Abstract: 【Abstract】Objective To observe the effect of a self- designed device for training grip strength on the maturation of internal arteriovenous fistulas. Methods A total of 49 patients on maintenance hemodialysis treated with autologous arteriovenous fistula surgery in the period from Jan. 2016 to Dec. 2016 were recruited as observation group, and a total of 58 patients on maintenance hemodialysis treated with the surgery in the period from Jan. 2015 to Dec. 2015 were used as control group. After the surgery for 2 weeks, they were asked to train grip strength: squeezing the palm squeezer for 15 seconds then relaxing slowly, repeating this training for 10 minutes and 5-10 times/day. A conventional grip device was used for the training in control group. For observation group, a grip device with grip strength monitor was used. Parameters of standard grip strength, exercise times and duration were input in the device before training. After the training, the actual training parameters including grip strength, exercise times and duration were displayed on the device or alerted by voice or lights. When the standard parameters were not achieved, required parameters were reset in the device, and the patient was asked to continue the exercise to meet the standard parameters. Diameter of the cephalic vein, blood flow, maturation degree, maturation period of the fistula, and compliance of grip training were evaluated after the surgery for 4, 8 and 12 weeks. Results After the surgery for 4, 8 and 12 weeks, diameters of the cephalic vein were 4.73±0.51mm, 4.89±0.65 and 5.15±0.95mm respectively in observation group, bigger than the diameters of 4.30±0.65mm, 4.41±0.71mm and 4.65±0.89mm respectively in control group (t=-2.970, -2.298 and - 2.928 respectively; P=0.004, 0.025 and 0.041 respectively); blood flows in cephalic vein were (501.12±125.32)ml/min, (568.13±183.39)ml/min, (675.33±213.04)ml/min respectively in observation group, higher than the blood flows of (443.64±112.21)ml/min, (496.88±164.74)ml/min, 538.84±190.08 ml/min re-spectively in control group (t=3.003, 2.932 and 2.765 respectively; P=0.005, 0.006 and 0.001 respectively). The maturation rate of fistula was 97.96% in observation group and was 87.94% in control group (χ²=3.861, P=0.049). The maturation duration was 1.75 weeks earlier in observation group than in control group. The compliance of grip strength training was higher in observation group than in control group (χ²=12.365, P=0.002). Conclusion The use of self-designed device is helpful for patients to actively train grip strength, to standardize the training, to improve compliance and training efficiency, and thus promotes fistula maturation after the surgery.

Key words: Autogenous arteriovenous fistula, Functional exercise,  Grip force monitoring device, Maturation