Physical Exercise With Flow Restriction of the Forearm in Chronic Kidney Disease

NCT02619968 | Unknown DMC

• 1 other identifier: 07587234403
• Study Type: interventional
• Target: 20
• Locations: 0 countries
• Sites: N/A

Brief Summary

The aim of this study is to analyze the effectiveness of physical exercise with blood flow restriction on the diameter and the flow of vessels, muscle strength and circumference of the forearm in patients with CKD prior to making FAV.

Conditions

Chronic Kidney Disease

Keywords

Chronic renal failure; Arteriovenous fistula; Isometric exercises; Vascular endothelium

Outcome Measures

Primary Outcomes (1)

• Increasing the diameter of the cephalic vein

  Increasing the diameter of the cephalic vein of at least 0.22 mm

  8 weeks of training for each patient

Secondary Outcomes (4)

• Increasing the diameter of the radial artery

  8 weeks of training for each patient

• Radial artery blood flow

  8 weeks of training for each patient

• Forearm Circumference

  8 weeks of training for each patient

• Muscle strength of the forearm

  8 weeks of training for each patient

Study Arms (2)

Experimental group

EXPERIMENTAL

Will be held isometric and isotonic concentric to the flexor muscles of the elbow and wrist using tennis ball, halter and handgrip added to partial occlusion of blood flow to tourniquet application. Application of the tourniquet Will be held in conjunction with exercises for the experimental group. Tennis ball: will initially be 3 sets, where one series with 10 grips, increasing 5 grips every week, 60 seconds rest every series. Halter: are performed with load of 1 kg, 2 kg and 3 kg. Handgrip: they will be performed 3 sets of dynamic manual hold exercises in the intensity of 40% of MVC. Home program: at home will be performed isometric exercises with tennis ball on the same frequency as in performing ambulatory without applying the tensiometer.

Other: experimental group

Group control

SHAM COMPARATOR

Will be held the same isometric and isotonic concentric ambulatory and home with the same duration, frequency and intensity, except is not to apply the tourniquet.

Other: experimental group

Interventions

experimental group OTHER

Will be held isometric and isotonic concentric to the flexor muscles of the elbow and wrist using tennis ball, halter and handgrip added to partial occlusion of blood flow to tourniquet application. The Application of the tourniquet will be held in conjunction with exercises for the experimental group.

Experimental group; Group control

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with Chronic Kidney Disease (CKD) stage 4 or 5;
• In conservative or dialysis treatment;
• Medical indication of arteriovenous fistula as an achievement of HD.

You may not qualify if:

• Cognitive impairment or changes that hinder understanding, realization of activities and interpretation of the issues;
• a history of making FAV in both upper limbs or some other type of vascular surgery in upper limbs, with some type of vascular access in upper limbs or in nearby regions;
• to develop some kind of manual work with heavy loads;
• Trauma-orthopedic lesions in the cervical, shoulder, elbow, wrist and untreated (or) hand;
• Signs of thrombophlebitis and hypoplasia / agenesis of the upper limbs.

Sponsors & Collaborators

• Universidade Federal de Pernambuco: lead

Related Publications (7)

• Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012 Jan 14;379(9811):165-80. doi: 10.1016/S0140-6736(11)60178-5. Epub 2011 Aug 15.

  PMID: 21840587 BACKGROUND

• National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266. No abstract available.

  PMID: 11904577 BACKGROUND

• Lugon JR. End-stage renal disease and chronic kidney disease in Brazil. Ethn Dis. 2009 Spring;19(1 Suppl 1):S1-7-9.

  PMID: 19484865 BACKGROUND

• Rus RR, Ponikvar R, Kenda RB, Buturovic-Ponikvar J. Effect of local physical training on the forearm arteries and veins in patients with end-stage renal disease. Blood Purif. 2003;21(6):389-94. doi: 10.1159/000073441.

  PMID: 14586181 BACKGROUND

• Rus RR, Ponikvar R, Kenda RB, Buturovic-Ponikvar J. Effect of intermittent compression of upper arm veins on forearm vessels in patients with end-stage renal disease. Hemodial Int. 2005 Jul;9(3):275-80. doi: 10.1111/j.1492-7535.2005.01142.x.

  PMID: 16191078 BACKGROUND

• Kumar S, Seward J, Wilcox A, Torella F. Influence of muscle training on resting blood flow and forearm vessel diameter in patients with chronic renal failure. Br J Surg. 2010 Jun;97(6):835-8. doi: 10.1002/bjs.7004.

  PMID: 20309951 BACKGROUND

• Nantakool S, Reanpang T, Prasannarong M, Pongtam S, Rerkasem K. Upper limb exercise for arteriovenous fistula maturation in people requiring permanent haemodialysis access. Cochrane Database Syst Rev. 2022 Oct 3;10(10):CD013327. doi: 10.1002/14651858.CD013327.pub2.

  PMID: 36184076 DERIVED

MeSH Terms

Conditions

Renal Insufficiency, Chronic; Kidney Failure, Chronic; Arteriovenous Fistula

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Arteriovenous Malformations; Vascular Malformations; Cardiovascular Abnormalities; Cardiovascular Diseases; Vascular Fistula; Vascular Diseases; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Fistula; Pathological Conditions, Anatomical

Study Officials

• Jefferson B Barbosa, physiotherapist

  Universidade Federal de Pernambuco

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jefferson B Barbosa, physiotherapist

CONTACT

55 21268496; jbnunesfisio@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: postgraduate in integrated multidisciplinary residency in health, concentration area in physical therapy in nephrology

Study Record Dates

• First Submitted: November 30, 2015
• First Posted: December 2, 2015
• Study Start: January 1, 2016
• Primary Completion: March 1, 2017
• Study Completion: March 1, 2017
• Last Updated: December 2, 2015

Record last verified: 2015-11