Adaptive equip- ment and skilled personnel can help to overcome many of these barriers to participation. A systematic review of inclusive studies of exercise-based pro- grams in stroke identified that exercise programs are safe and feasible to implement in nonambula- tory individuals, but to date, no evidence supports their impact on recurrent stroke,135 Promising pilot studies of aerobic exercise programs inclusive of those with motor disability have shown that with adequate pre-exercise screening they are safe and feasible in both subacute and community settings and can improve cardiovascular fitness and reduce cardiovascular risk profiles.136,137 4. Stroke survivors were noted to be sedentary for >78% of total accelerometry time measured in a Community-dwelling, inde- pendently mobile (with/without mobility aid) indi- viduals >6 months after stroke were identified as being sedentary for 10.9 h/d and having a low step count (mean, 2411 steps per day). These results were statistically significant compared with age- and sex-matched control subjects.138 This pro- longed sedentary time and inactivity increase future cardiovascular risk in stroke because these levels are associated with overall cardiovascular mortal- ity (HR, 1.15 [95% CI, 1.11 1.19]) and cardiovas- with HRs more pronounced with lower physical Prespecified secondary analysis from the BUST-Stroke trial (Breaking Up Sitting Time After Stroke) identified sitting with 3-minute bouts of light-intensity activity while standing every 1.7 5.4) compared with 8 hours of uninterrupted sitting. For participants not taking antihypertensive medications, sitting with 3-minute interruptions of either walking or light-intensity activity while standing every 30 minutes decreased SBP by with 8hours of uninterrupted sitting. No effect by condition for diastolic BP or plasma fibrinogen lev- els was observed.115 4.1.3. Smoking Cessation Recommendations for Smoking Cessation Referenced studies that support recommendations are summarized in online Data Supplements 7 and 8. 