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

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.

Keywords: arteriovenous fistula; blood flow rate; hand exercises; tourniquet-like compression; venous diameter.

Fig. 1 Illustration of ball-squeezing exercises: (A) without compression and (B) with compression

Fig. 2 CONSORT flowchart of patient recruitment and study flow. CONSORT: Consolidated Standards of Reporting Trials

Fig. 3 Changes in (A) venous diameter and (B) blood flow rate before and after exercise between the 2 exercise groups.