Handgrip Exercises for Blood Clots

Recruiting at 1 trial location

Overseen By Rachel Baker, PhD, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: TriHealth Inc.

Disqualifiers: Under 18, Bleeding disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: up to 4 weeks

2500 Participants Needed

Trial Summary

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the idea that Handgrip Exercises for Blood Clots is an effective treatment?

The available research shows that exercise, including handgrip exercises, is generally safe for patients with blood clots, but there is limited evidence to support its effectiveness as a primary treatment. One study suggests that exercise can help improve conditions related to blood clots, like post-thrombotic syndrome, but it doesn't specifically highlight handgrip exercises. Another study indicates that exercise might help with symptoms after a blood clot, but it doesn't provide strong evidence that it is better than other treatments. Overall, while exercise is safe, more research is needed to confirm its effectiveness compared to other treatments. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Handgrip Exercises for preventing blood clots?

Research suggests that exercise, in general, is safe for people with blood clots and may help with conditions like post-thrombotic syndrome, which can occur after a blood clot. However, there is limited evidence specifically supporting handgrip exercises for preventing blood clots. ^{1 2 3 4 5}

What safety data exists for handgrip exercises in blood clot treatment?

The available research primarily focuses on leg exercises for blood clot prevention, particularly using a novel leg exercise apparatus (LEX) for venous thromboembolism (VTE) prophylaxis. Studies indicate that exercise-based interventions, including those for deep vein thrombosis (DVT) and pulmonary embolism (PE), are generally safe. A pilot study on LEX showed no severe adverse events in patients post-surgery, suggesting safety in exercise interventions. Systematic reviews also support the safety of exercise in VTE patients, though evidence for its effectiveness as a standalone treatment is limited. No specific safety data for handgrip exercises in blood clot treatment was found in the provided research. ^{4 6 7 8 9}

Is it safe for humans to do handgrip exercises to prevent blood clots?

Research on exercise-based rehabilitation for blood clot conditions like deep vein thrombosis (DVT) and venous thromboembolism (VTE) suggests that exercise is generally safe for humans. However, specific studies on handgrip exercises for blood clots are not mentioned, so it's important to consult with a healthcare provider for personalized advice. ^{4 6 7 8 9}

Is Handgrip Exercises a promising treatment for blood clots?

Yes, Handgrip Exercises could be a promising treatment for blood clots. Exercise has been shown to improve blood flow and help prevent complications from blood clots. Studies suggest that physical activities, like handgrip exercises, can increase blood flow and may help in preventing or managing blood clots. ^{1 3 6 10 11}

How do handgrip exercises differ from other treatments for blood clots?

Handgrip exercises are unique because they are a physical intervention that can be done anywhere and do not require medication or special equipment, unlike traditional treatments that often involve drugs or mechanical devices. This approach may be particularly beneficial for individuals who cannot use their legs due to surgery or injury, as it can still help increase blood flow and potentially prevent blood clots. ^{1 3 6 10 11}

What is the purpose of this trial?

Patients who have a peripherally-inserted central catheter (PICC) placed are at a risk of developing a deep vein thrombosis (DVT). At TriHealth, approximately 2-4 patients per month who have a PICC placed experience a subsequent DVT. One innovative way to possibly mitigate the risk of DVTs is hand grip exercises. The current study will be the first study to evaluate hand grip exercises for the prevention of DVTs in adult patients hospitalized in the United States.

Research Team

Rachel Baker, PhD, RN

Principal Investigator

TriHealth Nurse Researcher

Eligibility Criteria

This trial is for adult patients who have a PICC line in place and are currently hospitalized. The goal is to see if handgrip exercises can prevent deep vein thrombosis (DVT), which is a type of blood clot that can occur with PICC lines.

Inclusion Criteria

Patient is admitted to either Bethesda North Hospital or Good Samarian Hospital

I had a PICC line inserted by a specialist team within the last day.

Exclusion Criteria

I am unable to give consent for research participation.

I have a bleeding disorder.

I am under 18 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants perform hand grip exercises or receive standard care from PICC placement to removal

up to 4 weeks

Daily exercises, no additional visits specified

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Handgrip Exercises

Trial Overview The study tests whether doing handgrip exercises can reduce the risk of developing DVT in patients with peripherally-inserted central catheters. It's the first study of its kind in the U.S., aiming to find an innovative prevention method.

Participant Groups

Group I: Handgrip Exercise Group Experimental Treatment 1 Intervention

Participants will be instructed to firmly grip and squeeze the ball for 10 seconds, relax for 10 seconds and repeat for 10 minutes. They will be instructed to do this 3 times per day.

Group II: Standard Care Group Active Control 1 Intervention

Participants will receive standard care that includes no instruction about conducting hand grip exercises.

Who Is Running the Clinical Trial?

TriHealth Inc.

Lead Sponsor

Trials

103

Recruited

54,100+

Findings from Research

In a study of 72 patients with deep vein thrombosis (DVT), early supervised exercise combined with standard treatment was found to be safe, showing no increase in complications such as recurrent DVT or pulmonary embolism over a six-month follow-up period.

However, early exercise did not significantly improve the recanalization of thrombi or reduce symptoms like pain and swelling compared to the control group, indicating that while safe, it may not provide additional therapeutic benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does supervised exercise after deep venous thrombosis improve recanalization of occluded vein segments? A randomized study. Isma, N., Johanssson, E., Björk, A., et al.[2018]

In a study of 1289 patients with acute deep vein thrombosis (DVT), early ambulation combined with compression therapy resulted in a low incidence of recurrent and fatal pulmonary emboli, supporting this approach over traditional bed rest.

The study found that 35.1% of patients with lower leg vein thrombosis had pulmonary emboli, highlighting the need for thorough diagnosis and treatment of calf clots, as many were asymptomatic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapy of deep vein thrombosis with low molecular weight heparin, leg compression and immediate ambulation. Partsch, H.[2012]

A six-month supervised exercise training program showed significant improvement in quality of life for patients with post-thrombotic syndrome, as measured by the VEINES-QOL questionnaire, compared to a control group.

The exercise training also led to a reduction in the severity of post-thrombotic syndrome symptoms, although this result was not statistically significant, indicating potential benefits that warrant further investigation in larger trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial. Kahn, SR., Shrier, I., Shapiro, S., et al.[2021]

Exercise-based rehabilitation is safe for patients with venous thromboembolism (VTE), including those with deep vein thrombosis (DVT), pulmonary embolism (PE), and postthrombotic syndrome (PTS), based on a review of nine studies.

However, there is limited evidence to suggest that regular exercise significantly improves exercise capacity in VTE patients, indicating a need for more robust studies in this emerging field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of exercise training in treating venous thromboembolism: a systematic review. Xu, L., Fu, C., Zhang, Q., et al.[2021]

Preventing deep vein thrombosis (DVT) is crucial to avoid post-thrombotic syndrome (PTS), which can severely impact quality of life; pharmacologic or mechanical thromboprophylaxis is recommended for high-risk patients.

For patients already experiencing PTS, daily use of 20-30 mm Hg knee-length elastic compression stockings is suggested, and if symptoms persist, stronger stockings or intermittent compression devices may be beneficial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guidance for the prevention and treatment of the post-thrombotic syndrome. Kahn, SR., Galanaud, JP., Vedantham, S., et al.[2022]

The Leg Exercise Apparatus (LEX) significantly increased blood flow in the lower leg compared to conventional ankle exercises, with a 1.76-fold increase in blood flow after using the LEX versus a 1.44-fold increase with traditional exercises.

The LEX also enhanced blood vessel diameter more effectively, suggesting it could be a promising new tool for preventing deep vein thrombosis (DVT) in bedridden individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of a novel in-bed active Leg Exercise Apparatus (LEX) for increasing venous blood flow. Tanaka, K., Kamada, H., Shimizu, Y., et al.[2022]

A novel leg exercise apparatus (LEX) was tested on 20 patients after total joint arthroplasty, showing that 80% completed the 7-day exercise regimen without severe adverse events.

The use of LEX did not result in any cases of deep vein thrombosis or significant changes in vital signs, indicating it is a safe and feasible method for preventing venous thromboembolism (VTE) in postoperative patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Safety of a Novel Leg Exercise Apparatus for Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty of the Lower Extremities-A Pilot Study. Tanaka, K., Shimizu, Y., Kamada, H., et al.[2022]

In a study involving 48 rabbits with induced deep vein thrombosis, early ambulation did not significantly increase the incidence of pulmonary embolism compared to immobilization, suggesting that movement may be safe post-thrombosis when anticoagulation is administered.

The research showed that regardless of the stage of thrombus organization (early, medium, or later), there were no statistically significant differences in pulmonary embolism incidence between immobilized and mobile groups, indicating that early exercise may not pose additional risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Exercise versus immobilization in the treatment of acute deep vein thrombosis during different clot-organized stage: an animal experiment]. Qi, H., Zhang, F., Liu, Y., et al.[2014]

Early exercise, such as walking, is safe for patients with acute DVT and can help reduce limb pain without increasing the risk of pulmonary embolism, based on a review of 9 studies.

For patients with previous DVT, structured exercise programs improve calf muscle strength and flexibility, and high levels of physical activity may reduce postthrombotic symptoms, indicating that exercise is beneficial for recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity in patients with deep venous thrombosis: a systematic review. Kahn, SR., Shrier, I., Kearon, C.[2022]

Preventing blood clots, such as deep vein thrombosis (DVT) and pulmonary embolism, is more cost-effective than treating them, yet compliance with prevention guidelines is often poor, highlighting the need for better adherence to clinical practices.

Both pharmacological (like heparin and factor Xa inhibitors) and nonpharmacological (like compression stockings and pneumatic devices) interventions are effective in preventing and treating DVT, but they must be properly implemented to reduce the risk of complications like excessive bleeding.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Venous thromboembolism: pharmacological and nonpharmacological interventions. Long, JB.[2014]

Upper body exercise, specifically three intermittent 30-second bouts of low-intensity cycling, significantly increased venous blood flow in the lower extremities by up to 57% in healthy individuals, suggesting a potential method to prevent DVT when lower body movement is restricted.

In patients with acute DVT, the same upper body exercise protocol resulted in an even greater increase in venous blood flow by 45% to 83%, lasting over 13 minutes, indicating its efficacy as a prophylactic measure for DVT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Upper body exercise increases lower extremity venous blood flow in deep venous thrombosis. Caldwell, K., Prior, SJ., Kampmann, M., et al.[2017]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Does supervised exercise after deep venous thrombosis improve recanalization of occluded vein segments? A randomized study. [2018]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Therapy of deep vein thrombosis with low molecular weight heparin, leg compression and immediate ambulation. [2012]

3. Canada pubmed.ncbi.nlm.nih.gov

Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial. [2021]

4. England pubmed.ncbi.nlm.nih.gov

The effectiveness of exercise training in treating venous thromboembolism: a systematic review. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Guidance for the prevention and treatment of the post-thrombotic syndrome. [2022]

6. Japan pubmed.ncbi.nlm.nih.gov

The use of a novel in-bed active Leg Exercise Apparatus (LEX) for increasing venous blood flow. [2022]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Feasibility and Safety of a Novel Leg Exercise Apparatus for Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty of the Lower Extremities-A Pilot Study. [2022]

8. China pubmed.ncbi.nlm.nih.gov

[Exercise versus immobilization in the treatment of acute deep vein thrombosis during different clot-organized stage: an animal experiment]. [2014]

9. United States pubmed.ncbi.nlm.nih.gov

Physical activity in patients with deep venous thrombosis: a systematic review. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Venous thromboembolism: pharmacological and nonpharmacological interventions. [2014]

11. United States pubmed.ncbi.nlm.nih.gov

Upper body exercise increases lower extremity venous blood flow in deep venous thrombosis. [2017]