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.
RCT Entities:
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.
Authors: Natália Ramos Costa Pessoa; Laís Helena de Souza Soares Lima; Gutembergue Aragão Dos Santos; Cecília Maria Farias de Queiroz Frazão; Clemente Neves Sousa; Vânia Pinheiro Ramos Journal: Int J Nurs Sci Date: 2020-06-13