AUTHOR=Shi Yanzhen , Yan Liming , Yang Ming 

TITLE=Early brain–heart health manager–led multidimensional rehabilitation improves functional and psychosocial outcomes in hemorrhagic stroke: a retrospective cohort study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1683579

DOI=10.3389/fneur.2025.1683579

ISSN=1664-2295

ABSTRACT=BackgroundHemorrhagic stroke is associated with substantial mortality and long-term disability. Conventional post-stroke care often overlooks the psychological and multidimensional needs of patients, limiting recovery potential. This study investigates the impact of an early, brain-heart health manager-led multidimensional rehabilitation program on functional, psychological, and quality-of-life outcomes in hemorrhagic stroke survivors.MethodsIn this single-center, retrospective cohort study, we reviewed the medical records of 216 consecutive patients with spontaneous intracerebral hemorrhage admitted between January and December 2023. Patients were categorized into an intervention group (n = 108) or a control group (n = 108) according to the type of inpatient care they had received in routine clinical practice. The intervention group received standard care plus a structured rehabilitation program directed by certified brain-heart health managers, encompassing psychological support, individualized physical rehabilitation, nutritional counseling, and continuous follow-up for 3 months post-discharge. Primary outcomes included functional recovery assessed via the modified Rankin Scale (mRS). Secondary outcomes comprised emotional status (SAS, SDS), sleep quality (PSQI), fatigue severity (FSS), and health-related quality of life (SF-36). Change scores (Δ values) and multivariate logistic regression were used to analyze treatment effects and identify prognostic predictors. Patient grouping was based on pre-existing ward-level clinical management pathways rather than investigator allocation, ensuring fairness and minimizing selection bias.ResultsCompared to the control group, the intervention group showed significantly greater improvements in mRS scores (mean 1.87 vs. 2.36, p < 0.001) and a higher proportion of favorable outcomes (mRS ≤ 2: 75.9% vs. 56.5%, p = 0.004). Marked reductions were observed in SAS, SDS, PSQI, and FSS scores, along with substantial gains across all SF-36 domains (all p < 0.001). Multivariate analysis identified early intervention, younger age, lower BMI, and lower baseline SAS/SDS scores as independent predictors of favorable prognosis.ConclusionEarly implementation of a multidimensional rehabilitation program led by brain-heart health managers significantly enhances neurological and psychosocial outcomes in hemorrhagic stroke patients. This integrated model offers a scalable strategy for optimizing recovery and quality of life in stroke care, while future multicenter prospective studies are warranted to validate and generalize these findings.