PMID- 35087707
OWN - NLM
STAT- MEDLINE
DCOM- 20220503
LR  - 20220603
IS  - 2214-9996 (Electronic)
IS  - 2214-9996 (Linking)
VI  - 88
IP  - 1
DP  - 2022
TI  - Feasibility of Cardiac Rehabilitation Models in Kenya.
PG  - 7
LID - 10.5334/aogh.3392 [doi]
LID - 7
AB  - BACKGROUND: Heart failure (HF), is a leading cause of cardiovascular morbidity 
      and mortality in Sub-Saharan Africa. Cardiac rehabilitation (CR) is known to 
      improve functional capacity and reduce morbidity associated with HF. Although CR 
      is a low-cost intervention, global access and adherence rates to CR remain poor. 
      In regions such as Western Kenya, CR programs do not exist. We sought to 
      establish the feasibility CR for HF in this region by testing adherence to 
      institution and home-based models of CR. METHODS: One hundred participants with 
      New York Heart Association (NYHA) class II and III HF symptoms were prospectively 
      enrolled from a tertiary health facility in Western Kenya. Participants were 
      non-randomly assigned to participate in one of two CR models based on their 
      preference. Institution based cardiac rehabilitation (IBCR) comprised 36 
      facility-based exercise sessions over a period of 12 weeks. Home based cardiac 
      rehabilitation (HBCR) comprised weekly pedometer guided exercise targets over a 
      period of 12 weeks. An observational arm (OA) receiving usual care was also 
      enrolled. The primary endpoint of CR feasibility was assessed based on study 
      participants to adherence to at least 25% of exercise sessions. Secondary 
      outcomes of change in NYHA symptom class, and six-minute walk time distance 
      (6MWTD) were also evaluated. Data were summarized and analyzed as means (SD) and 
      frequencies. Paired t-tests, Chi Square, Fisher's, and ANOVA tests were used for 
      comparisons. FINDINGS: Mean protocol adherence was greater than 25% in both CR 
      models; 46% +/- 18 and 29% +/- 11 (P < 0.05) among IBCR and HBCR participants 
      respectively. Improvements by at least one NYHA class were observed among 71%, 
      41%, and 54%, of IBCR, HBCR and OA participants respectively. 6MWTD increased 
      significantly by a mean of 31 +/- 65 m, 40 +/- 55 m and 38 +/- 71 m in the IBCR, HBCR 
      and OA respectively (P < 0.05). CONCLUSIONS: IBCR and HBCR, are feasible 
      rehabilitation models for HF in Western Kenya. Whereas improvement in functional 
      capacity was observed, effectiveness of CR in this population remains unknown. 
      Future randomized studies evaluating effect size, long term efficacy, and safety 
      of cardiac rehabilitation in low resource settings such as Kenya are recommended.
CI  - Copyright: (c) 2022 The Author(s).
FAU - Ngeno, G Titus K
AU  - Ngeno GTK
AD  - Duke University, Durham, NC, US.
AD  - Moi Teaching and Referral Hospital, Nandi Road, Eldoret, KE.
FAU - Barasa, Felix
AU  - Barasa F
AD  - Moi Teaching and Referral Hospital, Nandi Road, Eldoret, KE.
FAU - Kamano, Jemimah
AU  - Kamano J
AD  - Moi Teaching and Referral Hospital, Nandi Road, Eldoret, KE.
FAU - Kwobah, Edith
AU  - Kwobah E
AD  - Moi Teaching and Referral Hospital, Nandi Road, Eldoret, KE.
FAU - Wambui, Charity
AU  - Wambui C
AD  - Moi Teaching and Referral Hospital, Nandi Road, Eldoret, KE.
FAU - Binanay, Cynthia
AU  - Binanay C
AD  - Duke University, Durham, NC, US.
FAU - Egger, Joseph R
AU  - Egger JR
AD  - Duke University, Durham, NC, US.
FAU - Kussin, Peter S
AU  - Kussin PS
AD  - Duke University, Durham, NC, US.
FAU - Thielman, Nathan M
AU  - Thielman NM
AD  - Duke University, Durham, NC, US.
FAU - Bloomfield, Gerald S
AU  - Bloomfield GS
AD  - Duke University, Durham, NC, US.
LA  - eng
SI  - ClinicalTrials.gov/NCT02795936
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220118
PL  - United States
TA  - Ann Glob Health
JT  - Annals of global health
JID - 101620864
SB  - IM
MH  - *Cardiac Rehabilitation
MH  - Feasibility Studies
MH  - *Heart Diseases
MH  - *Heart Failure
MH  - Humans
MH  - Kenya
PMC - PMC8782083
COIS- The authors have no competing interests to declare.
EDAT- 2022/01/29 06:00
MHDA- 2022/05/04 06:00
PMCR- 2022/01/18
CRDT- 2022/01/28 05:54
PHST- 2022/01/28 05:54 [entrez]
PHST- 2022/01/29 06:00 [pubmed]
PHST- 2022/05/04 06:00 [medline]
PHST- 2022/01/18 00:00 [pmc-release]
AID - 10.5334/aogh.3392 [doi]
PST - epublish
SO  - Ann Glob Health. 2022 Jan 18;88(1):7. doi: 10.5334/aogh.3392. eCollection 2022.