Stroke may cause physical or cognitive impairments. Approximately 50% to 75% of all stroke survivors have residual motor or cognitive disabilities that prevent them from living independently. Muscle weakness is considered a major cause of motor disability in stroke patients.1 Impaired walking occurs in as many as 80% of individuals immediately after stroke,2 with muscle weakness in the paretic limb explaining ≤50% of the variance in gait among individuals with chronic mild-to-moderate poststroke hemiparesis.3 As a result, gait patterns become asymmetrical and gait speed reduced.4 Additionally, impaired walking is commonly observed beyond 6 months after stroke.5 This lack of walking competency can precipitate and exacerbate a sedentary lifestyle and cardiovascular deconditioning. Previous work has shown that maximal oxygen consumption (VO2max), as a measurement of cardiovascular fitness, is reduced to 10 to 17 mL/kg/min within the first month after stroke6 and remains below 20 mL/kg/min beyond 6 months.7 The same values can be 45% lower than in age-matched and healthy individuals.8 The implication of low VO2max becomes even more important knowing that a minimum of 20 mL/kg/min is needed for performing daily activities9 and for independent living among older stroke patients.10 In addition to stroke-related decline in cardiovascular fitness, a natural decline in VO2max occurs after the age of 50, averaging a 5% to 10% (or ≈ 5 mL/kg/min) loss per decade. Therefore, elderly stroke patients may face disease- and age-related declines in cardiorespiratory fitness. In a meta-analysis of 11 studies (n=1105), low physical activity (PA) levels, for example, 4355 daily steps taken, have been observed among stroke patients.11 People with other chronic diseases, such as chronic pulmonary obstructive disease, have reported as few as 2237 steps a day.12 The medical establishment, including …