Handgrip exercise after arteriovenous fistula creation: Vascular access and hand function outcomes—A randomized controlled trial
Nawaphan Taengsakul, Phornpa Lertutsahakul, Pantita Pooloui, Mullika ButtakosaBackground:
Postoperative exercise is widely recommended after arteriovenous fistula (AVF) creation, yet evidence for its effect on maturation remains inconsistent. We evaluated whether a structured isometric handgrip program improves AVF maturation and related functional outcomes.
Methods:
This single-center, parallel-group randomized controlled trial enrolled 80 patients undergoing radiocephalic or brachiocephalic AVF creation (October 2023–March 2025). Participants were randomized 1:1 to either a 12-week postoperative isometric handgrip exercise program (
Results:
AVF maturation at 12 weeks occurred in 84.6% (33/39) of the exercise participants and 92.5% (37/40) of the controls (adjusted risk ratio (RR) 0.91, 95% confidence interval (CI) 0.77–1.08;
Conclusions:
Postoperative isometric handgrip exercise did not improve AVF maturation but was associated with clinically meaningful gains in grip strength and, in an exploratory analysis, fewer cannulation-related hematomas. These findings support structured exercise as a safe, functionally beneficial adjunct to routine vascular access care rather than a stand-alone maturation therapy.
Trial registration:
Thai Clinical Trials Registry, TCTR 20230913009.