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Solutions include thorough education on adherence and study benefits, automated reminders via text messages or phone calls, and support systems, such as peer groups or regular check-ins

Interestingly, it should be noted that the data from the present study revealed substantial mitochondrial remodeling and elevated oxidative stress, which can amplify the stimulation of group III/IV afferents and increased the susceptibility to muscle fatigue thus providing an alternative mechanism by which exercise intolerance develops in these patients (16, 17)

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