Effect of cardiac rehabilitation on physical capacity in a Sub-Saharan African low resource setting

Background Despite its proven effectiveness, cardiac rehabilitation remains underutilized in many African countries, with significant disparities in access. Additionally, there is a scarcity of studies specifically targeting the Sub-Saharan context. Purpose To evaluate the effect of a cardiac rehabilitation program adapted to resource-limited settings on patients' physical capacity. Methods A single-center retrospective cross-sectional study was conducted between January 2022 and July 2024. We analyzed data from 98 patients; 50 in the pre-rehabilitation group and 48 in the post-rehabilitation group (Figure 1). Physical capacity was assessed through incremental exercise testing, and multivariate regression analysis was used to identify predictive factors for physical capacity improvement. Results Mean age was 58±13 years old in the pre-rehabilitation group and 60±11 years old in the post -rehabilitation group, p=0.05. Coronary artery disease was the most frequent pathology in both groups (77%). The study revealed significant improvements in physical capacity after rehabilitation. The average exercise duration increased from 5.8 ± 2.5 minutes in the pre-rehabilitation group to 7.8 ± 2.3 minutes in the post-rehabilitation group (p < 0.001). Maximal power (watts) increased from 58 ± 30 watts to 75 ± 28 watts; p < 0.001, and aerobic capacity (METs) improved from 4.1 ± 1.6 METs to 5.3 ± 1.7 METs; p < 0.001 (Figure 2). Hypertension (coefficient = -0.86167, p = 0.01595) and older age (coefficient = -0.03183, p = 0.02478) were inversely correlated with physical capacity level. Conclusion Cardiac rehabilitation adapted to low-resource settings significantly improves physical capacity. Future studies should focus on the long-term effects of CR and explore the feasibility of home-based rehabilitation programs in Sub-Saharan Africa.