Clinician's Commentary on Hui et al.

An important goal of stroke rehabilitation is to improve physical activity levels and cardiorespiratory fitness (CRF). A recent survey revealed that, of 155 Canadian physiotherapists practicing in the area of neurorehabilitation, 77% reported prescribing aerobic exercise.2 Similarly, in the United States, 66.7% of acute care therapists and 93.1% of therapists from other settings reported prescribing aerobic exercise to at least some people after stroke.3 These results are very promising, but prominent barriers to prescribing aerobic exercise in these and other studies were insufficient time during the therapy session and short length of stay in rehabilitation. Combined with the general lack of community based exercise programmes available after discharge, there is a great need for something to bridge the gap between behavioural prescriptions and the ability of patients to adhere to clinical recommendations in the long term. Clinicians must also focus on non–prescription-related activities because they are likely to be an important determinant of the CRF profile, risk factor modification, and reintegration into the community