Effects of Individualized Forearm Isometric Exercise on Blood Flow Volume After Arteriovenous Fistula Surgery: A Case Series

BACKGROUND End-stage renal disease is a global health problem requiring long-term hemodialysis. Arteriovenous fistula (AVF) creation is a common method to provide reliable vascular access for hemodialysis. Maturation failure remains a frequent challenge in AVF creation, and blood flow volume is a key indicator of successful maturation. Physical exercise, particularly resistance training, has been shown to accelerate AVF maturation and reduce its failure rate. Isometric handgrip exercise is suggested as a low-cost and practical intervention to enhance vascular remodeling and promote AVF maturation. This case series investigated the effects of a 4-week individualized forearm isometric exercise regimen on blood flow volume in 3 patients with recently formed radiocephalic AVFs. CASE REPORT We conducted an exercise program after AVF surgery in 3 patients. The regimen, based on 50% of maximum voluntary contraction, was performed twice daily with 10-second holds, 10 repetitions, and 3 sets, starting 24 hours after surgery. Doppler ultrasound measurements performed before and after 4 weeks of the program showed significant increases in blood flow volume in the 3 patients: patient A from 175 mL/min to 559 mL/min; patient B from 299 mL/min to 633 mL/min; and patient C from 289 mL/min to 725 mL/min. No adverse events were reported. CONCLUSIONS These results suggest that an individualized exercise regimen significantly enhances blood flow volume and may serve as a promising therapy after AVF. Isometric handgrip exercises at specific intensities may be a promising therapy to enhance AVF maturation. Further research is needed to evaluate the effectiveness of these exercises and determine optimal intensity.