Effect of Hand Exercise Program on AV-Shunt Maturation in Chronic Kidney Disease Patients: A Literature Review
Abstract
An important aspect in the management of chronic kidney disease is the establishment of adequate vascular access for hemodialysis. Arteriovenous fistula (AV-shunt) is the main and most ideal option for vascular access in the hemodialysis process. This study collected research on the assessment of the effectiveness of hand training programs on arteriovenous shunt (AV-Shunt) maturation in patients with chronic kidney disease (CKD). Searches were conducted on ScienceDirect and Google Scholar. Only experimental studies examining the effects of hand exercises after surgery were reviewed. Data that has been filtered and reviewed by researchers. This study aims to summarize the effects of various hand training programs in the process of AV-Shunt/AVF maturation in CKD patients through a literature review. This study uses the literature review method by analyzing articles from trusted electronic databases such as ScienceDirect and Google Scholar with the keywords maturation AV-Shunt, hand exercises and CKD. The selected articles met the inclusion criteria, namely focusing on hand training interventions analyzed with the PICOT approach. The results of the study show that regular exercise can increase blood diameter and flow, resulting in the patentability of vascular access for the hemodialysis process, which ultimately improves the quality of life. A structured exercise program is an effective intervention in the maturation process of AV-Shunt in CKD patients.
References
Chen, J. W., Fu, H. Y., Hii, H., Tseng, H. W., Chang, P. Y., Chang, C. H., ... & Chan, C. Y. (2023). A randomized trial of postoperative handgrip exercises for fistula maturation in patients with newly created wrist radiocephalic arteriovenous fistulas. Kidney International Reports, 8(3), 566-574.
González, I. T., Simó, V. E., Pallares, S. I, Guzman, F. M., Nicolás, M. F., Gallego, V. D., ... & Serna, M. R. D. A. (2021). Upper limb isometric exercise protocolled programme and arteriovenous fistula maturation process. Clinical Kidney Journal, 14(2), 688-695.
Kumar A/LS Katheraveloo, K., Suryani Safri, L., Guo Hou, L., Hafiz Maliki, A., Md Idris, M. A., & Harunarashid, H. (2020). Effect of isometric handgrip exercise on the size of cephalic veins in patients with stage 3 and 4 chronic kidney disease: A randomized controlled trial. The Journal of Vascular Access, 21(3), 372-378.
Li, Y., Huang, L. J., Hou, J. W., & Hu, D. D. (2024). Impact of stage-specific limb function exercises guided by a self-management education model on arteriovenous fistula maturation status. World Journal of Clinical Cases, 12(14), 2316.
Manjunath, P. M., Gurpremjit, S., Devender, S., Surabhi, V., Ramana, A. P., Sreenivas, V., & Aggarwal, S. K. (2021). The effect of post-operative handgrip exercise on the maturation of arteriovenous fistula: a randomized controlled trial. Indian Journal of Surgery, 83, 920-925.
Mo, Y. W., Song, L., Huang, J. Y., Sun, C. Y., Zhou, L. F., Zheng, S. Q., ... & Fu, X. (2020). Can the fistula arm be used to lift heavy items? Six-pound dumbbells versus handgrip exercise in a 6-month follow-up secondary analysis of a randomized controlled trial. The Journal of Vascular Access, 21(5), 602-608.
Nantakool, S., Srisuwan, T., Reanpang, T., Rerkasem, K., & Prasannarong, M. (2022). A randomized controlled trial of the effect of postoperative hand exercise training on arteriovenous fistula maturation in patients with chronic kidney disease. Journal of Vascular Surgery, 75(1), 230-237.
Nantakool, S., Rerkasem, K., Reanpang, T., Worraphan, S., & Prasannarong, M. (2020). A systematic review with meta‐analysis of the effects of arm exercise training programs on arteriovenous fistula maturation among people with chronic kidney disease. Hemodialysis International, 24(4), 439-453.
Poetra, J. F., Andriati, D. P., & Poerwandari, D. (2019). The Effect Of Hand Exercise On Grip Strength, Forearm Circumference, Diameter Of Vein, Blood Flow Volume And Velocity In Patient Who Underwent Arteriovenous Fistula Surgery And On Routine Haemodialysis. Surabaya Physical Medicine and Rehabilitation Journal, 1(1), 14-24.
Pol, M. M. (2018). Hand exercise for arteriovenous fistula. Glob Surg, 4, 1-3.
Reynolds, A., & Hamidian Jahromi, A. (2022). Improving postoperative care through mindfulness-based and isometric exercise training interventions: systematic review. JMIR Perioperative Medicine, 5(1), e34651.
Silva, I. B., Barbosa, J. B., Araújo, A. X. P., & Marinho, P. E. (2021). Effect of an exercise program with blood flow restriction on the muscular strength of patients with chronic kidney disease: a randomized clinical trial. Journal of Bodywork and Movement Therapies, 28, 187-192.
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