Prospective case series on home-based handgrip resistance training with WhatsApp monitoring in patients with newly created arteriovenous fistulas

Muhammad Syairozi Hidayat; Yose Waluyo; Sylvia  Evelyn  Aritonang; Andi Alfian  Zainuddin; Haerani  Rasyid; Jayarasti Kusumanegara; Umar Usman; Muhammad Zulfadly Nuralim

doi:10.31450/ukrjnd.4(88).2025.05

Muhammad Syairozi Hidayat Hasanuddin University, Physical Medicine and Rehabilitation Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0009-0004-7929-7421
Yose Waluyo Hasanuddin University, Physical Medicine and Rehabilitation Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0002-0759-3270
Sylvia Evelyn Aritonang Hasanuddin University, Physical Medicine and Rehabilitation Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0009-0009-3815-2492
Andi Alfian Zainuddin Hasanuddin University, Public Health Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0003-4590-6407
Haerani Rasyid Hasanuddin University, Internal Medicine Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0001-7404-2973
Jayarasti Kusumanegara Hasanuddin University, Cardiothoracic Surgery Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0002-9954-9081
Umar Usman Hasanuddin University, Cardiothoracic Surgery Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0009-0000-3414-8386
Muhammad Zulfadly Nuralim Hasanuddin University, Cardiothoracic Surgery Department, Makassar, South Sulawesi, Indonesia https://orcid.org/0000-0003-0655-2204

DOI: https://doi.org/10.31450/ukrjnd.4(88).2025.05

Keywords: arteriovenous fistula, renal dialysis, exercise therapy, resistance training, hemodynamics.

Abstract

Successful maturation of arteriovenous fistulas (AVFs) remains a challenge for patients with end-stage kidney disease, particularly in resource-limited settings. Handgrip resistance training may enhance vascular hemodynamics and support AVF maturation. This prospective uncontrolled case series evaluated the feasibility, safety, and vascular changes of a four-week home-based handgrip program in patients with new AVFs.

Methods. Twenty-eight adults with recent radiocephalic AVF creation performed daily handgrip training for four weeks (three sets of 10 contractions, 10 seconds each with 2-second rests; ~3–5 minutes/day). Adherence was tracked via logbooks and weekly WhatsApp submissions. Feasibility outcomes included adherence, completion, safety, and patient acceptability. Hemodynamic parameters (vein diameter, vein depth, and blood flow volume) were measured using Doppler ultrasonography before and after the intervention.

Results. Of 28 participants, 23 (82.1%) completed the program with high adherence (≥85% sessions). No AVF-related adverse events occurred. Significant vascular changes were observed: vein diameter increased from 3.1 ± 0.4 mm to 5.5 ± 0.6 mm (p < 0.001), vein depth decreased from 2.5 ± 0.3 mm to 2.1 ± 0.4 mm (p = 0.002), and blood-flow volume increased from 180 ± 55 mL/min to 565 ± 110 mL/min (p < 0.001).

Conclusions. Home-based handgrip training with digital monitoring is feasible, safe, and well accepted in patients with new AVFs. The observed vascular changes suggest this low-cost intervention may support AVF maturation and is suitable for integration into dialysis care in resource-limited settings.