Editorial: Evaluation of fitness in stroke survivors

I see zero use for assessments. Why not deliver EXACT STROKE PROTOCOLS THAT DELIVER 100% RECOVERY,  instead of this lazy shit. 

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful , I look forward to that day. 

(Where is the creation of protocols that deliver recovery? Without that this research is useless!)

 Editorial: Evaluation of fitness in stroke survivors

Felipe Cunha1†, Arthur de Sá Ferreira2*† and Adrian Wayne Midgley3†

1Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil

2Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, Rio de Janeiro, Brazil

3Department of Sport & Physical Activity, Edge Hill University, Ormskirk, United Kingdom

Edited and reviewed by

Anthony Pak Hin Kong, The University of Hong Kong, Hong Kong SAR, China

*Correspondence

Arthur de Sá Ferreira, asferreira@unisuam.edu.br

†These authors have contributed equally to this work and share first authorship

Received 08 August 2025

Accepted 14 August 2025

Published 29 August 2025

Citation

Cunha F, Ferreira AS and Midgley AW (2025) Editorial: Evaluation of fitness in stroke survivors. Front. Stroke 4:1682445. doi: 10.3389/fstro.2025.1682445

Keywords

stroke, recovery, rehabilitation, cardiorespiratory fitness, cardiopulmonary exercise test, balance, body composition, muscular fitness

Editorial on the Research Topic

Evaluation of fitness in stroke survivors

Stroke remains a leading cause of long-term disability worldwide, often resulting in impairments in cardiorespiratory and neuromuscular function (Tsao et al., 2023). These limitations contribute to decreased physical activity, increased fatigue, and heightened sedentary behavior, jeopardizing functional independence and increasing the risk of recurrence. This Research Topic showcase recent advances in evaluating key domains of physical fitness in stroke survivors, including cardiorespiratory fitness, muscular strength, and endurance, neuromotor control, fatigue tolerance, and body composition.

Cardiorespiratory fitness assessment remains a cornerstone of post-stroke evaluation. The cardiopulmonary exercise test (CPET) is recognized as the gold standard for determining maximal oxygen uptake (VO2max), however, its validation, safety, and feasibility in stroke populations remain underexplored. Qu et al. addressed this gap by examining the decline in cardiorespiratory fitness post-stroke using resting-state functional magnetic resonance imaging, opening new perspectives for combining physiological and neuroimaging data in this population.

Accurate assessment of neuromuscular function and physical performance is equally critical. Pu et al. developed a nomogram to predict sarcopenia risk in stroke patients, incorporating anthropometric and biochemical markers, while Zhong et al. validated a Chinese version of the performance-oriented mobility assessment, ensuring reliability for use in chronic stroke survivors. Bi et al. further linked serum albumin levels to severe impairment in activities of daily living (ADLs), reinforcing the role of nutritional and metabolic markers in functional prognosis.

The interplay between physical health, psychological status, and functional independence also emerged as a key theme. Dan et al. demonstrated how depression mediates the link between stroke and fracture risk, highlighting the need for integrative assessments that include emotional and cognitive domains. Similarly, Lin and Liu proposed a predictive model for ADL dysfunction, offering clinicians a tool to anticipate limitations early in the recovery process.

Contributions addressed innovative assessment and rehabilitation strategies. Bian et al. performed a network meta-analysis comparing different physical stimulation therapies, offering evidence to guide upper limb motor rehabilitation strategies. Dai et al. explored the concept of exercise preference in stroke survivors, emphasizing the value of patient-centered approaches when designing fitness evaluations and rehabilitation plans.

Lastly, Yin et al. analyzed thrombectomy timing by stroke subtype, and Chunjuan et al. applied machine learning clustering to inflammatory profiles, both enhancing our understanding of physiological factors influencing recovery potential.

These studies represent a multidisciplinary effort to improve the precision, relevance, and personalization of fitness assessment in stroke rehabilitation. Continued research must ensure that tools are accessible, scalable, and responsive to the specific needs of stroke survivors across the recovery continuum. We hope this Research Topic inspires further innovation and collaboration in optimizing fitness assessment and rehabilitation strategies in stroke care.