Objective <p>This study investigates the effectiveness of a nursing strategy incorporating ischemic adaptation training on improving neurological outcomes, personal identity, and long-term prognosis in patients diagnosed with acute stroke.</p> Methods <p>This was a quasi-experimental study. A total of 50 patients with acute stroke admitted between February 2019 and June 2021 were non-randomly assigned to two groups: a control group receiving standard nursing care and an intervention group receiving ischemic adaptation-based intensive nursing. Parameters compared between groups included nursing satisfaction, neurological function via NIHSS, activities of daily living via Barthel Index, self-identity via Segment Involvement Score (SIS), patient compliance, and quality of life scores.</p> Results <p>The intervention group demonstrated a higher rate of nursing satisfaction compared to the control group (100% vs. 92%, <i>P</i> &lt; 0.05). Post-intervention assessments showed significant improvement in neurological scores (NIHSS), Barthel Index, and SIS in the intervention group at discharge, and 1, 3, and 6 months after discharge (<i>P</i> &lt; 0.05). Quality of life outcomes also significantly favored the intervention group across all domains. Compliance was markedly higher in the intervention group (<i>P</i> &lt; 0.05).</p> Conclusion <p>Intensive nursing based on ischemic adaptation training significantly enhances neurological recovery, independence in daily activities, and overall quality of life in patients with acute stroke. This method holds potential as a supportive rehabilitative strategy.</p>