Effects of Cardiac Rehabilitation Treatment Modalities in Sub-Saharan Africa: A Systematic Review

Overview

Journal Malawi Med J

Specialty General Medicine

Date 2022 Mar 16

PMID 35291387

Authors

Alice Namanja

Anas Usman

Toyin Odunuga

Affiliations

Soon will be listed here.

Abstract

Purpose: Although Cardiac Rehabilitation (CR) implementation models recommend delivery of any CR treatment component, Sub-Saharan Africa (SSA) constitutes only 17% of globally available CR programs. The aims of this review were to assess the benefits of employing any CR treatment modality in SSA, and evaluate if this approach should be encouraged in this resource-constrained region.

Methodology: Records were identified electronically via CINAHL, MEDLINE, Cochrane library, African journal online, PubMed, Web of science and google scholar, and grey literature was hand-searched. Articles reporting effectiveness of any CR treatment modality were included if participants had any cardiovascular disease and if the study was conducted in SSA. Quality assessment for each enrolled study was done using Downs and Black (1998) checklist and data was extracted using a modified standard tool.

Results: Searches identified 1666 records, 24 full text articles were examined and 10 were included for the review; 60%, 30% and 10% of the enrolled studies were done in South Africa, Nigeria and Benin respectively. The studies implemented exercise, psychosocial and education treatment modalities of CR, and the approach of delivery was either comprehensive or modified. Comprehensive CR and delivery of combined aerobic and resistance exercises improved physical (13%, p=0.001), social (40%, p=0.001) and mental aspects of quality of life and reduced anxiety (-12%, p<0.05) and depression (-6%, p<0.001) respectively. Comprehensive CR and aerobic training both reduced systolic blood pressure (range of mean reduction [RMR] -6 to -14mmHg), diastolic blood pressure (RMR -4 to -6mmHg) and resting heart rate (RMR -7 to -17bpm). Overall, all types of exercises showed a 1-5ml.kg-1.min-1 increase in peak oxygen consumption.

Conclusion: The findings support delivery of exercise treatment modality and comprehensive delivery of CR in SSA. However, efficacy of independent implementation of education and psychosocial therapeutic components of CR remains unclear; hence the need for further investigations.

Citing Articles

Delivering effective, comprehensive, multi-exercise component cardiac rehabilitation (CR) for chronic heart failure patients in low resource settings in sub-Saharan Africa: Queen Elizabeth Central Hospital-(QECH-CR) randomised CR study, Malawi.

Namanja A, Nyondo D, Banda T, Mndinda E, Midgely A, Hobkirk J PLoS One. 2024; 19(5):e0297564.

PMID: 38787817 PMC: 11125511. DOI: 10.1371/journal.pone.0297564.

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