KITE Research Institute, Toronto Rehab-University Health Network, Toronto, Ontario, Canada; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Toronto, Ontario, Canada; Faculty of Kinesiology and Physical Education, University of Toronto, Ontario, Canada; and Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada.
J Cardiopulm Rehabil Prev. 2020 Sep;40(5):294-301. doi: 10.1097/HCR.0000000000000540.
More than 13 million cases of stroke are occurring annually worldwide. Approximately a quarter of these strokes are recurrent strokes, and there is compelling evidence of the benefit of supervised exercise and risk factor modification programming in the secondary prevention of these strokes. However, there is insufficient time in inpatient and outpatient stroke rehabilitation for focused exercise interventions. General lifestyle interventions on their own, without guidance and supervision, are insufficient for improving physical activity levels. Cardiac rehabilitation (CR) is a setting where cardiac patients, and increasingly stroke patients, receive comprehensive secondary prevention programming, including structured exercise. Unfortunately, not all CR programs accept referrals for people following a stroke and for those that do, only a few patients participate. Therefore, the purpose of this review is to report the barriers and facilitators to improving linkage between health services, with a focus on increasing access to CR. In the next two decades, it is projected that there will be a marked increase in stroke prevalence globally. Therefore, there is an urgent need to create cross-program collaborations between hospitals, outpatient stroke rehabilitation, CR, and community programs. Improving access and removing disparities in access to evidence-based exercise treatments would positively affect the lives of millions of people recovering from stroke.
全球每年有超过 1300 万例中风病例。这些中风中约有四分之一是复发性中风，有确凿的证据表明，在这些中风的二级预防中，监督下的运动和危险因素修正方案是有益的。然而，在住院和门诊中风康复中，用于集中运动干预的时间不足。一般的生活方式干预本身，如果没有指导和监督，对于提高身体活动水平是不够的。心脏康复（CR）是一个为心脏病患者，以及越来越多的中风患者提供全面二级预防方案的场所，包括结构性运动。不幸的是，并非所有的 CR 项目都接受中风后患者的转介，而对于那些接受转介的项目，只有少数患者参与。因此，本综述的目的是报告改善卫生服务之间联系的障碍和促进因素，重点是增加获得 CR 的机会。在未来二十年，预计全球中风患病率将显著增加。因此，迫切需要在医院、门诊中风康复、CR 和社区项目之间建立跨项目合作。改善获得机会和消除获得循证运动治疗的差距，将对数百万从中风中康复的人的生活产生积极影响。
