Core Strategies and Digital Health Technology Empowerment for Co-Rehabilitation of Cerebrocardiovascular Diseases
ZHOU Jing1,2, YUAN Jian1, YE Liang2, WANG Yulong1
1 Department of Rehabilitation Medicine, Shenzhen Second People’s Hospital (The First Affiliated Hospital of Shenzhen University), Shenzhen 518035, China
2 Department of Rehabilitation Medicine, Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 311103, China
ZHOU Jing, YUAN Jian, YE Liang, WANG Yulong. Core Strategies and Digital Health Technology Empowerment for Co-Rehabilitation of Cerebrocardiovascular Diseases[J]. Chinese Journal of Stroke, 2025, 20(11): 1371-1379.
[1]AN X Q,LIU Z Y,ZHANG L W,et al. Co-occurrence patterns and related risk factors of ischaemic heart disease and ischaemic stroke across 203 countries and territories:a spatial correspondence and systematic analysis[J/OL]. Lancet Glob Health,2025,13(5):e808-e819[2025-10-21]. https://doi.org/10.1016/S2214-109X(25)00013-0.
[2] MARTIN S S,ADAY A W,ALLEN N B,et al. 2025 heart disease and stroke statistics:a report of us and global data from the American Heart Association[J/OL]. Circulation,2025,151(8):e41-e660[2025-10-21]. https://doi.org/10.1161/cir.0000000000001303.
[3] Joint Committee for Comprehensive Risk Management Chart for the Prevention of Cerebro-Cardiovascular Diseases. Comprehensive risk management for the prevention of cerebro-cardiovascular diseases in Japan[J]. Clin Exp Nephrol,2017,21(5):743-754.
[4] ROSSI A,MIKAIL N,BENGS S,et al. Heart-brain interactions in cardiac and brain diseases:why sex matters[J]. Eur Heart J,2022,43(39):3971-3980.
[5] CHEN Z L,VENKAT P,SEYFRIED D,et al. Brain-heart interaction:cardiac complications after stroke[J]. Circ Res,2017,121(4):451-468.
[6] SPOSATO L A,HILZ M J,ASPBERG S,et al. Post-stroke cardiovascular complications and neurogenic cardiac injury:JACC state-of-the-art review[J]. J Am Coll Cardiol,2020,76(23):2768-2785.
[7] ARDELL J L,ARMOUR J A. Neurocardiology:structure-based function[J]. Compr Physiol,2016,6(4):1635-1653.
[8] 李淑娟,马雅军. 树立“脑心同治”观念 助力脑心共病诊断与治疗发展[J]. 中国现代神经疾病杂志,2024,24(2):65-67.
LI S J,MA Y J. Establish the concept of“synchronous treatment for brain and heart”to help the comprehensive diagnosis and treatment of brain and heart comorbidity[J]. Chin J Contemp Neurol Neurosurg,2024,24(2):65-67.
[9] 关于印发健康中国行动——心脑血管疾病防治行动实施方案(2023—2030年)的通知[EB/OL].(2023-10-30)[2025-10-21]. https://www.gov.cn/zhengce/zhengceku/202311/content 6915365.htm.
[10] VALENZA G,MATIĆ Z,CATRAMBONE V. The brain-heart axis:integrative cooperation of neural,mechanical and biochemical pathways[J]. Nat Rev Cardiol,2025,22(8):537-550.
[11] SCHWAERZER G. Stroke alters the innate immune memory and drives inflammatory cardiac dysfunction
[J/OL]. Nat Cardiovasc Res,2024,3(8):887[2025-10-21]. https://doi.org/10.1038/s44161-024-00526-9.
[12] MACHADO N,WINGFIELD M,KRAMER S,et al. Maintenance of cardiorespiratory fitness in people with stroke:a systematic review and meta-analysis[J]. Arch Phys Med Rehabil,2022,103(7):1410-1421.
[13] ARNETT D K,BLUMENTHAL R S,ALBERT M A,et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease:a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines[J/OL]. Circulation,2019,140(11):e596-e646[2025-10-21]. https://doi.org/10.1161/CIR.0000000000000678.
[14] BILLINGER S A,ARENA R,BERNHARDT J,et al. Physical activity and exercise recommendations for stroke survivors:a statement for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke,2014,45(8):2532-2553.
[15] VISSEREN F L J,MACH F,SMULDERS Y M,et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice[J]. Eur Heart J,2021,42(34):3227-3337.
[16] CHO S H,CHOI K B. Guidelines for the evaluation of cardiorespiratory physiotherapy in stroke patients[J/OL]. Healthcare(Basel),2020,8(3):222[2025-10-21]. https://doi.org/10.3390/healthcare8030222.
[17] DE RUBEIS G,CHATURVEDI S,KAMEL H,et al. Heterogeneity in measurement of NIHSS:a systematic review and meta-analysis[J/OL]. Neurol Sci,2025,46:227-237[2025-10-21]. https://doi.org/10.1007/s10072-024-07733-z.
[18] PRANGE-LASONDER G B,ALT MURPHY M,LAMERS I,et al. European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation(CAULIN):data synthesis from systematic reviews,clinical practice guidelines and expert consensus[J/OL]. J Neuroeng Rehabil,2021,18:162[2025-10-21]. https://doi.org/10.1186/s12984-021-00951-y.
[19] HEIDENREICH P A,BOZKURT B,AGUILAR D,et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure:a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines[J/OL]. Circulation,2022,145(18):e895-e1032[2025-10-21]. https://doi.org/10.1161/cir.0000000000001063.
[20] 中华医学会物理医学与康复学分会,四川大学华西医院. 中国冠心病康复循证实践指南(2024版)第二部分[J]. 中华物理医学与康复杂志,2024,46(7):577-586.
Chinese Society of Physical Medicine and Rehabilitation,Chinese Medical Association;West China Hospital,Sichuan University. Chinese guidelines for evidence-based practice of coronary heart disease rehabilitation(2024 edition):part 2[J]. Chin J Phys Med Rehabil,2024,46(7):577-586.
[21] TAYLOR J L,MYERS J,BONIKOWSKE A R. Practical guidelines for exercise prescription in patients with chronic heart failure[J]. Heart Fail Rev,2023,28(6):1285-1296.
[22] MACKAY-LYONS M,BILLINGER S A,ENG J J,et al. Aerobic exercise recommendations to optimize best practices in care after stroke:AEROBICS 2019 update[J]. Phys Ther,2020,100(1):149-156.
[23] HANSEN D,BECKERS P,NEUNHÄUSERER D,et al. Standardised exercise prescription for patients with chronic coronary syndrome and/or heart failure:a consensus statement from the EXPERT Working Group[J]. Sports Med,2023,53(11):2013-2037.
[24] SAUNDERS D H,SANDERSON M,HAYES S,et al. Physical fitness training for stroke patients[J/OL]. Cochrane Database Syst Rev,2020,3(3):CD003316[2025-10-21]. https://doi.org/10.1002/14651858.CD003316.pub7.
[25] 贾凌云,刘丽旭. 脑心共患疾病的康复评定及治疗研究进展[J]. 中华脑血管病杂志(电子版),2025,19(3):167-174.
JIA L Y,LIU L X. Research progress in rehabilitation assessment and treatment of brain-heart comorbidity diseases[J]. Chin J Cerebrovasc Dis(Electronic Edition),2025,19(3):167-174.
[26] VEMURI A K,HEJAZIAN S S,SADR A V,et al. Adherence to physical activity recommendations among stroke survivors in the United States[J]. Stroke,2025,56(1):113-121.
[27] MURIE-FERNÁNDEZ M,IRIMIA P,MARTÍNEZ-VILA E,et al. Neuro-rehabilitation after stroke[J]. Neurologia,2010,25(3):189-196.
[28] LI K P,WU J J,ZHOU Z L,et al. Noninvasive brain stimulation for neurorehabilitation in post-stroke patients[J/OL]. Brain Sci,2023,13(3):451[2025-10-21]. https://doi.org/10.3390/brainsci13030451.
[29] MESSINA G,MONDA A,MESSINA A,et al. Relationship between non-invasive brain stimulation and autonomic nervous system[J/OL]. Biomedicines,2024,12(5):972[2025-10-21]. https://doi.org/10.3390/biomedicines12050972.
[30] SUN Z M,LIU L,PENG H J,et al. The efficacy of transcutaneous vagus nerve stimulation in heart failure management—a systematic review and meta-analysis[J/OL]. BMC Cardiovasc Disord,2025,25:481[2025-10-21]. https://doi.org/10.1186/s12872-025-04919-x.
[31] KIRTON A,METZLER M J,CRAIG B T,et al. Perinatal stroke:mapping and modulating developmental plasticity[J]. Nat Rev Neurol,2021,17(7):415-432.
[32] MEKBIB D B,ZHAO Z Y,WANG J B,et al. Proactive motor functional recovery following immersive virtual reality-based limb mirroring therapy in patients with subacute stroke[J]. Neurotherapeutics,2020,17(4):1919-1930.
[33] CASSANI R,NOVAK G S,FALK T H,et al. Virtual reality and non-invasive brain stimulation for rehabilitation applications:a systematic review[J/OL]. J Neuroeng Rehabil,2020,17:147[2025-10-21]. https://doi.org/10.1186/s12984-020-00780-5.
[34] SKI C F,TAYLOR R S,MCGUIGAN K,et al. Psychological interventions for depression and anxiety in patients with coronary heart disease,heart failure or atrial fibrillation[J/OL]. Cochrane Database Syst Rev,2024,4(4):CD013508[2025-10-21]. https://doi.org/10.1002/14651858.CD013508.pub3.
[35] TERRILL A L. Mental health issues poststroke:underrecognized and undertreated[J]. Stroke,2023,54(6):1528-1530.
[36] MORTENSEN J K,ANDERSEN G. Safety considerations for prescribing SSRI antidepressants to patients at increased cardiovascular risk[J]. Expert Opin Drug Saf,2022,21(4):467-475.
[37] 中华预防医学会,中华预防医学会心脏病预防与控制专业委员会,中华医学会糖尿病学分会,等. 中国健康生活方式预防心血管代谢疾病指南[J]. 中国循环杂志,2020,35(3):209-230.
Chinese Preventive Medicine Association;Branch of Heart Disease Prevention and Control,Chinese Preventive Medicine Association;Chinese Diabetes Society;et al. Chinese guideline on healthy lifestyle to prevent cardiometabolic diseases[J]. Chinese Circulation Journal,2020,35(3):209-230.
[38] 中国医师协会睡眠医学专业委员会,中国医师协会神经内科医师分会睡眠学组. 中国成人失眠共病阻塞性睡眠呼吸暂停诊治指南(2024版)[J]. 中国全科医学,2025,28(11):1289-1303.
Chinese Academy Society of Sleep Medicine,Chinese Medical Doctor Association;Sleep Medicine Group,China Neurologist Association. Chinese guideline for diagnosis and treatment of co-morbid insomnia and obstructive sleep apnea(2024)[J]. Chinese General Practice,2025,28(11):1289-1303.
[39] 中国高血压防治指南修订委员会,高血压联盟(中国),中国医疗保健国际交流促进会高血压病学分会,等. 中国高血压防治指南(2024年修订版)[J]. 中华高血压杂志(中英文),2024,32(7):603-700.
Writing Group of 2018 Chinese Guidelines for the Management of Hypertension,Chinese Hypertension League,Hypertension Branch of China International Exchange and Promotive Association for Medical and Health Care,et al. Chinese guidelines for the management of hypertension(2024 edition)[J]. Chin J Hypertens,2024,32(7):603-700.
[40] 欧阳子祺,王剑,廖旭兴.“互联网+脑心同治”心脑血管疾病全生命周期健康管理新模式[J]. 中国临床神经外科杂志,2025,30(3):177-180.
OUYANG Z Q,WANG J,LIAO X X. Internet+brain-heart co-treatment:a new model for whole life cycle health management of cardiovascular and cerebrovascular diseases[J]. Chin J Clin Neurosurg,2025,30(3):177-180.
[41] MACKINNON G E,BRITTAIN E L. Mobile health technologies in cardiopulmonary disease[J]. Chest,2020,157(3):654-664.
[42] THOMAS R J,BEATTY A L,BECKIE T M,et al. Home-based cardiac rehabilitation:a scientific statement from the american association of cardiovascular and pulmonary rehabilitation,the American Heart Association,and the American College of Cardiology[J/OL]. Circulation,2019,140(1):e69-e89[2025-10-21]. https://doi.org/10.1161/cir.0000000000000663.
[43] MCDONAGH S T,DALAL H,MOORE S,et al. Home-based versus centre-based cardiac rehabilitation[J/OL]. Cochrane Database Syst Rev,2023,10(10):CD007130[2025-10-21]. https://doi.org/10.1002/14651858.CD007130.pub5.
[44] OBERMEYER Z,EMANUEL E J. Predicting the future—big data,machine learning,and clinical medicine[J]. N Engl J Med,2016,375(13):1216-1219.
[45]YE W X,GAN J,WANG M,et al. A combined-mode machine learning model for predicting stroke recurrence during hospitalization in patients with acute minor ischemic stroke[J/OL]. MedComm,2025,6(6):e70234[2025-10-21]. https://doi.org/10.1002/mco2.70234.