Toronto Rehab-University Health Network, Toronto, Ontario, Canada.
Can J Cardiol. 2018 Oct;34(10 Suppl 2):S240-S246. doi: 10.1016/j.cjca.2018.06.017. Epub 2018 Jul 11.
Following stroke, people are at high risk for repeat strokes and for complications related to coronary artery disease (CAD). Indeed, stroke and CAD share many of the same risk factors. Unfortunately, patients become sedentary after stroke, which leads to cardiorespiratory deconditioning as well as muscle atrophy and weakness that in turn leads to deterioration in metabolic, cardiorespiratory, and functional health. Access to intensive secondary prevention programs with structured exercise components that include both aerobic and resistance training can help to prevent and reverse these health hazards. Traditional stroke rehabilitation programs face many barriers to providing exercise programming early post-stroke, such as lack of available therapy time and short length of stay, lack of equipment for exercise and assessments, and concerns for patient safety related to cardiac status. Building a partnership between traditional stroke rehabilitation programs and cardiac rehabilitation by operationalizing an automatic referral process has the potential to affect secondary prevention of stroke and cardiovascular risk significantly. It could also mitigate the tremendous burden on patients and their family members. This is an easily identified group that can achieve significant gains over multiple domains of recovery with the targeted exercise and risk-factor modification components offered by comprehensive cardiac rehabilitation programs.
中风后，人们有很高的再次中风风险，以及与冠状动脉疾病（CAD）相关的并发症风险。事实上，中风和 CAD 有许多相同的风险因素。不幸的是，中风后患者会变得久坐不动，这会导致心肺功能下降，以及肌肉萎缩和无力，从而导致代谢、心肺和功能健康恶化。通过提供包括有氧运动和抗阻训练在内的结构化运动成分的强化二级预防计划，可以帮助预防和逆转这些健康危害。传统的中风康复计划在中风后早期提供运动计划面临许多障碍，例如缺乏可用的治疗时间和住院时间短、缺乏运动和评估设备，以及与心脏状况相关的患者安全问题。通过实施自动转诊流程，在传统的中风康复计划和心脏康复之间建立伙伴关系，有可能显著影响中风和心血管风险的二级预防。它还可以减轻患者及其家属的巨大负担。这是一个容易识别的群体，通过综合心脏康复计划提供的针对性运动和危险因素改变成分，可以在多个康复领域取得显著的收益。
