Outcome of a Supervised Cardiovascular Rehabilitation Program on Muscle Strength, Symptoms, and Functional Capacity in Patients with Stable Chronic Heart Failure: A Multicentre Longitudinal Study in Yaoundé, Cameroon

Background: Peripheral muscle weakness contributes significantly to exercise intolerance in chronic heart failure (CHF). This multicenter longitudinal study evaluated the impact of a supervised cardiovascular rehabilitation (CVR) program on segmental muscle strength, symptoms, and functional capacity in stable CHF patients in Yaoundé, Cameroon. Methods: In this multicentre longitudinal study, adults aged ≥ 18 years with stable CHF (NYHA class I-III) underwent a standardized outpatient CVR program targeting 18 sessions (3 sessions/week over 6 - 7 weeks on average; minimum 15 sessions; median 18, range 15 - 20). The program comprised aerobic exercise (treadmill/cycling at 50% - 75% heart rate reserve) interspersed with segmental resistance training (body weight/light loads, 10 - 15 repetitions in 2 - 3 sets for major muscle groups), warm-up, cool-down, and therapeutic education. Baseline data were retrospectively extracted from program intake records; post-intervention assessments were prospectively conducted within one week of completion. The primary outcome was lower-limb segmental muscle strength (handheld dynamometry: quadriceps). Secondary outcomes included symptoms (dyspnoea, palpitations), body weight, Duke Activity Status Index (DASI), six-minute walk test (6 MWT) distance, and peak metabolic equivalents/estimated VO_2max (cycle ergometer). Pre-post changes were analysed with Wilcoxon signed-rank tests (p < 0.05). Results: The cohort (median age 56 years; 54% female; 70% preserved ejection fraction) showed significant improvements post-CVR. Lower limb strength increased dramatically (median 0.0 to 10.0 kgf; p < 0.001). Symptoms reduced markedly (dyspnoea: 22% to 2%, p = 0.037; palpitations: 16% to 2%, p < 0.001). Functional capacity improved robustly: 6 MWT +100 m (400 to 500 m; p < 0.001), DASI score + 26.25 (24.45 to 50.70; p < 0.001), peak METs + 3.37 (p < 0.001), estimated VO_2max + 11.72 ml/kg/min (p < 0.001). Modest weight loss occurred (？1.5 kg; p = 0.001). No adverse events were reported. Conclusion: A supervised CVR program with combined aerobic and resistance training significantly enhanced lower limb strength, reduced symptoms, and improved functional capacity in stable CHF patients in a resource-limited setting. These findings support CVR implementation to optimize outcomes in sub-Saharan Africa.