Objective To explore the effects of hierarchical exercise therapy combined with Tuina on the psychological state and limb function of elderly stroke patients. Methods A total of 96 elderly stroke patients admitted to a hospital in Nanyang from June 2020 to June 2021 were selected as subjects

who were assigned to a control group（n=50） and a study group（n=46） using the random number table method. Patients in the control group received conventional care in combination with Tuina intervention

while patients in the study group used hierarchical exercise therapy in addition to the care in the control group

and both groups continued the intervention for one month. The clinical nursing effect and the changes of psychological state and limb function before and after the nursing were compared between the 2 groups of patients. Results The FMA scores and BBS scores of patients in the 2 groups after nursing were higher than those before care

with the study group higher than the control group

and the differences were statistically significant（P<0.05）. The MEP wave amplitude after nursing was longer in the 2 groups than before nursing

with the study group longer than the control group

and MEP latency was shorter than before nursing

with the study group shorter than the control group

and the differences were statistically significant（P<0.05）. After nursing

the HAMA and HAMD scores of the two groups were lower than before nursing

with the study group lower than the control group

and the difference was statistically significant（P<0.05）. After nursing

SS-QOL and Barthel scores of patients in the 2 groups were higher than those before nursing

with the study group higher than the control group

and the difference was statistically significant（P<0.05）. Conclusion Hierarchical exercise therapy in combination with Tuina can effectively improve the physical function

psychological state and quality of life of elderly stroke patients. These benefits justify a wider application of this nursing in clinical practice.