Stroke is a leading cause of death and disability worldwide. Many stroke survivors face difficulties with daily activities, sleep problems, anxiety, and depression during recovery. Health education videos can help patients learn about rehabilitation, but standard videos often contain too much information and are hard for patients to follow. This study aims to test whether using semiotics - the science of signs and symbols - to redesign health education videos can help stroke patients better comprehend and apply rehabilitation instructions. The study is designed to include 200 stroke patients at Siping Central Hospital in Jilin Province, China. Patients will be randomly assigned to either the semiotic-optimized video group or the standard health education video group. Outcome measures, including activities of daily living, sleep quality, anxiety, depression, and satisfaction with care, will be assessed before and after the intervention to evaluate the effectiveness of the optimized video education model.

Stroke rehabilitation requires patients to acquire and retain complex self-care knowledge, yet cognitive impairments following stroke often limit their ability to process standard verbal and written health education. Conventional video-based education, while beneficial, frequently presents information in ways that overlook patients' cognitive load and perceptual limitations. Semiotic theory - the systematic study of how signs, symbols, and multimodal cues construct meaning - offers a framework for redesigning educational content to enhance comprehension, retention, and behavioral adoption.

This is a randomized controlled trial conducted at the Rehabilitation Department of Siping Central Hospital, with the intervention period scheduled from January to December 2023. The intervention was developed by a multidisciplinary team of eight specialists and nurses from the Rehabilitation and Neurology Departments. Twenty-two educational videos were produced across three domains: rehabilitation science, exercise guidance, and dietary advice. Each video averaged five to eight minutes in duration. In the experimental group, videos were redesigned using semiotic principles: key rehabilitation actions were highlighted through local magnification with bold, red subtitles and auditory cues; incorrect postures were filmed and contrasted with correct demonstrations using comparative visual cues; and a curated music library was integrated to support relaxation and sleep. Video feedback techniques were also employed, including on-site assessment of movement accuracy and post-training questioning to evaluate knowledge retention. The intervention was delivered twice daily under nursing supervision throughout the 28-day inpatient rehabilitation period.

The control group received standard care with the same set of rehabilitation videos delivered through routine face-to-face guidance, without semiotic optimization or structured video feedback. The primary objective is to evaluate whether the semiotically-optimized video education model can improve activities of daily living compared to standard video education. Secondary objectives will assess changes in sleep quality, anxiety, depression, and patient satisfaction.

Inclusion Criteria:

1. Imaging-confirmed cerebral infarction per 2019 Chinese Guidelines
2. Age ≥18 years
3. Stable condition during rehabilitation phase
4. Alert, able to comprehend and operate video playback
5. Signed informed consent

Exclusion Criteria:

1. Incomplete records, inaccurate data, or failure to complete the intervention