Early Brain–Heart Health Manager–Led Multidimensional Rehabilitation Improves Functional and Psychosocial Outcomes in Hemorrhagic Stroke: A Retrospective Cohort Study

Yanzhen Shi¹Liming Yan¹Ming Yang^2*

• ¹Brain Hospital of Hunan Province, Changsha, China
• ²College of Clinical Medicine, Brain Hospital of Hunan Province (The Second Hospital of Hunan Province), Hunan University of Chinese Medicine, Changsha, China

Background: Hemorrhagic 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. Methods: In 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 three 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. Results: Compared 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. Conclusions: Early 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.