Exploring the relationship between physical activity and anthropometric and demographic characteristics among individuals with heart failure undergoing cardiac rehabilitation.

Abstract

ABSTRACTBackground: Heart Failure (HF) is a significant contributor to cardiovascular morbidity and mortality in Sub-Saharan Africa. Step counts are vital in HF management, providing insights into physical activity levels, predicting clinical outcomes, and enabling remote monitoring to improve patient care. This study aims to evaluate the relationship between individual-level physical activity (measured by change in step counts) and anthropometric measures. Step counts are key indicators of cardiac health, with counts below 35000/week indicating a sedentary lifestyle (Tudor-Locke et al., 2013). Through the analysis of these multidimensional factors, the study aims to inform the tailoring of cardiac rehabilitation programs to improve outcomes in HF patients.Methods: We analyzed step counts among 68 patients with New York Heart Association class II/III HF symptoms participating in a 12-week cardiac rehabilitation study in Western Kenya. Thirty patients participated in home-based cardiac rehabilitation (HBCR), while 38 participants were in a usual care arm. HBCR comprised individualized step count targets derived from baseline cadence at the aerobic threshold for 20 minutes and increased weekly by 10%. The Mann-Whitney U test was used to compare medians, and multiple regression analyses were conducted to assess group differences. Results: Box plots show no difference in the median change in step counts where as the different study arm trend lines show differences in step counts. Individuals with higher BMI possibly experienced larger step count improvements and those with comorbidities tend to have limited physical activity levels. There is a positive relationship between step counts and 6MWT distance covered. Individuals with higher WHR achieved fewer step counts. Conclusion: There is no difference in change in step counts between the two study arms, as intervention arm patients started off at a higher number of step counts. BMI, WHR, and comorbidities were associated with a change in step counts. Step counts can be used as a supplementary tracking metric and may be used in places with limited staffing to monitor functional capacity Source of Funding: Fogarty International Center, the Duke Global Health Institute, and the Hubert Yeargan Center for Global Health. Key Words: Kenya, Moi Teaching and Referral Hospital, Step Counts, New York Heart Association, Motivation, Cardiac Disease