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Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review
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, an...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Medical Association Of Malawi
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892999/ https://www.ncbi.nlm.nih.gov/pubmed/35291387 http://dx.doi.org/10.4314/mmj.v33i4.10 |
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author | Namanja, Alice Usman, Anas Odunuga, Toyin |
author_facet | Namanja, Alice Usman, Anas Odunuga, Toyin |
author_sort | Namanja, Alice |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8892999 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Medical Association Of Malawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-88929992022-03-14 Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review Namanja, Alice Usman, Anas Odunuga, Toyin Malawi Med J Systematic Review 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. The Medical Association Of Malawi 2021-12 /pmc/articles/PMC8892999/ /pubmed/35291387 http://dx.doi.org/10.4314/mmj.v33i4.10 Text en © 2021 The College of Medicine and the Medical Association of Malawi. https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Systematic Review Namanja, Alice Usman, Anas Odunuga, Toyin Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title | Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title_full | Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title_fullStr | Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title_full_unstemmed | Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title_short | Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review |
title_sort | effects of cardiac rehabilitation treatment modalities in sub-saharan africa: a systematic review |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892999/ https://www.ncbi.nlm.nih.gov/pubmed/35291387 http://dx.doi.org/10.4314/mmj.v33i4.10 |
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