Clinical trial NCT03741985: Effect of Dumbbell Exercise on Arteriovenous Fistula in Patients With Hemodialysis
Official title: Effect of Dumbbell Exercise on Arteriovenous Fistula in Patients With Hemodialysis：A Prospective Randomized,Controlled Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Arteriovenous Fistula
Lead sponsor: Guangdong Provincial People's Hospital
Sponsor class: OTHER
First posted: 2018-11-15
Enrollment: 80
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Isometric exercise has been shown to increase the diameter and the blood flow rate of forearm veins.At present, more studies focus on the perioperative period to promote the maturation of arteriovenous fistula(AVF), while there are few reports on functional maintenance measures for the patients with maintenance hemodialysis.This study aims to explore the effect of dumbbell exercise on AVF，and evaluate whether patients can carry a 6-pound item with the fistula limb in a reasonable way.

Detailed description: Autologous arteriovenous fistula (AVF) is the preferred vascular access for maintenance hemodialysis patients. It is estimated that AVF accounts for 85-90% of the permanent vascular access in Chinese hemodialysis patients. With the prolongation of dialysis time, aging, and the increase of diabetes incidence, the complications of AVF are more and more common, which affect the lifetime of AVF. Therefore,self-maintenance of AVF is essential. Among them, exercise should be used throughout the entire process of AVF use for the reason that it is economical, easy to operate, and highly repeatable.The most common isometric exercise is handgrip exercise. However, there are some deficiencies in this exercise, such as lack of quantitative standards and burnout of repeated actions. As a result, this study uses quantitative dumbbells as a training tool to explore the effect of dumbbell exercise on the maintenance of AVF, and further evaluates and breaks the nursing routine of "no lifting weights" of fistula limb.

Eligibility criteria: Inclusion Criteria:

1. Patients who have established arteriovenous fistula
2. Patients whose muscle strength of the fistula limb is graded 4-5, which can overcome the 6-pound gravity and external resistance to complete the range of joint activity
3. Patients who provided informed consent.

Exclusion Criteria:

1. Left ventricular cardiac ejection fraction \<30%;
2. Using a arteriovenous graft or a long-term catheter as a permanent access;
3. The diameter of the aneurysm is greater than 2 cm or the aneurysm has a risk of rupture;
4. Participation in other clinical trials at the same time;
5. Severe cardiovascular diseases and other organ complications,malignant tumors, mental illnesses, etc.

Primary outcomes:
measure: Changes in blood flow of AVF draining vein
timeFrame: from Baseline to 3 months
Secondary outcomes:
measure: Changes in diameter of AVF draining vein
timeFrame: from Baseline to 3 months
measure: The ratio of pre-pump arterial pressure and blood flow
timeFrame: from Baseline to 3 months
measure: Adverse event
timeFrame: from Baseline to 3 months
measure: Changes in blood flow of AVF proximal artery
timeFrame: from Baseline to 3 months
measure: Changes in blood flow of brachial artery
timeFrame: from Baseline to 3 months
Other outcomes:
Locations:
city: Guangzhou
country: China
facility: Guangdong General Hospital
state: Guangdong
Study officials:
References:
citation: Nantakool S, Reanpang T, Prasannarong M, Pongtam S, Rerkasem K. Upper limb exercise for arteriovenous fistula maturation in people requiring permanent haemodialysis access. Cochrane Database Syst Rev. 2022 Oct 3;10(10):CD013327. doi: 10.1002/14651858.CD013327.pub2.