Efficacy of the LEARNS-Based Health Education Program on Motor Recovery, Self-Efficacy, and Rehabilitation Adherence in Ischemic Stroke Patients.

BACKGROUND: Motor recovery in stroke survivors often declines post-discharge. This study evaluated the efficacy of a LEARNS-based health education program on functional recovery and behavioral adherence. METHODS: In this single-center, parallel-group randomized controlled trial, 128 ischemic stroke patients were assigned to either a LEARNS-based intervention (n=64; mean age: 72.9 years; 40.6% male) or a control group (n=64; mean age: 72.5 years; 42.2% male). Primary outcome was the Fugl-Meyer Assessment (FMA) score measured across a 3-month follow-up period at baseline (T0), discharge (T1), 1-month (T2), and 3-month (T3) follow-ups. Linear Mixed-Effects Models were used for statistical analysis. RESULTS: A total of 117 participants completed the 3-month follow-up (overall attrition rate: 8.6%, 11/128). Baseline mean FMA scores were comparable between groups (32.1 in intervention vs 31.8 in control). A significant Group by Time interaction was found for FMA scores (β = 3.81, p < 0.001). At T3, the intervention group achieved significantly higher motor recovery compared to the control group (mean FMA score: 54.2 vs 43.0; Difference = 11.21, p < 0.001). The intervention group also showed significant improvement in self-efficacy at T1 and sustained higher rehabilitation adherence through T3, whereas the control group demonstrated a significant decrease in adherence post-discharge. CONCLUSION: The LEARNS model effectively improves post-discharge motor recovery and sustains self-efficacy and long-term adherence in ischemic stroke patients.