Reduced Cardiorespiratory Fitness after Stroke: Biological Consequences and Exercise-Induced Adaptations

I saw NO references to solutions to this problem, just descriptions of the problems with maybe some causes.  These people should not be allowed to practice research until they come up with solutions to their described problems. I'm probably an outlier, three years post stroke at a physical I had a resting heart rate of 54 at age 53, that translates to having an athlete  cardiovascular system, with absolutely no real exercise in those 3 years.

Reduced Cardiorespiratory Fitness after Stroke: Biological Consequences and Exercise-Induced Adaptations

1. Introduction
Little is known about the biology surrounding decrements in cardiorespiratory (CR) fitness after stroke, but evidence has gradually begun to track the damage caused to multiple
physiological systems by stroke-related chronic inactivity [1–8]. Collectively, these changes negatively impact morbidity and mortality prospects and contribute to reduced quality of
life [9]. Because CR fitness is a measure that quantifies the ability of the heart, lungs, blood vessels, and skeletal muscles to work together to deliver oxygen and remove metabolic
byproducts during exercise, it is indirectly reflective of broad categories of cardiovascular,metabolic, and functional health. Most often, CR fitness is measured using a metabolic cart for gas analysis and exercise equipment (e.g., treadmill, recumbent stepper, or cycle ergometer) to determine peak
oxygen-consuming capacity (VO2 peak) and is quantified during exercise to complete exhaustion [10–16].  CR fitness varies according to age, gender, physical activity levels, body composition, and the absence or presence of chronic disease or disability. In the poststroke population, the literature suggests that CR fitness is reduced by as much as 50% when compared to age-matched sedentary counterparts [12, 14]. The extent of deterioration is associated with several clinically relevant biological correlates which were the focus of this review. It remains unclear whether reduced CR fitness after stroke is due primarily to premorbid conditions, direct effects of the stroke itself, or poststroke physical inactivity. All are likely contributors but understanding the relative
contributions of each will require further research into biological/etiological mechanisms [17].Whatever the cause, it is important to assess the capacity of stroke survivors to physiologically
adapt in response to aggressive rehabilitation therapy interventions. Hence, this review also outlines some of the preliminary progress made in deciphering the physiological benefits of exercise training after stroke. Arriving at a better understanding of the cardiovascular, metabolic, and functional adaptations resulting from a variety of therapy protocols and how these contribute to improved CR fitness is especially important for healthcare providers, rehabilitation specialists, and others working towards the common goal of improving overall health and quality of life in this clinical
population.