Resistance of Arm Exercise Patterns on Maturation of Vascular Accesses Among Persons Receiving Hemodialysis: A Systematic Review

Abstract

The treatment of chronic kidney disease is hemodialysis through the arteriovenous fistula (AVF) which is an acceptable method to remove waste products and excess water from the blood. Thus, the preparation of vascular maturation is crucial to a patient’s life. The objective of this systematic review was to review knowledge of arm exercise patterns for the maturation of vascular access in hemodialysis patients by using the Joanna Briggs Institute Systematic Review Guidelines (JBI, 2020). We searched the databases for primary research from 2017 to 2021. From a total of 442 primary research studies, six studies that used a randomized controlled trial methodology which met the qualifying inclusion criteria were included in the study. Of these six, two studies were conducted during the pre-operative period, three studies were conducted during the post-operative period and one study was conducted continuously across the pre-operative and post-operative periods. Meta-analysis did not apply as these studies were dissimilar in terms of types of intervention, the time periods of measurement and their outcomes. Instead, narrative summarization was used in this systematic review.
The results of this systematic review show clearly that nurses should advise patients to continue exercise for 12 weeks from the preoperative to the postoperative period for AVF maturation to have an effective outcome. However, it was not clear regarding the outcomes of handgrip exercise. The findings also showed that isometric exercise combined with handgrip exercise is effective for upper and lower limb maturation. This research also requires primary research to draw conclusions and develop definite guidelines.