MO776THE USE OF HAND GRIP DEVICE IN ELDERLY PATIENTS ON ARTERIOVENOUS FISTULA MATURATION PROCESS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Irati Tapia González ◽  
Vicent Esteve ◽  
Sara Ibañez ◽  
Sandra Rubio ◽  
Fatima Moreno Guzman ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Training Program ◽  
Arteriovenous Fistula ◽  
Elderly Population ◽  
Therapeutic Option ◽  
Demographic Data ◽  
Blood Flow Rate ◽  
Control Group ◽  
Maturation Process ◽  
Hand Grip

Abstract Introduction The indication of creation arteriovenous fistula(AVF) may be controversial in elderly population with advanced chronic kidney disease (CKD). Postoperative exercises improve maturation. However, sometimes these exercises could be difficult to perform in the elderly CKD patients. The hand grip device is easy to use, inexpensive and able to increase the muscles of the hand and foream. Nevertheless, scarce scientific evidence has been reported about the role of hand grip device on AVF maturation process in elderly population. Objectives To evaluate the efficacy of a hand grip training program on AVF maturation in our patients older than 75 years old with stages 5-5D CKD. Methodology A 15 months prospective study. After surgery, all patients were randomized to hand grip group (HG) or control group (CG). HG performed a training program using a hand grip device. CO received usual care. Demographics data, upper limb muscle strength (ULMS), Doppler ultrasound (DUS), measurements (outflow vein (OV) diameter and humeral artery blood flow rate (BFR), DUS and clinical AVF maturation as well as VA related complications (hematoma, stenosis, thrombosis, pseudoaneurysm, aneurysm) were assessed at 4 and 8 weeks postoperatively. Results 29 patients. 16 HG, 13 CO. 69% men. Mean age 80,5±2,9 years. 41,4% Radiocephalic AVF. Demographic data, ULMS and DUS measurement at baseline were similar. A significant increase was observed in ULMS only in HG at the end of study (18,8±6,5 vs 21,3±7,1Kg, p=0,005). DUS measurements statistically increased for both groups (OV diameter: CG 2,9 ± 0,6 vs. 5,8 ± 1,4mm; HG 2,9 ± 0,8 vs. 7,2 ± 2,2 mm; humeral artery BFR: CG 132,9± 30,3 vs. 1310,2 ± 691,8ml/min; HG 128,1± 28,9 vs. 1530,7 ± 708,9 ml/min) at the end of study. HG group obtained highest clinical (CG 21,4% vs HG 78,6%;p=0,018) and DUS maturation (CG 27,8% vs HG 72,2%; p=0,011) at 4 weeks and highest clinical (CG 20% vs HG 80%;p=0,007) and DUS maturation (CG 25% vs HG 75%; p=0,002) at 8 weeks, significantly. Despite no significant differences, the number of complications was lower in the HG, mainly significant stenosis (CG 60% vs HG 40%; p=0,428). Conclusions The hand grip device is a useful, safety and easy to use training device to improve the AVF maturation in elderly patients. This device results a novel therapeutic option for the AVF maturation in elderly patients. Further studies are required to support these outcomes in this population.

scholarly journals P1338ELDERLY PATIENTS, UPPER LIMB ISOMETRIC EXERCISES AND ARTERIOVENOUS FISTULA MATURATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Irati Tapia González ◽  
Vicent Esteve Simo ◽  
Sara Ibañez Pallares ◽  
Sandra Rubio ◽  
Fatima Moreno Guzman ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Arteriovenous Fistula ◽  
Upper Limb ◽  
Elderly Population ◽  
Scientific Evidence ◽  
Demographic Data ◽  
Isometric Exercise ◽  
Blood Flow Rate ◽  
Exercise Group ◽  
Control Group

Abstract Background and Aims: Introduction Arteriovenous fistula (AVF) creation may be controversial in elderly population, given their comorbidities, reduced life expectancy and vascular access (VA) complications. Postoperative upper limbs isometric exercise improves AVF maturation. Nevertheless, scarce scientific evidence has been reported about their utility in elderly population until date. Objectives To assess the effect of a postoperative isometric exercises program on native VA maturation in our patients older than 75 years old with stages 5-5D chronic kidney disease. Method A 24 months prospective single-center study. After surgery, all patients were randomized to an isometric exercise group (EG) or a control group (CG). Isometric exercises protocolled programm, was performed in EG. CO received usual care. Demographical data, muscle strength using handgrip (HG) dynamometer, main Doppler ultrasound (DUS) measurements (outflow vein (OV) diameter and humeral artery blood flow rate (BFR), clinical and DUS maturation as well as medical (hematoma, stenosis, thrombosis, pseudoaneurysm, aneurysm) or surgical VA complications were assessed at 8 weeks postoperatively. Results 27 patients. 14 EG, 13 CO. 74,1% men. Mean age 79,9±2,8 years. 59,2% Radiocephalic AVF. Demographic data, HG and DUS measurement at baseline were similar. A significant increase in HG was observed only in EG at the end of study (19,1±7,8 vs 22,9±9,7Kg, p=0,001). DUS measurements statistically increased for both groups (OV diameter: EG 3,1 ± 0,8 vs. 5,9 ± 1,7 mm; CG 2,9 ± 0,6 vs. 5,8 ± 1,4mm; humeral artery BFR: EG 150,7± 42,7 vs. 1165,0 ± 664,5 ml/min; CG 132,9± 30,3 vs. 1310,2 ± 691,8ml/min) at the end of study. EG group obtained highest clinical (CG 46,2% vs EG 78,6%;p=0,049) and DUS maturation (CG 30,8% vs EG 71,4%; p=0,041) at 8 weeks, significantly. Despite no significant differences, the number of complications was lower in the EG, mainly hematomas and significant stenosis. Conclusion The upper limb isometric exercises protocolled program improved clinical and DUS maturation in our elderly patients. With our results, isometric exercises should be guaranteed in elderly patients in order to obtain a correct maturation of the performed AVF. Further studies are required to support these outcomes in this population.

scholarly journals Upper limb isometric exercise protocolled programme and arteriovenous fistula maturation process

2020 ◽  
Author(s):  
Irati Tapia González ◽  
Vicent Esteve Simó ◽  
Sara Ibañez Pallares ◽  
Fátima Moreno Guzman ◽  
Miquel Fulquet Nicolás ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Upper Limb ◽  
Scientific Evidence ◽  
Demographic Data ◽  
Isometric Exercise ◽  
Exercise Programme ◽  
Exercise Group ◽  
Control Group ◽  
Hand Grip ◽  
End Stage

Abstract Introduction Arteriovenous fistula (AVF) is the gold standard for vascular access (VA) for end-stage chronic kidney disease (CKD) patients. Post-operative exercises may help to improve maturation. Nevertheless, scarce scientific evidence has been reported about their utility to date. Our objective was to assess the effect of a post-operative isometric exercise programme on native VA maturation in patients with stage 5–5D CKD. Methods We performed a 24-month prospective study. After surgery, patients were randomized to the isometric exercise group (EG) or control group (CG). An isometric exercise protocolled programme was performed in the EG. The CG received usual care. Demographic data, muscle strength using a hand-grip (HG) dynamometer, main Doppler ultrasound (DUS) measurements, clinical and DUS maturation and VA complications were assessed at 4 and 8 weeks post-operatively. Results For 60 sixty patients (30 in the EG), demographic data and HG and DUS measurements at baseline were similar. A significant increase in HG was observed only in the EG at the end of the study (20.7 ± 8.1 versus 25.1 ± 10.3 kg, P = 0.001). The EG obtained the highest clinical maturation at 4 (CG 33.3% versus EG 70%, P = 0.009) and 8 weeks (CG 33.3% versus EG 76.7%, P = 0.002). Similarly, DUS maturation was better in the EG at 4 (CG 40% versus EG 80%, P = 0.003) and 8 weeks (CG 43.3% versus EG 83.3%, P = 0.003) and remained so in the EG for both distal and proximal VA territories for all these periods. Conclusions The upper limb isometric exercise protocolled programme improved clinical and DUS maturation in our patients in both the distal and proximal VA territories. Further studies are required to support these results.

scholarly journals Impact of Resistance Exercise On Hand Grip: An Experimental study

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 371-375
Author(s):  
Bhuvaneshwari G ◽  
Nithya Manogaran
Keyword(s):  
Resistance Exercise ◽  
Research Design ◽  
Elderly Population ◽  
Demographic Data ◽  
The Elderly ◽  
Muscle Quality ◽  
Control Group ◽  
Hand Grip ◽  
The Impact ◽  
Experimental Group

Sarcopenia is a significant medical issue related with aging, characterized as loss of bulk and capacity. It is a condition portrayed by loss of skeletal bulk and quality, with a danger of antagonistic results, for example, handicap, improvement of delicacy, low quality of life and death. Its etiology is still inadequately comprehended. Opposition preparing intercession is sheltered and compelling for checking sarcopenia. Resistance exercise (RE) programs improve muscle anabolism, bulk and muscle quality. The present study aims to assess the impact of resistance exercise on hand grip among the elderly population with sarcopenia. A quasi experimental research design with non-randomized control research design was conducted among 30 elderly population in Arrakonam among which 15 were chosen for the experimental group and 15 were chosen as the control group. A purposive sampling technique was used to select samples. Structured questionnaires were used to collect demographic data and BMI and hand grip was assessed. The resistance exercises were taught to the elderly population and they were asked to perform the exercise every day for one week. After a week, the BMI and hand grip was re-assessed. The studies thus indicates that the experimental group had a reduction in the hand grip and increase in the BMI value after resistance exercise and is also an effective method to prevent further complications that can be caused due to sarcopenia.

scholarly journals Factors Affecting Mortality in Elderly Patients Hospitalized for Nonmalignant Reasons

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Teslime Ayaz ◽  
Serap Baydur Sahin ◽  
Osman Zikrullah Sahin ◽  
Ozlem Bilir ◽  
Halil Rakıcı
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Elderly Population ◽  
Demographic Data ◽  
The Elderly ◽  
Hospital Records ◽  
Factors Affecting ◽  
Duration Of Hospital Stay ◽  
Patient Profiles ◽  
The Mean

Elderly population is hospitalized more frequently than young people, and they suffer from more severe diseases that are difficult to diagnose and treat. The present study aimed to investigate the factors affecting mortality in elderly patients hospitalized for nonmalignant reasons. Demographic data, reason for hospitalization, comorbidities, duration of hospital stay, and results of routine blood testing at the time of first hospitalization were obtained from the hospital records of the patients, who were over 65 years of age and hospitalized primarily for nonmalignant reasons. The mean age of 1012 patients included in the study was 77.8 ± 7.6. The most common reason for hospitalization was diabetes mellitus (18.3%). Of the patients, 90.3% had at least a single comorbidity. Whilst 927 (91.6%) of the hospitalized patients were discharged, 85 (8.4%) died. Comparison of the characteristics of the discharged and dead groups revealed that the dead group was older and had higher rates of poor general status and comorbidity. Differences were observed between the discharged and dead groups in most of the laboratory parameters. Hypoalbuminemia, hypertriglyceridemia, hypopotassemia, hypernatremia, hyperuricemia, and high TSH level were the predictors of mortality. In order to meet the health necessities of the elderly population, it is necessary to well define the patient profiles and to identify the risk factors.

scholarly journals Effects of a Floor Hockey Intervention on Motor Proficiency, Physical Fitness, and Adaptive Development in Youths with Mild Intellectual Disabilities

2021 ◽  
Vol 18 (13) ◽  
pp. 7059
Author(s):  
Po-Jen Hsu ◽  
Hung-Ling Yeh ◽  
Chia-Liang Tsai ◽  
Chia-Hua Chu ◽  
Fu-Chen Chen ◽  
...  
Keyword(s):  
Physical Fitness ◽  
Intellectual Disabilities ◽  
Training Program ◽  
Therapeutic Option ◽  
Exercise Group ◽  
Assessment System ◽  
Control Group ◽  
Motor Proficiency ◽  
Physical Fitness Test ◽  
Adaptive Development

This study examined the effects of a 12-week floor hockey training program on the motor proficiency, physical fitness, and adaptive development of youths with mild intellectual disabilities (IDs). A total of 54 youths with IDs were divided into two groups: a floor hockey exercise group (EG; n = 27; age, 16.59 ± 0.56 years) and a control group (CG; n = 27; age, 16.65 ± 0.63 years). The participants in the EG attended sessions of a floor hockey training program 3 times per week over a 12-week period. The CG group maintained their standard activities of daily living. The participants’ scores on the Bruininks–Oseretsky Test of Motor Proficiency, Second Edition, Brockport Physical Fitness Test, and traditional Chinese version of the teacher form of the Adaptive Behavior Assessment System, Second Edition, were obtained before and after the intervention. The results of the study indicate that the 12-week floor hockey training program significantly increased the participants’ scores for most indicators of motor proficiency (p < 0.01), physical fitness (p < 0.01), and adaptive development (p < 0.01). The findings provide evidence that physical activity interventions focusing on floor hockey training are a viable therapeutic option for treating youths with IDs.

Combined use of heparin and anisodamine reduces the risk of early thrombosis in native arteriovenous fistula

Vascular ◽  
2013 ◽  
Vol 21 (6) ◽  
pp. 369-374 ◽  
Author(s):  
Lan Chen ◽  
Yi-Sheng Ling ◽  
Chun-Hua Lin ◽  
Tian-Jun Guan
Keyword(s):  
Treatment Group ◽  
Arteriovenous Fistula ◽  
Color Doppler ◽  
Blood Flow Rate ◽  
Color Doppler Ultrasound ◽  
Control Group ◽  
Combined Application ◽  
Combined Use ◽  
Stage 4

The greatest threat of arteriovenous fistula (AVF) is early thrombosis. There remains limited evidence for the use of agents for the prevention of AVF thrombosis. A total of 180 patients with stage 4 or 5 chronic kidney disease were enrolled in the present study. They were expected to have hemodialysis (HD) within the next six months and a planned lower arm AVF is expected to be the primary HD access. They were randomly divided into a control group with 60 patients, a heparin (H) treatment group with 60 patients and a heparin/anisodamine (H/A)-treatment group with 60 patients. The H/A-treatment group was given 50 IU/kg of heparin and 10 mg of anisodamine for seven days after the AVF was generated. The H-treatment group was given 50 IU/kg of heparin for seven days whereas the control group was given no treatment. The diameter and blood flow rate of the AVF were evaluated by color Doppler ultrasound at the fourth week after the operation. Patency rates of AVF were 96.7% in the H/A-treatment group, 86.7% in the H-treatment group ( P < 0.05) and 83.3% in the control group ( P < 0.05). The present research indicates that combined application of heparin and anisodamine can effectively relieve the vessel spasm that often occurs after establishment of an AVF and reduce the risk of early thrombosis. However, further evidence is required to validate the maintenance of long-term patency of AVF.

scholarly journals A two-stage model of an arteriovenous fistula maturation process

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Daniel M. Jodko ◽  
Damian S. Obidowski ◽  
Piotr Reorowicz ◽  
Krzysztof Jóźwik
Keyword(s):  
Arteriovenous Fistula ◽  
Blood Flow Rate ◽  
Maturation Process ◽  
Two Stage ◽  
Physiological Level ◽  
Short Period ◽  
Venous Diameter ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation ◽  
Venous Wall

Purpose: An arteriovenous fistula has been a widely accepted vascular access for hemodialysis, however, a fistula maturation proces is still not fully understood. In the short period of time, right after vein and artery shunting, the physical and biological changes take place mainly in the venous wall. A two-stage modeling method of arteriovenous fistula maturation process was proposed and presented. Methods: The first stage of the maturation was modeled with two-way coupled fluid structure interaction computer simulations. Whereas for the second, biological stage, a model was based on the change in the elasticity of the venous wall due to wall shear stress (WSS) modifications. Results: The relation between stress and radial and circumferential strain, based on Lame’s theory, makes possible to introduce a mathematical model defining modulus of elasticity, averaged WSS, and venous diameter as time functions. The presented model enables one to predict changes in the monitored parameters in the arteriovenous fistula taking place in the time longer than 90 days. Conclusions: We found that probably the majority of fistulas can be assessed to be mature too early, when the adequate blood flow rate is achieved but mean WSS still remains at the non-physiological level (>10 Pa).

scholarly journals Primary patency of native arteriovenous fistula in elderly at Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia

2021 ◽  
Vol 1 (1) ◽  
pp. 4-7
Author(s):  
Muhammad Rizki Bachtiar ◽  
Ivan Joalsen ◽  
Izzati Nurmaya Sari ◽  
Made Angga Putra
Keyword(s):  
Elderly Patients ◽  
Arteriovenous Fistula ◽  
Survival Data ◽  
Demographic Data ◽  
The Elderly ◽  
Primary Patency ◽  
Dialysis Access ◽  
Term Survival ◽  
First Choice ◽  
The Right

Introduction. Arteriovenous fistula (AVF) is preferred to be selected by the patient and clinician due to long term survival and fewer complications than other vascular access. Radiocephalic (RC) fistula is the first choice for dialysis access and should be performed in elderly renal failure patients. Several authors have advocated that the brachiocephalic (BC) fistula should be considered the surgeons' first option. We aim to analyze the primary patency of RC and BC AVF in the elderly. Method. This prospective cohort study was conducted from June 2018 to March 2020, which included 58 elderly patients who underwent surgery to create AVF. Demographic data were collected from medical records. Meanwhile, information about patient’s primary patency of RC and BC AVF were followed up to first access dysfunction or any intervention by phone. The survival data were analyzed using the Kaplan-Meier method Result. There were 58 elderly patients divided into 51 (87.9 %) patients with RC, 4 (6.9%) patients with BC, and 3 (5.2%) patients with Basilic Vein Transposition (BVT). The survival rate of RC was 70.5 % after six months and 29.4 % after 12 months. Meanwhile, 50% of BC patients survived in the first six months, and 25% survive for a year. On the other hand, 1 of 3 patients died in the BVT group in the first month after access placement due to hemodialysis complication, and the remaining two BVT patients survived in three months. Conclusion. RC has a patency rate of 70.5% in six months and 29.4% in a year. Choosing the right type and site of the anastomosis is essential as life expectancy increases in the elderly to preserve the veins for future access site.

Auricular vagal nerve stimulation in peripheral arterial disease patients

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Gerald Hackl ◽  
Andreas Prenner ◽  
Philipp Jud ◽  
Franz Hafner ◽  
Peter Rief ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Nerve Stimulation ◽  
Short Form ◽  
Therapeutic Option ◽  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Sf 36 ◽  
Peripheral Arterial ◽  
Double Blinded

Abstract. Background: Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. Patients and methods: In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128–236] meters to 345 [95 % CI 227–463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109–210] meters to 268 [95 % CI 182–366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

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