups, including cephalic venous blood flow, venous diameter, and skin-to-thickness distance. Clinical maturation outcomes were recorded and observed, including pump-controlled blood flow compliance rate, target values of pump-controlled blood flow, and single-needle puncture success rate. The Chinese version of the Kidney Disease Quality of Life Questionnaire (KDQOL-SFTM) was employed to evaluate patients’ quality of life before and after the intervention.

Prior to the intervention, there were no significant differences between the two groups in general patient data, venous diameter, skin-to-thickness ratio, and various dimensions of quality of life, indicating balanced comparability (χ2/|t| ≤ 1.900, P ≥ 0.062). Regarding cephalic venous blood flow metrics, as preoperative values were extremely low and unstable, making measurement challenging, this study only compared post-intervention cephalic venous blood flow. For pump-controlled blood flow measurements, since patients lacked access to arteriovenous fistulas (AVF) prior to intervention, this study only analyzed post-intervention pump-controlled blood flow values. Post-intervention analysis revealed that the intervention group demonstrated significantly better outcomes in all metrics compared to the control group: superior cephalic venous blood flow, venous diameter, skin-to-vessel distance (STED), pump-controlled blood flow rate, single-needle puncture success rate, and quality of life dimensions (χ2/|t| ≥ 2.574, P ≤ 0.012). However, no significant difference was observed in the pump-controlled blood flow rate qualification rate (χ2 = 3.486, P = 0.507).

Rhythmic dumbbell upper limb rehabilitation exercise based on M-PAC theory can promote the physiological and clinical maturity of AVF and improve the quality of life of patients.