Objective To compare the assessment results of Loewenstein occupational therapy cognitive assessment (LOTCA) and mini-mental state examination(MMSE) in stroke patients,and to analyze the correlation between the two assessments and to explore the applicable values of LOTCA in assessing vascular cognitive function impairment (VCI).Methods According to the diagnostic standard of cognitive impairment with MMSE,thirty stroke patients with cognitive impairment were selected as cognitive impairment group,thirty stroke patients without markedly cognitive impairment as stroke control group,and thirty normal subjects served as normal control group.All the subjects' age,gender and level of education were matched in the three groups. All the subjects were assessed with LOTCA and MMSE.ResultsThe total scores of LOTCA had high positive correlation with the total scores of MMSE in cognitive impairment group ( r =0.934,P ＜ 0.01 ),the correlations were also found between every sub-items of LOTCA and those of MMSE (P ＜ 0.01 ).The total scores and the scores of sub-items of LOTCA in cognitive impairment group were significantly lower than those in stroke control group and were those in normal control group(P ＜ 0.01 ),particularly lower scores in LOTCA sub-items of thinking operations,orientation,visuomotor organization.The scores of sub-items of LOTCA,including thinking operations,visuo-motor organization,attention,orientation,spatial perception were all significantly lower in stroke control group than those in normal control group(P ＜0.01 ),especially in thinking operations and visuo-motor organization sub-items.Conclusions Correlations were found between LOTCA and MMSE.Compared to MMSE,LOTCA could detect vascular cognitive function impairment earlier and is much more comprehensive,so it is suitable to assess vascular cognitive impairment patients with no dementia.

Objective To explore the correlation between P300 and Loewenstein occupational therapy cognitive assessment (LOTCA) results, and to analyze its clinical significance. Also to explore whether P300 might represent specific cognitive functions. Methods Sixty stroke patients were matched with 30 healthy persons serving as a control group. All were examined with auditory evoked potential P300 and the LOTCA, and the correlation between the results was analyzed.Results The stroke patients had significantly longer P200,N200 and P300 latencies and significantly lower P300 amplitude compared with the controls. The LOTCA total scores and each sub-item score in the patient group were all significantly lower than those in the control group. In the patient group, there was strong negative correlation between P300 latency and the total LOTCA score, weak positive correlation between P300 amplitude and the total LOTCA score, and medium to high negative correlation between P300 latency and LOTCA sub-item scores. Stepwise regression and multivariate analysis revealed that sub-items of LOTCA, followed by thinking operations, motor praxis and spatial perception, were strongly correlated with P300 latencies.Conclusions Significant correlation were found between P300 and LOTCA. The combination of P300 and LOTCA can enable earlier, more objective and more comprehensive assessment of vascular cognitive impairment. The latency of P300 has no obvious specificity in reflecting cognitive function, and it is affected by thinking operations most.

Objective To explore the applicability of the Loewenstein occupational therapy cognitive assessment (LOTCA) in evaluating cognitive function and observing the curative effect of stroke treatment.Methods Thirty stroke patients with cognitive impairment (the cognitive impairment group) and thirty stroke patients without marked cognitive impairment (the stroke control group) were screened using the mini-mental status examination (MMSE),and thirty healthy subjects served as a normal control group.The gender distributions,ages and levels of education of the three groups were matched.All cases were examined with the LOTCA.After two months of treatment,the three groups were assessed again.Results The average total scores and the scores on the LOTCA subitems were significantly lower in the cognitive impairment group than in the stroke control group and were even lower than those in the normal control group.Particularly conspicuous were their lower scores on the thinking operations and orientation and visuo-motor organization LOTCA sub-items,In the stroke control group the average scores on the thinking operations,visuo-motor organization,attention,orientation and spatial perception sub-items were all significantly lower than those in the normal control group,especially on the thinking operations and visuo-motor organization sub-items.After treatment,the LOTCA scores in all three groups had improved significantly compared with before treatment.Conclusion The LOTCA can assess the severity and characteristics of cognitive impairment in stroke patients.It offers an effective method for identifying cognitive impairment and tracking any improvements.The scores reflect patients' cognitive levels,and so have clinical value.

Objective To investigate the association between chronotropic incompetence (CI)and motor ability in type 2 diabetic mellitus (T2DM) patients complicated with metabolic syndrome (MS).Methods One hundred and twenty patients with T2DM were enrolled in the study,including 66 cases with MS (MS group) and 54 without MS (non-MS group).The electrocardiographic exercise test was performed,the CI indexes including ratio of heart rate (rHR),heart rate reserve (HRR)were measured and the max metabolic equivalents(maxMETs) were calculated.Result The rHR(0.77 ±0.04 vs.0.81 ±0.06,t =3.41,P ＜ 0.05),HRR (0.62 ± 0.05 vs.0.70 ± 0.07,t =5.96,P ＜ 0.05) and maxMETs (8.8 ± 1.1 vs.9.7 ± 1.2,t =0.16,P ＜ 0.05) in patients of MS group all lower than those in non-MS group.The maxMETs were positively correlated with rHR (r =0.81,P ＜ 0.05) and HRR (r =0.78,P ＜ 0.05).Conclusion The results indicate that CI as well as maxMETs and rating of perceived exertion can be used as monitoring index in type 2 diabetic patients complicated with metabolic syndrome.

Objective To explore the impact of low frequency repetitive transcranial magnetic stimula tion (rTMS) on executive dysfunction after stroke by magnetic resonance spectroscopy (MRS) and neuropsychological scale.Methods 60 stroke patients with executive dysfunction were recruited and randomly divided into a study group and a control group,with 30 in each.The study group was treated with rTMS in addition to routine treatment,while the control group received routine treatment only.Before and after treatment,the neuropsychological scale and MRS were measured in both groups.Results After treatment,the scores on the LOTCA and FAB of neuropsychological scale in the treatment group were (87.10 ± 3.16) and (11.97 ± 0.48),significantly better than before the baselines.NAA/Cr was (1.64 ± 0.08) and Cho/Cr was (1.17 ± 0.07),which were significantly better than the baselines.In the control group,significant differences were also observed in the scores of the neuropsychological scale and in the indicators of MRS before and after treatment.Conclusions rTMS can effectively improve executive function in patients with cerebral apoplexy by influencing the metabolites related with cognitive function in the brain.Magnetic resonance spectroscopy can show the therapeutic effect at molecular level.

Objective To explore the effect of early rehabilitation on function recovery in stroke patients.Methods 70 patients were divided into two groups, rehabilitation group (38 cases) and control group (32 cases). Rehabilitation group was given clinical treatment and early rehabilitatio therapy, while control group was given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and eight weeks after the treatment respectively. Motor function of limbs was assessed in Brunnstrom grade and Fugl-Meyer Assessment (FMA), Neurological Function would be assessed with the scale of Clinical Neurological Function Defects (CNFD), and Activities of Daily Living was assessed in Modified Barthel Index(MBI). Results All scores in the rehabilitation group were superior to that in the control group (P< 0.05). Conclusion Early rehabilitation training on stroke patients may obviously improve motor function, promote neurological function and increasing the activities of daily living.

ObjectiveTo observe the therapeutic effect of proprioception strengthening training on knee osteoarthritis.MethodsBased on clinical diagnostic criteria, 80 patients with knee osteoarthritis were randomly divided into a treatment group(41 cases) and a control group(39 cases). The patients in the treatment group were administered proprioception strengthening training, muscle strengthening exercise and treatment with sodium hyaluronate injection of knee joint, while the patients in the control group were administered muscle strengthening exercise and treatment with sodium hyaluronate injection of knee joint. Before and after the treatment, knee function were assessed with Lysholm Assessment Standard on knee function.ResultsThe patients in both groups scored significantly higher on Lysholm on knee function than the patients before the treatment (P<0.01). The patients in the treatment group are better than the patients in the control group(P<0.01).ConclusionProprioception strengthening training can improve the knee function and it is a valid method to treat knee osteoarthritis.

Objective To explore the cognitive impairment of stroke survivors using magnetic resonance spectra (MRS) and the Loewenstein occupational therapy cognitive assessment (LOTCA),and to analyze their correlation and their clinical significance.Methods Thirty stroke survivors diagnosed with cognitive impairment using the mini-mental state examination formed a cognitive impairment group.Another 30 stroke survivors without cognitive impairment served as stroke controls,while a third group of 30 healthy counterparts were the normal controls.All were assessed using magnetic resonance imaging and the LOTCA and the results were correlated.Results The average LOTCA total score and sub-scores of the impaired group were significantly lower than those of the other two groups.The average LOTCA total scores and the orientation and spatial perception,apparent motion and thinking operation sub-scores of the stroke control group were also significantly lower than those of the normal control group,though their average visual perception and motor praxis scores were not.The average levels of N-acetyl aspartate and creatine (NAA and Cr) in the bilateral hippocampus of the cognitively impaired group were significantly lower than among the controls,while their choline and creatine (Cho/Cr) levels were significantly higher.The average NAA/Cr and Cho/Cr levels in the bilateral hippocampus of the stroke control group were similarly significantly lower and higher than among the healthy controls.The average NAA/Cr levels in the left and right hippocampus were weakly to moderately correlated with the total LOTCA scores and the LOTCA sub-score for attention (r=0.376-0.661 and r=0.396-0.691 respectively).The average value of Cho/Cr in the left hippocampus showed weak to moderate negative correlation with the LOTCA total scores (r=-0.368-0.619),but not with the attention scores.The value of Cho/Cr in the right hippocampus had weak to moderate negative correlation with the LOTCA total score and with the orientation,visual perception,visuo-motor organization and thinking operations sub-scores (r=-0.391-0.632),but no obvious correlation with the scores for spatial perception,motor praxis or attention.Conclusion MRS can be used to assess the cognitive impairment of stroke survivors.MRS and LOTCA scores are closely correlated.MRS combined with LOTCA can evaluate cognitive dysfunction more comprehensively and objectively.

Objective:To explore the utility of applying low frequency transcranial magnetic stimulation (rTMS) in the acute stage of ischemic stroke in terms of improving upper limb motor function.Methods:Eighty ischemic stroke survivors in the acute stage were randomly divided into a control group and an experimental group, with 40 in each. In addition to routine rehabilitation, the experimental group was given low frequency rTMS, while the control group was provided with sham rTMS. Before and after 4-weeks of treatment, upper limb motor function was evaluated using the Fugl-Meyer rating scale (FMA), Wolf motor function tests (WMFTs), the modified Barthel index (MBI) and in terms of motor evoked potential (MEP) latency and amplitude.Results:There were no significant differences between the two groups before the treatment. Afterward, however, the average FMA, WMFT, MBI scores had improved significantly more in the experimental group, on average, as had the average MEP amplitude.Conclusion:Low frequency rTMS in the acute phase of ischemic stroke can improve upper limb motor function and ability in the activities of daily living.

Objective To explore the application of the model of team nursing in hospital nursing and continuing nursing in stroke patients with deglutition dysfunction.Methods A total of 78 stroke inpatients with deglutition dysfunction of department of rehabilitation from November 2014 to June 2015 were randomly divided into the intervention group and the control group. Patients in the control group received routine nursing method,while patients in the intervention group received team nursing method. The water-swallowing test and the investigation with Hamilton anxiety scale (HAMA) were carried out before admission and at discharge. The results of patients were compared between two groups. The changes of classification of water-swallowing test were compared between two groups 6 and 12 months after discharge.Results At discharge,the improvement rate of deglutition dysfunction in the intervention group (66.7%) was higher than that in the control group (35.9%) with a significant difference (P<0.05);the score of HAMA in the intervention group was better than that in the control group with a significant difference (P<0.05). There was no statistically significant difference in the classification of water-swallowing test and the improvement rate between two groups 6 months after discharge (P>0.05). There were significant differences in the classification of water-swallowing test and the improvement rate (the deterioration rate of the intervention group was lower than that of the control group) between two groups 12 months after discharge (P<0.05).Conclusions The application of team nursing model in stroke patients with deglutition dysfunction can strengthen the rehabilitation training effect and can improve the quality of life of patients after discharge.