[Programme d'exercice supervisé de réadaptation cardiovasculaire pour l'artériopathie oblitérante des membres inférieurs : effet sur l'amélioration de la marche, des paramètres hémodynamiques, de l'anxiété, de la dépression et de la qualité de vie au Cameroun].

BACKGROUND

Lower-limb peripheral arterial disease (PAD) is underdiagnosed despite its high prevalence among patients with cardiovascular risk factors. Given the well-documented benefits of physical activity on physical and mental capacities, we aimed to assess the effects of a supervised exercise-based cardiac rehabilitation program for PAD on walking performance, hemodynamic parameters, anxiety, depression, and quality of life.

METHODS

We conducted a prospective quasi-experimental before-after study at Yaoundé General Hospital from November 2024 to June 2025 among adult patients, with or without prior revascularization (bypass, stent, or angioplasty), at Leriche and Fontaine stages II/III, recruited consecutively in clinic. The intervention comprised 20 sessions over 7 weeks combining therapeutic education, walking-centered endurance training (45-60 min) and muscle strengthening (15-30 min), with psychological support. Maximal walking distance, pain-free walking distance, hemodynamic parameters, anxiety/depression, and quality of life were assessed pre- and post-intervention.

RESULTS

We included 13 patients (mean age 57 ± 10 years), predominantly male. Hypertension was present in 67% and diabetes in 31%. After 7 weeks, walking performance improved markedly: pain-free walking time increased from 3.70 ± 1.57 to 6.30 ± 1.95 min (p = 0.006) and pain-free distance from 220.30 ± 76.21 to 350.10 ± 89.39 m (p = 0.002); maximal walking time from 8.00 ± 4.08 to 14.00 ± 5.06 min (p = 0.003) and maximal distance from 446.38 ± 258.75 to 754.50 ± 331.09 m (p = 0.002). Hemodynamically, systolic blood pressure decreased significantly in both arms (≈154-153 to ≈134 mmHg) and diastolic blood pressure decreased in the right arm (p = 0.039); BMI also declined (28.63 to 27.01 kg/m²; p < 0.001). Anxiety scores decreased from 8.46 ± 2.63 to 5.38 ± 1.45 (p < 0.001), while the reduction in depression scores (7.31 ± 2.78 to 4.69 ± 2.06) did not reach significance (p = 0.16). Finally, optimal quality of life was achieved in 100% of patients (p < 0.001).

CONCLUSION

The rehabilitation program improved walking capacity, systolic blood pressure, weight/BMI, and anxiety, with overall better quality of life. However, evidence remains limited (pre-post without control, single center, small sample, short follow-up), underscoring the need for multicenter randomized controlled trials.