The effect of arteriovenous fistula longevity preservation exercise program combined with video-assisted patient education on fistula maturation for maintenance hemodialysis patients

OBJECTIVES: This study aimed to investigate the efficacy of arteriovenous fistula (AVF) exercise training combined with video-assisted patient education on AVF maturation in adults undergoing maintenance hemodialysis (MHD). METHODS: A prospective non-randomized controlled trial was conducted at Guangdong Provincial Hospital of Chinese Medicine from September 2023 to November 2024. A total of 88 eligible patients with newly created forearm AVFs were recruited and divided into an intervention group (n = 43) and a control group (n = 45) according to their willingness to perform novel or traditional exercise training. The control group received standard postoperative care, while the intervention group underwent a structured 8-week program that combined supervised AVF exercise training guided by Chinese Medicine theory with video-assisted feedback education. Primary outcomes included AVF maturation rate, time to maturation, and ultrasonographic parameters (brachial artery blood flow, arterial/venous inner diameter, AVF depth). Secondary outcomes included AVF-related complication rates. RESULTS: At 8 weeks, the intervention group demonstrated significantly higher brachial artery flow (P < 0.001), larger brachial artery inner diameter (P < 0.001), and venous diameter (P < 0.001), alongside reduced fistula depth (P < 0.001). The intervention group also demonstrated higher maturation rates (P = 0.030) and shorter median maturation time (P = 0.040) compared to the control group. No significant differences in complication rates were observed. CONCLUSION: An optimized exercise training program, combined with video-assisted education, enhances fistula maturation parameters and accelerates functional readiness for hemodialysis, suggesting its potential as a complementary strategy to standard AVF care in MHD populations. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/index.html, identifier ChiCTR2400080010.