Application effects of early pulmonary rehabilitation evidence-based nursing protocol in patients with stroke-associated pneumonia: A historical controlled quasi-experimental study

Stroke-associated pneumonia (SAP) is one of the most common poststroke complications, significantly affecting patient prognosis. Early pulmonary rehabilitation (PR) has gained increasing attention in SAP management; however, evidence-based, systematic, and standardized programs remain lacking in clinical practice. This study aimed to summarize domestic and international evidence on SAP PR via evidence-based nursing, develop a comprehensive early PR program, and evaluate its efficacy. A quasi-experimental study design was employed. A total of 70 patients diagnosed with SAP who were admitted to the Department of Neurology of our hospital between July 2024 and June 2025 were enrolled in this study. Using a historical control approach, 35 SAP patients admitted from July to December 2024 were allocated to the control group, and 35 SAP patients admitted from January to June 2025 were allocated to the observation group. The control group received standard nursing care, while the observation group received nursing care incorporating an evidence-based PR program in addition to standard nursing care. Outcome measures included pulmonary ventilation function assessed by peak expiratory flow, respiratory muscle function assessed by maximal inspiratory pressure, pulmonary infection status assessed by the Clinical Pulmonary Infection Score, limb motor function assessed by the Fugl-Meyer Assessment Scale, and activities of daily living assessed by the Modified Barthel Index. Before the intervention, there were no statistically significant differences in peak expiratory flow, maximal inspiratory pressure, Clinical Pulmonary Infection Score, Fugl-Meyer Assessment Scale score, and Modified Barthel Index score between the 2 groups (all P  > .05). After the intervention, all indicators in both groups improved compared with baseline, and all indicators in the observation group were significantly better than those in the control group, with statistically significant differences (all P  < .05). The evidence-based comprehensive early PR program for SAP patients developed in this study has clinical practicability, operability, and generalizability. Clinical verification confirmed that this program exerts positive effects on improving pulmonary function, limb motor function, and self-care ability in SAP patients, and can effectively alleviate pulmonary infection. It is therefore suitable for further clinical promotion and implementation.