Clinical Research Directory

Patients in this group will receive low-level laser therapy using the BS-W11 semiconductor low-level laser device, which emitted a red laser at 650 nm with a power output of 5 mW per diode. The laser will be applied over the arteriovenous fistula site. Each session lasts 30 minutes and is administered three times a week for a total period of eight consecutive weeks. A trained therapist will perform all procedures, and patients were monitored for any potential adverse reactions during and after each session.

Patients will be instructed to perform daily isometric handgrip exercises using a standard squeeze ball. Patients will be positioned seated comfortably, with the forearm of the exercising limb resting on the ipsilateral thigh and the elbow maintained in slight flexion throughout the exercise, in order to minimize compensatory shoulder and elbow movement and ensure that the contraction remained isolated to the forearm muscles. The exercise protocol involves squeezing at a rate of approximately 20 squeezes per minute for a total of 30 minutes per day, at 30-40% of maximum voluntary contraction (MVC). To improve compliance, participants will be allowed to divide the daily session into two 15-minute intervals if required. The exercise program continued for 8 consecutive weeks, and patients will be instructed to maintain adherence by recording their daily sessions in a logbook

It includes wound and dressing management (keeping the dressing dry for the initial 48-72 hours, followed by regular dressing changes and site hygiene), activity restriction (avoiding heavy lifting or direct pressure over the access site during the early postoperative period), patient education on self-palpation of the access thrill, and routine follow-up visits at approximately 1 week and 6 weeks postoperatively to assess wound healing and access patency.