Physical Activity Recommendations for Physical Activity Referenced studies that support recommendations are summarized in online Data Supplements 5 and 6. COR LOE Recommendations In patients with stroke or TIA who are capable of physical activity, engaging in at least moderate- intensity aerobic activity for a minimum of 10 min- utes 4 times a week or vigorous-intensity aerobic activity for a minimum of 20 minutes twice a week is indicated to lower the risk of recurrent stroke and the composite cardiovascular end point of recurrent stroke, MI, or vascular death.110 In patients with stroke or TIA who are able and willing to increase physical activity, engaging in an exercise class that includes counseling to change physical activity behavior can be beneficial for reducing cardiometabolic risk fac- tors and increasing leisure time physical activity In patients with deficits after stroke that impair their ability to exercise, supervision of an exercise program by a health care professional such as a physical therapist or cardiac reha- bilitation professional, in addition to routine rehabilitation, can be beneficial for secondary stroke prevention. 