Background
Stroke is a leading cause of long-term disability worldwide and substantially increases the risk of cognitive impairment and progression to dementia. Despite established cardiovascular rehabilitation protocols, there remains a crucial unmet need for effective prevention and treatment strategies targeting poststroke cognitive decline. Cardiorespiratory exercise (CRX) has been demonstrated to preserve brain health in general populations by increasing brain volumes and cognitive function, with prior evidence linking aerobic fitness to hippocampal volume (HV), a key region implicated in memory and cognition. However, direct evidence of CRX benefits on brain volume and cognition after ischemic stroke is limited, and safety concerns have constrained adoption in clinical practice.
