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Feasibility of Cardiac Rehabilitation Models in Kenya.

Publication ,  Journal Article
Ngeno, GTK; Barasa, F; Kamano, J; Kwobah, E; Wambui, C; Binanay, C; Egger, JR; Kussin, PS; Thielman, NM; Bloomfield, GS
Published in: Ann Glob Health
2022

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.

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Published In

Ann Glob Health

DOI

EISSN

2214-9996

Publication Date

2022

Volume

88

Issue

1

Start / End Page

7

Location

United States

Related Subject Headings

  • Kenya
  • Humans
  • Heart Failure
  • Heart Diseases
  • Feasibility Studies
  • Cardiac Rehabilitation
  • 4206 Public health
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Ngeno, G. T. K., Barasa, F., Kamano, J., Kwobah, E., Wambui, C., Binanay, C., … Bloomfield, G. S. (2022). Feasibility of Cardiac Rehabilitation Models in Kenya. Ann Glob Health, 88(1), 7. https://doi.org/10.5334/aogh.3392
Ngeno, G Titus K., Felix Barasa, Jemimah Kamano, Edith Kwobah, Charity Wambui, Cynthia Binanay, Joseph R. Egger, Peter S. Kussin, Nathan M. Thielman, and Gerald S. Bloomfield. “Feasibility of Cardiac Rehabilitation Models in Kenya.Ann Glob Health 88, no. 1 (2022): 7. https://doi.org/10.5334/aogh.3392.
Ngeno GTK, Barasa F, Kamano J, Kwobah E, Wambui C, Binanay C, et al. Feasibility of Cardiac Rehabilitation Models in Kenya. Ann Glob Health. 2022;88(1):7.
Ngeno, G. Titus K., et al. “Feasibility of Cardiac Rehabilitation Models in Kenya.Ann Glob Health, vol. 88, no. 1, 2022, p. 7. Pubmed, doi:10.5334/aogh.3392.
Ngeno GTK, Barasa F, Kamano J, Kwobah E, Wambui C, Binanay C, Egger JR, Kussin PS, Thielman NM, Bloomfield GS. Feasibility of Cardiac Rehabilitation Models in Kenya. Ann Glob Health. 2022;88(1):7.
Journal cover image

Published In

Ann Glob Health

DOI

EISSN

2214-9996

Publication Date

2022

Volume

88

Issue

1

Start / End Page

7

Location

United States

Related Subject Headings

  • Kenya
  • Humans
  • Heart Failure
  • Heart Diseases
  • Feasibility Studies
  • Cardiac Rehabilitation
  • 4206 Public health
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences