Exercise device for internal arteriovenous fistula postoperative rehabilitation and implementation method

Abstract

The invention discloses an exercise device for internal arteriovenous fistula postoperative rehabilitation and an implementation method, and relates to the field of medical instruments.The method comprises the steps that the fistula side hand and the forearm of a patient stretch into a containing space of a cylindrical body, and the forearm is attached to a regional water bag; the control module controls the temperature adjusting module and adjusts the water temperature according to the preset temperature so as to achieve cold compress or hot compress on the fistula side forearm, and after the water temperature is adjusted, the water pump is controlled to conduct regular water charging and discharging on the regional water bag according to the preset water charging and discharging configuration so as to simulate the hemodynamic environment. When a patient exercises the upper limb on the fistula side, the pressure monitoring module and the blood flow monitoring module collect pressure data and blood flow data in real time respectively, and the control module judges whether the pressure data and / or the blood flow data of the upper limb on the fistula side are / is abnormal or not according to preset pressure and / or preset blood flow speed and gives an alarm through the alarm module when the pressure data and / or the blood flow data are / is abnormal.

Description

Technical Field

[0001] This invention relates to medical devices, and more particularly to an exercise device and method for rehabilitation after arteriovenous fistula surgery. Background Technology

[0002] The global incidence of chronic renal failure is 10%-15%, while the prevalence in my country is 10.8%. Among them, 86.8% require hemodialysis for maintenance treatment, and 80%-85% of hemodialysis patients use arteriovenous fistulas (AVFs) as vascular access.

[0003] After autogenous arteriovenous fistula (AVF) surgery, the AVF needs to undergo a process of venous arterialization, achieving lumen expansion and wall thickening, in order to withstand the high-speed blood flow pressure required for repeated punctures and hemodialysis. This process usually takes 8-12 weeks, and the AVF maturation failure rate is relatively high: the immaturity rate at 12 weeks post-surgery is as high as 20%-30%, and some studies show that this rate can be as high as 30%-50%.

[0004] Current traditional rehabilitation exercises have many problems, as follows:

[0005] 1. Inaccurate pressure control: Relying on the patient to manually press, excessive pressure can easily damage immature blood vessels, while insufficient pressure will not achieve the expected training effect;

[0006] 2. Limited training modes: unable to simulate real hemodynamic environments (such as periodic pulse pressure changes);

[0007] 3. Lack of data feedback: Patients and doctors cannot quantify the effects of exercise and cannot detect abnormalities in the vascular maturation process in a timely manner;

[0008] 4. Patient compliance is difficult to guarantee: The exercise process is boring, which makes patients easily forget or interrupt the exercise. Summary of the Invention

[0009] To address the aforementioned problems, this invention provides an exercise device and method for postoperative rehabilitation of arteriovenous fistulas.

[0010] This invention provides an exercise device for postoperative rehabilitation of arteriovenous fistula, comprising:

[0011] The cylindrical body has an internal space that accommodates the patient's forearm on the side of the fistula. Its inner wall is equipped with a regional water bladder that allows for passive movement of the forearm or relief of fatigue through regular filling and emptying of water.

[0012] The temperature control module is used to adjust the temperature of the water tanks in different zones to a preset temperature.

[0013] Fistula-side exercise kit, used to exercise the hand, wrist and forearm of the patient's upper limb on the fistula side;

[0014] The pressure monitoring module, installed on the fistula-side exercise component, is used to collect pressure data when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb;

[0015] The blood flow monitoring module has a probe fixed to the upper limb on the side of the fistula to collect blood flow data during the movement of the patient's upper limb on the side of the fistula;

[0016] The control module is used to control the temperature adjustment module to adjust the temperature of the regional water bladder according to the preset temperature, so as to achieve cold or hot compress on the forearm on the fistula side; to control the water pump to regularly inflate and deflate the regional water bladder according to the preset water filling and defilling configuration, so as to simulate the hemodynamic environment; and to determine whether the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal according to the preset pressure and / or preset blood flow velocity.

[0017] The alarm module is used to issue an alarm when the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal.

[0018] Preferably, the temperature control module includes:

[0019] The water storage tank is connected to the water pump and the water tanks in different areas via pipelines.

[0020] The temperature control assembly includes a temperature sensor disposed in the water storage tank, a semiconductor cooling and heating element attached to the outer wall of the water storage tank, and a drive unit for driving the semiconductor cooling and heating element.

[0021] The control module acquires the water temperature collected by the temperature sensor, and outputs a temperature control signal based on the preset temperature and water temperature. The signal is then used by the drive unit to control the semiconductor cooling and heating element to cool or heat the water entering the sub-zone water tank so that the temperature reaches the preset temperature.

[0022] Preferably, the fistula-side exercise component includes:

[0023] A wrist pillow, set inside a cylindrical body, is used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body.

[0024] A display screen, located outside the cylindrical main body, is used to display the exercises the patient is to perform.

[0025] The keyboard is used to receive input operations performed by the patient based on the content displayed on the screen, in order to exercise the hand and wrist muscles of the upper limb on the side of the fistula;

[0026] A hand grip strengthener is used by patients to grip and exert force to exercise the hand, wrist, and forearm muscles of the upper limb on the side of the fistula.

[0027] Preferably, the pressure monitoring module includes a pressure sensor disposed on each key of the keyboard and a pressure sensor disposed on the grip strength unit.

[0028] Preferably, the fistula-side exercise component includes:

[0029] A wrist pillow, set inside a cylindrical body, is used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body.

[0030] A touchscreen, located outside the cylindrical body, is used to display the content to be exercised by the patient and to receive input operations performed by the patient based on the content displayed on the screen, in order to exercise the hand and wrist muscles of the upper limb on the side of the fistula.

[0031] A hand grip strengthener is used by patients to grip and exert force to exercise the hand, wrist, and forearm muscles of the upper limb on the side of the fistula.

[0032] Preferably, the pressure monitoring module includes a pressure sensor disposed on the gripper.

[0033] Preferably, the blood flow monitoring module is an ultrasound device, the probe of the blood flow monitoring module is an ultrasound probe, and the ultrasound probe is detachably fixed to the forearm on the fistula side near the fistula area by an elastic fixing strap.

[0034] Preferably, it further includes:

[0035] The vibration sound monitoring component is an auscultatory pickup probe, which is coaxially fixed to the fistula-side arm with an ultrasound probe via an elastic fixing strap. It is used to collect the vibration sound signal of the arteriovenous fistula and transmit it to the control module so that the control module can determine the status of the arteriovenous fistula.

[0036] This invention provides a method for implementing an exercise device for postoperative rehabilitation of arteriovenous fistulas, applied to the aforementioned exercise device, the method comprising:

[0037] The probe of the blood flow monitoring module is fixed to the patient's upper limb on the side of the fistula;

[0038] By inserting the patient's fistula-side hand and forearm into the receiving space of the tubular main body, the forearm is made to fit against the segmented water sac;

[0039] The control module adjusts the water temperature according to the preset temperature control module to achieve cold or hot compresses on the forearm on the side of the fistula.

[0040] After the water temperature is adjusted, the control module controls the water pump to regularly fill and drain the water in the water bladders in different areas according to the preset filling and draining configuration, in order to simulate the hemodynamic environment.

[0041] The pressure monitoring module collects pressure data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb;

[0042] The blood flow monitoring module collects blood flow data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb;

[0043] The control module determines whether the pressure data collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal according to the preset pressure and / or preset blood flow velocity, and issues an alarm through the alarm module when an abnormality is found.

[0044] Preferably, it further includes:

[0045] The flutter monitoring component acquires flutter signals from the arteriovenous fistula;

[0046] The control module determines the status of the arteriovenous fistula based on blood flow data and thriller signals.

[0047] The present invention has the following technical effects:

[0048] 1. This invention uses a pressure monitoring module to monitor the pressure data applied by the patient in real time. This pressure data can be used to determine whether the pressure is abnormal. When an abnormality occurs, an alarm module will issue an alarm reminder, which can avoid excessive pressure on the fistula and ensure effective exercise within a safe pressure range.

[0049] 2. The control module of the present invention can control the water pump to regularly fill and drain the water bladder in different areas, such as periodic pulse pressure changes, to simulate the real hemodynamic environment, which can accelerate the maturation of the arteriovenous fistula and shorten the maturation time of the arteriovenous fistula.

[0050] 3. The present invention uses blood flow data monitored by the blood flow monitoring module, or blood flow data monitored by the blood flow monitoring module and the vibration sound monitoring component to monitor the vibration sound signal of the arteriovenous fistula, to assess the exercise effect and the health status of the arteriovenous fistula.

[0051] 4. This invention can provide users with gamified exercise content through a display screen and keyboard, or through a touch screen, making boring exercise interesting and easy to stick to, thereby improving patient compliance. Attached Figure Description

[0052] Figure 1 This is a schematic diagram of the front structure of an exercise device for postoperative rehabilitation of arteriovenous fistula according to an embodiment of the present invention.

[0053] Figure 2 It is along Figure 1 Top view after being cut open along the middle AA' direction;

[0054] Figure 3 This is a schematic diagram of the front structure of an exercise device for postoperative rehabilitation of arteriovenous fistula, according to another embodiment of the present invention.

[0055] Figure 4 It is along Figure 3Top view after being cut open along the middle AA' direction;

[0056] Figure 5 This is a schematic diagram of the control structure of the exercise device for postoperative rehabilitation of arteriovenous fistula according to the present invention;

[0057] Figure 6 This is a schematic diagram of the control structure of the temperature control module of the present invention;

[0058] Figure 7 This is a schematic diagram of the control structure for filling and releasing water into regional water bladders using a water pump, as described in this invention.

[0059] Figure 8 This is a timeline diagram of the various stages of rehabilitation training after arteriovenous fistula surgery according to the present invention.

[0060] Figure 9 This is a schematic diagram of the rehabilitation exercise process after arteriovenous fistula surgery according to the present invention. Detailed Implementation

[0061] The embodiments of the present invention will be described in detail below with reference to the accompanying drawings. It should be understood that the preferred embodiments described below are only for illustration and explanation of the present invention and are not intended to limit the present invention.

[0062] This invention discloses an exercise device and its implementation method for postoperative rehabilitation of arteriovenous fistulas (AVFs). The exercise device includes a fistula-side exercise component, various monitoring modules, an alarm module, and a setting module. It features pressure and blood flow monitoring functions, enabling real-time pressure monitoring and indicating grip strength to prevent excessive compression and vascular damage. It automatically alarms when pressure or blood flow is abnormal, such as audible alerts when the patient's grip strength is too high or too low, or when blood flow is abnormal, allowing for personalized exercise. It provides guidance before wound recovery, after wound healing, and for long-term maintenance, achieving closed-loop management of the entire AVF cycle. It is suitable for patients with CKD stages 3 / 4, those scheduled for arteriovenous fistula reconstruction, newly diagnosed fistula patients, patients with insufficient AVF blood flow, and AVF patients undergoing long-term hemodialysis.

[0063] See Figure 1 , Figure 2 and Figure 5 An embodiment of the present invention provides an exercise device for postoperative rehabilitation of arteriovenous fistula, comprising a cylindrical main body 1, a temperature control module, a fistula-side exercise component, a pressure monitoring module, a blood flow monitoring module, a control module, and an alarm module. Wherein:

[0064] 1. Tubular body 1

[0065] The cylindrical body 1 has an internal space that accommodates the patient's fistula-side forearm, and its inner wall is provided with a regional water sac 11 that allows the forearm to move passively or relieve fatigue through regular filling and emptying of water.

[0066] The subdivided water sac 11 may include two water sacs, which are in contact with the forearm extensor muscles and flexor muscles respectively. By regularly filling and emptying the two water sacs (e.g., alternating filling and emptying according to a set pulse pattern), passive flexion and extension exercises of the forearm can be achieved, which can assist in rehabilitation and relieve fatigue.

[0067] Alternatively, the sub-regional water sac 11 may include multiple water sacs, see [reference]. Figure 2 All extend along the direction of the arm into the cylindrical body 1. Multiple water sacs surround the forearm. By regularly filling and releasing water in the multiple water sacs, passive exercise of the forearm can be achieved, which can assist in rehabilitation and relieve fatigue.

[0068] It should be noted that patients can perform active and passive exercises separately or in combination.

[0069] Furthermore, a flexible protective layer can be provided on the inner wall of the cylindrical body 1, and the regional water bladders 11 are embedded inside the flexible protective layer. The flexible protective layer is used to buffer the pressure impact of the water bladders on the forearm.

[0070] 2. Temperature control module

[0071] The temperature control module is used to adjust the temperature of the zoned water bladder 11 to the preset temperature.

[0072] The preset temperatures include preset cold compress temperatures and preset hot compress temperatures. The preset cold compress temperature can be any value within the range of 0-5℃, and can be used to reduce local swelling in the early postoperative period (e.g., within 72 hours after surgery). The preset hot compress temperature can also be any value within the range of 38-40℃, and can be used in the middle postoperative period to promote blood circulation and promote repair.

[0073] In one embodiment, the temperature control module may include a water storage tank and a temperature control component. The water storage tank may be disposed between the outer shell and inner wall of the cylindrical main body 1, or at a suitable location outside the cylindrical main body 1, and is connected to a water pump and regional water bladders via pipelines. The temperature control component includes a temperature sensor disposed within the water storage tank, a semiconductor cooling and heating element attached to the outer wall of the water storage tank, and a drive unit for driving the semiconductor cooling and heating element. See also... Figure 6 The control module acquires the water temperature from the temperature sensor and outputs a temperature control signal based on the preset cold / hot compress temperature and the water temperature. This signal, transmitted via a drive unit, controls the semiconductor cooling / heating element to cool or heat the water into the designated zones, ensuring the water entering the zoned water tanks reaches the preset temperature. When the control module controls the water pump to fill and empty the zoned water tanks, see [further details omitted]. Figure 7Taking the aforementioned regional water bladder 11, which includes two water bladders, as an example, the water storage tank, water pump, inlet valve 1, water bladder 1 and return valve 1 form the circulating water path 1 of water bladder 1, and the water storage tank, water pump, inlet valve 2, water bladder 2 and return valve 2 form the circulating water path 2 of water bladder 2. The control module controls the inlet valves 1 and 2 and the return valves 1 and 2 to connect or disconnect the circulating water paths 1 and 2, so that the water pump fills the water bladder 1 and 2 with water from the water storage tank or pumps the water in the water bladder 1 and 2 back to the water storage tank.

[0074] In another embodiment, the temperature control module includes only a temperature control component and does not include a water storage tank. The temperature control component includes a temperature sensor disposed on the surface of the water bladder, a semiconductor cooling and heating element disposed at a distance from the water bladder, and a drive unit for driving the semiconductor cooling and heating element. The control module acquires the water bladder temperature collected by the temperature sensor, and outputs a temperature control signal according to the preset cold compress temperature / preset hot compress temperature and the water bladder temperature. The control module then controls the semiconductor cooling and heating element to cool or heat the water bladder through the drive unit so that the temperature of the water bladder in different areas reaches the preset temperature. After the water bladder reaches the preset temperature, the control module controls the water pump to fill and drain the water bladders in different areas. Taking the aforementioned water bladder 11, which includes two water bladders, as an example, water bladder 1, water pump, inlet valve, water bladder 2, and return valve form a circulating water circuit. The control module controls the inlet valve to open and the return valve to close, so that the water pump pumps the water in water bladder 1 into water bladder 2. Water bladder 2 expands and exerts force. Then, the control module controls the inlet valve to close and the return valve to open, so that the water pump flows the water in water bladder 2 into water bladder 1. Water bladder 1 expands and exerts force. By alternating the above steps, the purpose of alternating filling and draining of water is achieved to passively flex and extend the forearm or relieve fatigue after exercise.

[0075] 3. Fistula-side exercise components

[0076] The fistula-side exercise kit is used to exercise the hand, wrist, and forearm of the patient's fistula-side upper limb.

[0077] The fistula-side exercise component includes: a wrist pillow 12, disposed inside the cylindrical body 1, used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body 1, reducing wound traction and relieving pain; a display screen 2, disposed outside the cylindrical body 1, for example, disposed on the top of the cylindrical body 1, used to display the content to be exercised by the patient; a keyboard 13, used to receive input operations performed by the patient based on the content displayed on the display screen 2, to exercise the hand and wrist muscles of the fistula-side upper limb; and a grip strengthener 14, used by the patient to grip and exert force, to exercise the hand, wrist, and forearm muscles of the fistula-side upper limb.

[0078] During the first week of postoperative rehabilitation exercises, the exercise content is displayed on screen 2, and the patient performs the exercises by inputting the information on keyboard 13 according to the display on screen 2. One week after the start of postoperative rehabilitation, grip strength exercises can be performed in conjunction with a hand gripper (such as a hand grip ball). By contracting the flexor muscles of the hand, the forearm on the fistula side is squeezed, indirectly applying radial pressure to the subcutaneous arteriovenous fistula.

[0079] It should be noted that the keyboard 13 and the hand gripper 14 can be housed inside the cylindrical body 1, or, like the display screen 2, outside the cylindrical body 1. Furthermore, the keyboard 13 can be connected to the control module via wired or wireless means.

[0080] 4. Pressure monitoring module

[0081] A pressure monitoring module is installed on the fistula-side exercise component to collect pressure data when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb. Specifically, the module may include a pressure sensor installed on the grip strengthener, and additionally, may include a pressure sensor installed on each key of the keyboard.

[0082] Based on a pre-established correspondence between the pressure applied by the hand when typing on a keyboard or holding a grip strengthener at different postoperative stages and the radial pressure of the subcutaneous arteriovenous fistula (AVF), the control module can determine the range of pressure applied by the hand corresponding to the safe range of radial pressure in the AVF at different postoperative stages. This allows the module to determine whether the pressure data collected by the pressure sensor is too high or too low. The safe range of radial pressure in the AVF at different postoperative stages, and the correspondence between the pressure applied by the hand and the radial pressure in the AVF, are derived from clinical experience and big data analysis modeling.

[0083] 5. Blood Flow Monitoring Module

[0084] The probe of the blood flow monitoring module is fixed to the upper limb on the side of the fistula to collect blood flow data (i.e., blood flow velocity data) during the movement of the patient's upper limb on the side of the fistula. Specifically, the module can use an ultrasound device, and the probe of the blood flow monitoring module is an ultrasound probe, which is detachably fixed to the forearm on the side of the fistula near the fistula area by an elastic fixing strap.

[0085] The blood flow velocity in a mature arteriovenous fistula is typically greater than 500 ml / min, which is the ideal range for maintaining fistula patency and meeting dialysis needs. With postoperative rehabilitation exercises, the blood flow velocity in the arteriovenous fistula should be continuously increased until it eventually exceeds 500 ml / min.

[0086] The control module receives blood flow data collected by the blood flow monitoring module. If, after several days of continuous exercise, the blood flow data does not increase or increases too slowly, or if the blood flow data suddenly drops in a short period of time, it is determined that the blood flow data is abnormal, i.e., the blood flow velocity is abnormal.

[0087] 6. Control Module

[0088] The control module is used to control the temperature adjustment component to adjust the temperature of the regional water bladder according to the preset temperature, so as to achieve cold or hot compress on the forearm on the fistula side; to control the water pump to regularly inflate and deflate the regional water bladder according to the preset water filling and defilling configuration, so as to simulate the hemodynamic environment; and to determine whether the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal according to the preset pressure and / or preset blood flow velocity.

[0089] 7. Alarm Module

[0090] The alarm module is used to issue an alarm when the pressure data collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal. This alarm module is connected to the control module. When the control module determines that the pressure data collected by the pressure monitoring module is abnormal (too high or too low), or the blood flow data collected by the blood flow monitoring module is abnormal (e.g., a sudden drop), it controls the alarm module to issue an alarm sound or provide an audible and visual alarm to promptly alert the patient and their family. Additionally, the control module can also generate an alarm signal and send it to the medical staff terminal so that medical personnel can promptly detect abnormalities.

[0091] 8. Vibration sound monitoring component

[0092] As a supplement, the exercise device also includes a vibration sound monitoring component, which is an auscultatory pickup probe. It is coaxially fixed to the fistula-side arm with an ultrasound probe via an elastic fixing strap. It is used to collect the fistula vibration sound signal and transmit it to the control module so that the control module can determine the fistula status.

[0093] Monitoring the thrill sound signal of an arteriovenous fistula (AVF) helps determine its patency and maturity. Analysis of the thrill sound signal extracts its intensity, pitch, and regularity. If the thrill sound intensity is greater than the first intensity threshold and is regular (i.e., strong and regular), it indicates sufficient blood flow and AVF patency. If the thrill sound intensity is less than the second intensity threshold (weak thrill sound) and / or the pitch changes, it indicates a high probability of thrombosis or stenosis. If no thrill sound signal is detected (i.e., the thrill sound disappears), AVF occlusion should be suspected. In this case, the control module controls the alarm module to issue an alarm sound or provide an audible and visual alarm to remind the patient to seek medical attention promptly. Alternatively, the control module generates an alarm signal regarding the disappearance of the patient's thrill sound and sends it to the medical terminal for timely intervention by healthcare personnel. Generally, the thrill sound should gradually increase with postoperative exercise, reflecting the continuous maturation of the AVF. Therefore, the intensity of the AVF thrill sound can be used to assess the AVF status.

[0094] See Figure 3 , Figure 4 and Figure 5 Another embodiment of the present invention provides an exercise device for postoperative rehabilitation of arteriovenous fistulas. The main difference between this device and the previous embodiment lies in the fistula-side exercise component. The fistula-side exercise component in this embodiment includes:

[0095] A wrist pillow, set inside a cylindrical body, is used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body.

[0096] A touchscreen, located outside the cylindrical body, is used to display the content to be exercised by the patient and to receive input operations performed by the patient based on the content displayed on the screen, in order to exercise the hand and wrist muscles of the upper limb on the side of the fistula.

[0097] A hand grip strengthener is used by patients to grip and exert force to exercise the hand, wrist, and forearm muscles of the upper limb on the side of the fistula.

[0098] That is, in this embodiment, a touchscreen is used instead of the keyboard and mouse of the previous embodiment. To facilitate observation of the touchscreen display content and operation of the touchscreen by the hand on the fistula side, the touchscreen is disposed on the outside of the cylindrical body 1.

[0099] The grip strengthener can be installed inside the cylindrical body 1, such as... Figure 2 The position shown can also be set outside the cylindrical main body 1.

[0100] During the first week of postoperative rehabilitation, the exercises are displayed on a touchscreen, and the patient follows the instructions to perform the exercises. After one week of postoperative rehabilitation, a hand grip strengthener (such as a hand grip ball) can be used to perform grip strength exercises. By contracting the flexor muscles of the hand, the forearm on the fistula side is squeezed, indirectly applying radial pressure to the subcutaneous arteriovenous fistula.

[0101] In addition, the two embodiments described above also include a setting module, which is used to set guidance data, such as preset pressure data, preset hot compress temperature, preset cold compress temperature, preset blood flow rate, etc. In specific implementation, the guidance data can be directly input into the device, or the guidance data can be input into the data management system, and the setting module can obtain the guidance data from the data management system and make the settings.

[0102] When using the above-mentioned exercise device, guidance data is set through the setting module. The control module determines whether the current exercise stage is in the early postoperative period. If it is in the early postoperative period, the following steps are performed: (1) The control module controls the temperature adjustment module to start and adjusts the temperature according to the preset temperature; (2) The ultrasound probe of the blood flow monitoring module is fixed to the forearm on the fistula side; (3) The patient inserts his hand and forearm into the accommodating space of the cylindrical body 1, so that the forearm is in contact with the sub-area water sac; (4) The control module controls the water pump and electric ball valve to regularly fill and release water in the sub-area water sac, driving the arm to complete the passive movement; (5) During the passive movement or when the patient actively exercises through the keyboard / touch screen / grip exerciser, the pressure sensor collects pressure data in real time, the ultrasound probe collects fistula blood flow data in real time, and transmits it to the control module. (6) The control module analyzes the pressure data and blood flow data. If the pressure data is greater than the preset upper limit threshold or less than the preset lower limit threshold, or the blood flow data exceeds the preset normal blood flow velocity range, the control alarm module issues an audible and visual alarm; if the data are all normal, the current exercise state is maintained. If it is not the early postoperative period, only the following steps can be performed: (1) Fix the ultrasound probe of the blood flow monitoring module to the forearm on the fistula side; (2) When the patient actively exercises with the hand gripper, the pressure sensor collects pressure data in real time, the ultrasound probe collects blood flow data of the fistula in real time, and transmits it to the control module; (3) The control module analyzes the pressure data and blood flow data. If the pressure data is greater than the preset upper limit threshold or less than the preset lower limit threshold, or the blood flow data exceeds the preset normal blood flow velocity range, the control alarm module will issue an audible and visual alarm; if the data are all normal, the current exercise state will be maintained. That is, if only active exercise with the hand gripper is required, the patient does not need to put their hand and forearm into the accommodating space of the cylindrical body 1. At this time, the control module controls the electric ball valve, water pump, and temperature control component.

[0103] This invention is a training device that combines "pressure + blood flow" dual monitoring, achieving a brand-new upgrade in professionalism, comfort, and data closed loop.

[0104] This invention also provides a method for implementing an exercise device for postoperative rehabilitation of arteriovenous fistulas, applicable to the aforementioned exercise device. The method includes: fixing the probe of the blood flow monitoring module to the patient's fistula-side upper limb; inserting the patient's fistula-side hand and forearm into the receiving space of the cylindrical body, so that the forearm fits against the segmented water sacs; the control module adjusting the water temperature according to a preset temperature control module, enabling cold compresses to reduce swelling on the fistula-side forearm within 72 hours post-surgery, or hot compresses after 72 hours, promoting blood flow and increasing repair through phased temperature management; after water temperature adjustment, the control module controlling the water pump to pump water to the segmented areas according to a preset filling and discharging configuration. The water bladder is regularly inflated and deflated to simulate a hemodynamic environment; the pressure monitoring module collects pressure data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb; the blood flow monitoring module collects blood flow data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb; the control module judges whether the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal (e.g., excessive or insufficient grip force on the hand gripper, sudden drop in blood flow velocity) according to the preset pressure and / or preset blood flow velocity, and issues an alarm through the alarm module (e.g., audible reminder) when abnormalities occur, so as to accurately control the exercise intensity and realize personalized exercise.

[0105] In addition, the method may also include: a flutter monitoring component acquiring the intensity of the arteriovenous fistula flutter; and a control module determining the arteriovenous fistula status based on blood flow data and flutter intensity.

[0106] Furthermore, the present invention can set guidance data in the data management system for providing feedback and guidance on the collected data.

[0107] The method of this invention embodies an intelligent design from data monitoring and personalized instructions to multi-dimensional rehabilitation execution, covering the entire rehabilitation logic of monitoring, feedback, exercise, physiotherapy and protection, and can be used for precise rehabilitation training after surgery.

[0108] See Figure 8This diagram uses postoperative time as the horizontal axis to divide postoperative rehabilitation of arteriovenous fistulas (AVFs) into three stages: early postoperative period (1-3 weeks), mid-term (4-8 weeks), and maturation period (after 8 weeks). The early postoperative period (1-3 weeks) is crucial for fistula healing. Cold compresses are used to control local swelling, combined with low-intensity grip strength training. A wrist pillow is used for wrist support to reduce traction on the fistula opening from upper limb movements on the fistula side, lowering the risk of bleeding and hematoma, and laying the foundation for fistula maturation. The mid-term (4-8 weeks) is the stage where the fistula initially forms a blood flow pathway. Grip strength training intensity is increased to medium intensity, and "water balloon pulse" pressure is added to simulate the periodic pressure changes of physiological blood flow. This strengthens the forearm muscles and maintains the hemodynamic environment of the fistula through pulse stimulation, helping to accelerate fistula maturation. Combining active patient movement with passive movement from "water balloon pulse" pressure enhances the training experience. After training, local heat application promotes local blood circulation, and "water balloon pulse" pressure relieves muscle fatigue. The maturation phase (after 8 weeks) is the stage where the arteriovenous fistula (AVF) is basically mature. High-intensity training is employed, incorporating gamified challenges to enhance the stability and durability of the AVF while simultaneously increasing patient motivation for long-term training through engaging activities, thereby improving adherence. As a supplement, the intensity of the fistula thrill can be monitored at various stages of AVF postoperative rehabilitation to assess the fistula's health status. This diagram visually illustrates the correspondence between postoperative rehabilitation timelines and training intensity and methods, helping healthcare professionals and patients quickly identify the key training focuses at each postoperative stage, balancing safety and effectiveness. It provides guidance both before wound healing and for long-term maintenance.

[0109] See Figure 9 Regarding the intensity of exercise, this invention provides a rehabilitation exercise program for arteriovenous fistula surgery, as follows:

[0110] Whispering with Fingertips (24 hours post-surgery): Fingertip exercises, where the patient gently taps the bright spot on the screen with the fingers of the upper limb on the side of the fistula to perform low-frequency, small-amplitude exercises.

[0111] Finger Jumping Challenge (2-3 days post-surgery): Hand movement. The patient taps the bright spot on the screen with the fingers of the upper limb on the side of the fistula to perform high-frequency, large-amplitude exercises.

[0112] Wrist dancing (3-7 days post-surgery): The patient moves the wrist of the fistula-side upper limb up, down, left, and right according to the instructions on the screen.

[0113] Fist Release and New Life (Postoperative 1-4): The patient performs fist-clenching exercises with the hand on the fist side of the upper limb using a hand gripper.

[0114] Arm extension conquest (4-8 weeks post-surgery): After the patient extends the arm on the fistula side, clench the fist and hold for 10 seconds. 3 sets per day, 10-15 repetitions per set.

[0115] Arm-binding exercises (8 weeks post-surgery): Patients perform coordinated "grip strength + wrist flexion and extension + arm-binding" exercises on the fistula side of the upper limb, 3-5 sets per day, 15-20 repetitions per set.

[0116] It should be noted that the specific methods for increasing exercise intensity are not limited to the above process, and can be flexibly replaced or adjusted according to actual needs.

[0117] This invention is a dual-monitoring exercise device that combines pressure and blood flow, covering the entire AVF (Artificial Blood Flow) cycle from pre-wound recovery to post-wound healing and lifelong maintenance. This closed-loop management achieves a new level of professionalism, comfort, and data closure, and offers the following technical advantages:

[0118] 1. Precision and safety: Closed-loop pressure control eliminates the problem of unstable pressure caused by manual pressing, ensuring effective exercise within a safe range.

[0119] 2. Scientific and efficient: Multimodal training, especially pulse and synergistic modes, can better simulate physiological states than traditional training methods and may shorten the maturation time of arteriovenous fistulas.

[0120] 3. Data-driven: Quantitatively assess the effectiveness of exercise and the health status of the arteriovenous fistula, realizing the transformation from experience-based rehabilitation to data-driven rehabilitation.

[0121] 4. Improve adherence: Gamified workout design and convenient operation make boring workouts fun and easy to stick to.

[0122] 5. Doctor-patient communication: Establish a remote management platform to improve follow-up efficiency and achieve early intervention.

[0123] Although the present invention has been described in detail above, it is not limited thereto, and those skilled in the art can make various modifications based on the principles of the present invention. Therefore, all modifications made in accordance with the principles of the present invention should be understood to fall within the protection scope of the present invention.

Claims

1. An exercise device for rehabilitation after arteriovenous fistula surgery, characterized in that, include: The cylindrical body has an internal space that accommodates the patient's forearm on the side of the fistula. Its inner wall is equipped with a regional water bladder that allows for passive movement of the forearm or relief of fatigue through regular filling and emptying of water. The temperature control module is used to adjust the temperature of the water tanks in different zones to a preset temperature. Fistula-side exercise kit, used to exercise the hand, wrist and forearm of the patient's upper limb on the fistula side; The pressure monitoring module, installed on the fistula-side exercise component, is used to collect pressure data when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb; The blood flow monitoring module has a probe fixed to the upper limb on the side of the fistula to collect blood flow data during the movement of the patient's upper limb on the side of the fistula; The control module is used to control the temperature adjustment module to adjust the temperature of the regional water bladder according to the preset temperature, so as to achieve cold or hot compress on the forearm on the fistula side; to control the water pump to regularly inflate and deflate the regional water bladder according to the preset water filling and defilling configuration, so as to simulate the hemodynamic environment; and to determine whether the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal according to the preset pressure and / or preset blood flow velocity. The alarm module is used to issue an alarm when the pressure collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal.

2. The exercise device according to claim 1, characterized in that, The temperature control module includes: The water storage tank is connected to the water pump and the water tanks in different areas via pipelines. The temperature control assembly includes a temperature sensor disposed in the water storage tank, a semiconductor cooling and heating element attached to the outer wall of the water storage tank, and a drive unit for driving the semiconductor cooling and heating element. The control module acquires the water temperature collected by the temperature sensor, and outputs a temperature control signal based on the preset temperature and water temperature. The signal is then used by the drive unit to control the semiconductor cooling and heating element to cool or heat the water entering the sub-zone water tank so that the temperature reaches the preset temperature.

3. The exercise device according to claim 1, characterized in that, The fistula-side exercise component includes: A wrist pillow, set inside a cylindrical body, is used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body. A display screen, located outside the cylindrical main body, is used to display the exercises the patient is to perform. The keyboard is used to receive input operations performed by the patient based on the content displayed on the screen, in order to exercise the hand and wrist muscles of the upper limb on the side of the fistula; A hand grip strengthener is used by patients to grip and exert force to exercise the hand, wrist, and forearm muscles of the upper limb on the side of the fistula.

4. The exercise device according to claim 3, characterized in that, The pressure monitoring module includes pressure sensors installed on each key of the keyboard and pressure sensors installed on the grip strengthener.

5. The exercise device according to claim 1, characterized in that, The fistula-side exercise component includes: A wrist pillow, set inside a cylindrical body, is used to support the wrist of the patient's fistula-side upper limb after the patient inserts the fistula-side upper limb into the cylindrical body. A touchscreen, located outside the cylindrical body, is used to display the content to be exercised by the patient and to receive input operations performed by the patient based on the content displayed on the screen, in order to exercise the hand and wrist muscles of the upper limb on the side of the fistula. A hand grip strengthener is used by patients to grip and exert force to exercise the hand, wrist, and forearm muscles of the upper limb on the side of the fistula.

6. The exercise device according to claim 5, characterized in that, The pressure monitoring module includes a pressure sensor mounted on the gripper.

7. The exercise device according to claim 1, characterized in that, The blood flow monitoring module is an ultrasound device, and the probe of the blood flow monitoring module is an ultrasound probe. The ultrasound probe is detachably fixed to the forearm on the fistula side near the fistula area by an elastic fixing strap.

8. The exercise device according to any one of claims 1-7, characterized in that, Also includes: The vibration sound monitoring component is an auscultatory pickup probe, which is coaxially fixed to the fistula-side arm with an ultrasound probe via an elastic fixing strap. It is used to collect the vibration sound signal of the arteriovenous fistula and transmit it to the control module so that the control module can determine the status of the arteriovenous fistula.

9. A method for implementing an exercise device for postoperative rehabilitation of arteriovenous fistula, characterized in that, The method, applied to the exercise apparatus according to any one of claims 1-8, comprises: The probe of the blood flow monitoring module is fixed to the patient's upper limb on the side of the fistula; By inserting the patient's fistula-side hand and forearm into the receiving space of the tubular main body, the forearm is made to fit against the segmented water sac; The control module adjusts the water temperature according to the preset temperature control module to achieve cold or hot compresses on the forearm on the side of the fistula. After the water temperature is adjusted, the control module controls the water pump to regularly fill and drain the water in the water bladders in different areas according to the preset filling and draining configuration, in order to simulate the hemodynamic environment. The pressure monitoring module collects pressure data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb; The blood flow monitoring module collects blood flow data in real time when the patient uses the fistula-side exercise component to exercise the fistula-side upper limb; The control module determines whether the pressure data collected by the pressure monitoring module and / or the blood flow data collected by the probe are abnormal according to the preset pressure and / or preset blood flow velocity, and issues an alarm through the alarm module when an abnormality is found.

10. The method according to claim 9, characterized in that, Also includes: The flutter monitoring component acquires flutter signals from the arteriovenous fistula; The control module determines the status of the arteriovenous fistula based on blood flow data and thriller signals.

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