Handgrip Exercise for Arteriovenous Fistula Maturation

Bangor University31 enrolled

Overview

The purpose of this study is to investigate whether post operative progressive forearm exercise is effective in improving arteriovenous fistula maturation in chronic kidney disease patients.

The arteriovenous fistula is considered to be the gold standard form of access for haemodialysis patients, however only 37% of haemodialysis patients have this form of access. A possible explanation for this could be the high fistula failure rate due to the lack of maturation. Therefore interventions aimed at enhancing fistula maturation are warranted. One such intervention could be forearm exercise, however this recommendation is not evidence based. Therefore, the purpose of this study is to investigate whether a program of post operative progressive hand grip exercise can improve fistula maturation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

SINGLE

Enrollment

Conditions

Chronic Kidney Disease

Interventions

Post operative progressive handgrip exerciseOTHER

As soon as possible post operation the patient will commence an eight week progressive handgrip training intervention

Treatment as usualOTHER

Continue routine care, with removal of exercise information given to patients(if anye.g. do not give out squeeze balls)

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Stage 4-5 chronic kidney disease, attending for arteriovenous fistula creation in forearm Exclusion Criteria: * Are under the age of 18years; * Not able to exercise forearm safely (as decided by the patients consultant) * Have any other uncontrolled medical condition * Unable to withstand transiently raised systolic blood pressure by 35 mmHg and diastolic by 25 mmHg * Or are unable to give consent

Locations (1)

Renal unit, Ysbyty Gwynedd, North West Wales NHS Trust

Bangor, Gwynedd, United Kingdom

Outcomes

Primary Outcomes

Venous Diameter.

Measurements were made using duplex ultrasonagraphy. Measurements were made at predetermined distances 5 to 10 cm proximal to the anastomosis (dependent on wound dressings and turbulent flow around the anastomosis). The scanning position for each patient was traced using transparent sheets which allowed analogous measurement positions for all scans. Cross sectional vascular diameter measurements were made using conventional grey scale B Mode imaging. Diameters were measured from the inner edges of the vascular wall (Wiese \& Nonnast-Daniel, 2004).

Time frame: 3 months

Secondary Outcomes

Maximum Handgrip Strength

Time frame: 3 months

Handgrip Endurance

Time frame: 3 months

Forearm Muscle Cross Sectional Area

Time frame: 3 months

Data from ClinicalTrials.gov

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