Executive dysfunction is one of the cognitive impairment in patients with stroke. This paper reviewed the assessment tools and rehabilitation approaches for post-stroke executive dysfunction, and the interactive game such as Xbox Kinect may be prospective rehabilitation for executive dysfunction.

Objective To investigate the effect of Tomatis audio training on executive dysfunction in patients with stroke. Methods A total of 80 stroke patients from the Rehabilitation Branch,Tangshan Worker′s Hospital were enrolled prospectively. They were divided into either a music group or a control group (n = 40 in each group)according to random number table. On the basis of conventional rehabilitation training,both groups received music training. The patients of the control group received conventional music training (conventional frequency music without audio processing);the patients of the music group received Tomatis audio training. Both groups were trained at the same time,once a day for 60 -90 min,and they were trained for 2 cycles. The first cycle was 14 days and the second one was 10 days,the interval of the 2 cycles was 30 days (a total of 54 days). The Behavioral Assessment of Dys-executive Syndrome (BADS)was used to assess their executive dysfunction before and after music training. Results The 6 sub-projects of BADS in the music group after music training:the rule shift cards test,action program test,key seek test, temporal judgment test,zoo map test,modified six elements test,and total standard score (median 75 ])2. 0 (1. 2,2. 7),2. 0 (1. 0,2. 0),2. 0 (1. 0,2. 0),2. 0 (1. 0,2. 0),2. 0 (2. 0,2. 0),2. 0 (2. 0,3. 0),and 11. 0 (11. 0,12. 0),respectively). They were compared with those of the control group (1. 0[1. 0,2. 0],1. 0[1. 0,2. 0],1. 0[1. 0,2. 0],1. 0[1. 0,2. 0],1. 0[1. 0,2. 0],1. 0[1. 0,1. 0],and 8. 0[8. 0,10. 0],respectively]. There were significant differences between the 2 groups (all P < 0. 05). Conclusion Tomatis audio training may effectively improve the executive function in patients with stroke.

Objective To discuss the application of Chinese version of Stanford Acute Stress Reaction Questionnaire (SASRQ) in trau-matic fracture patients. Methods 96 patients with traumatic fracture in the Second Hospital of Tangshan City were recruited in the early stage. All the subjects were assessed with SASRQ in 2 weeks after trauma for the first time, and then they were assessed with SASRQ for the second time after an interval of 2 days. 496 patients with traumatic fracture completed SASRQ and Abbreviated Injury Scale-Injury Se-verity Score (AIS-ISS) assessment. Results The Cronbach's alpha was 0.930 in SASRQ, and were 0.729~0.812 in each dimension (P<0.01). Test-retest reliability at 2-day intervals was 0.980 (P<0.01). 133 cases (26.8%) were detected with acute stress disorder (ASD). According to a single entry≥3 as a positive screening, 31.7%suffered separation symptoms, 49.6%suffered re-experience traumatic symptoms, 39.5%suffered avoidance symptoms, 75.6%suffered symptoms of anxiety or increased awareness. The scores of SASRQ (t=37.807, P<0.05) and each dimension (t=36.503, 29.019, 31.111, 19.369, respectively, P<0.001) was significantly higher in the ASD positive group than in the neg-ative group. There was significantly difference in the score of SASRQ and each dimension in different age groups (F=112.319, 94.109, 95.099, 103.291, 61.497, respectively, P<0.001), the acute stress symptoms were lighter in the older group than in the other groups. There was significantly difference in the score of SASRQ and each dimension between men and women (t=7.707,-6.190,-8.944,-7.221,-9.949, respectively, P<0.001), the acute stress symptoms were lighter in men than women. There was sig-nificantly difference in the score of SASRQ and each dimension in different trauma types (F=68.516, 44.464, 59.725, 48.966, 54.827, P<0.001), the acute stress symptoms were severer in the traffic accident patients group than in the other groups. There was significantly differ-ence in the score of SASRQ and each dimension in different trauma degrees (F=63.584, 69.704, 51.569, 43.669, 33.911, respectively, P<0.001), the acute stress symptoms were lighter in the lighter group than in the other groups. Conclusion There is a high incidence and clear gender and age differences of ASD in patients with traumatic fracture.

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

Objective To explore the impact of executive function intervention on the executive functioning of elderly patients with cerebral infarction,and to seek the best way to improve executive function in such patients.Methods Eighty elderly patients with cerebral infarction were randomly divided into an intervention group and a control group.A series of executive function interventions were administered to those in the intervention group with no intervention in the control group.The two groups were given the same conventional medication.The Behavioral Assessment of the Dysexecutive Syndrome (BADS) was taken before the intervention,then 3 months and 6 months after recruitment.Results In the intervention group the average score and the total standard score had increased significantly after 3 months except for the action program test and the modified six elements test.Both indicators were still significantly increased from the baseline afar 6 months except for the modified six elements test.The average score and the total standard score had increased significantly between 3 months and 6 months except on the key search test.Both the time determination test and the total standard score had statistically significant average differences.The control group showed no significant differences.After 3 months,the average scores and the total test standard scores in the intervention group were signifieantiy higher than those in control group except on the action program test.The rules conversion card test,the time determination test and the total standard score difference all showed statistically significant differences between the groups.After 6 months the intervention group's scores remained significantly higher than those of the control group except on the action program test.Conclusions Executive function interventions are effective in delaying the progress and improving the prognosis of executive dysfunction in elderly patients with cerebral infarction,and the therapy has persistent effects.

Objective:To explore the intervention effects of high and low audio-motor stimulation mode on attention and memory of elderly with mild cognitive impairment in rural areas.Methods:From September 2019 to May 2020, 80 subjects with mild cognitive impairment meeting the inclusion and exclusion criteria were selected and randomly divided into experimental group and control group according to the drawing lots, with 40 participants in each group.The experimental group was given high and low audio-motor stimulation mode training, and the control group was given finger exercises training.Before and after the intervention, sustained and selective attention were assessed using number cancellation test(NCT), E-Prime paradigm based on Stroop effect design, and memory was assessed using the Rivermead behavioral memory test, version 2 (RBMT-Ⅱ). SPSS 17.0 software was used to perform data statistics. The independent sample t test, paired sample t test and Mann Whitney U test were used for statistical analysis. Results:After intervention, the sustained attention index of the experimental group (0.86±0.48) was significantly higher than that of the control group (0.63±0.47, t=4.336, P<0.05). After intervention, the unanimous response time of the experimental group ((2 263.38±437.87) ms) and the reverse reaction time ((2 335.75±599.86) ms) were significantly lower than those of the control group ((2 703.95±506.34) ms, (2 667.43±585.38) ms) ( t=-4.068, -2.447, P<0.05). The consistent correct rate ((0.84±0.14)) and the reverse correct rate ((0.87±0.10))were significantly higher than those of the control group ((0.71±0.19), (0.73±0.15)) ( t= 3.571, 4.931, both P<0.05). RBMT-Ⅱ dimensions and total standard scores of the experimental group (19.00 (18.00, 20.00)) were higher than those of the control group (11.00 (10.00, 12.00))( Z=7.299, P<0.05). Conclusion:High and low audio-motor stimulation improves attention and memory in rural elderly with mild cognitive impairment.

Objective To explore the resilience characteristics of the traumatic fracture patients and its influence on acute stress disorder(ASD),and provide the basis for improving the population's ability to cope with stressful events and resilience level for clinic.Methods 440 cases of traumatic fracture patients hospitalized in Tangshan Second Hospital were selected in this study.All subjects were assessed with SAS-RQ,CD-RISC,AIS-ISS,VAS and the general condition of investigations.Results The resilience level of traumatic fracture patients was at the middle,the resilience total score was(51.13±14.81) points,and lower than that of the national norm(t=-20.217,P＜0.01).Sex,age,personality and injury severity had the impact on resilience (P＜0.05).Resilience dimensions and total scores had negative correlation with SASRQ dimen sions and its total score (r=-0.587--0.739,P＜0.01).High-leveled resilience patients have lower ASD scores and lighter symptoms(P＜ 0.05).The multivariate analysis appeaed that resilience and the degree of pain were the main factors affecting ASD (P＜ 0.05).Conclusion The resilience level of the traumatic frac ture patients should be further improved and the construction of resilience should be strengthened in order to prevent the occurrence of ASD.

Objective To investigate the incidence of the cognitive disorder in cerebrovascular patients and to its risk factors.Methods Cerebrovascular patients were surveyed with Mini-Mental State Examination(MMSE)Chinese-version in county or above hospitals among 23 provinces(cities).Results 915 cerebrovascular patients were surveyed and 281 patients(30.71%)were of cognitive disorder.And the incidence of the patients with hypertension or/and diabetes mellitus was significantly higher than the others(P<0.01).Conclusion The incidence of cognitive disorder is high in cerebrovascular patients,and the hypertension and diabetes mellitus are both the risk factors.

Objective To study the effects of mindfulness behavior training on coping style and illness uncertainty in patients of shoulder hand syndrome (SHS) after ischemic stroke.Methods 65 cases with SHS were randomly divided into two groups by digit method: the control group (n=32) and experimental group (n=33).Patients in control group only received routine rehabilitation, while patients in experimental group also received mindfulness behavior training.The daily life, medical coping style, illness uncertainty and mindfulness were evaluated respectively by Barthel Index (BI) , Medical Coping Style Questionnaire (MCMQ) , Illness Uncertainty Scale (IUS) and Mindful Attention Awareness Scale (MAAS).Results Before training, there were no significant difference in BI,MCMQ,IUS and MAAS (P＞0.05).After treatment, scores in BI improved significantly in the experimental group than that in the control group(72.4± 11.6 vs 62.9±10.1) ,scores in IUS improved significantly in the experimental group than that in the control group(69.3±9.3 vs 86.9±7.2) and scores in MCMQ and MAAS improved significantly in the experimental group than that in the control group(P＜0.05).26 cases whose Barthel index was more than 60 points in experimental group after treatment were found while 17 cases whose Barthel index was more than 60 points in control group were done after treatment (x2 =6.415, P＜0.05).Conclusion Mindfulness behavior training can regulate the patient coping style and weaken illness uncertainty,and improve functions rehabilitation.

Objective To study the utility of sleep intervention combined with memory training for alleviating dysmnesia in the elderly and provide a basis for improving memory function. Methods A total of 647 community-dwelling elderly people were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Rivermead behavioral memory test ( RBMT). One hundred and fifty elderly persons with sleep disorders and dysmnesia were divided into three groups; the control group, the memory intervention group, and the sleep plus memory training group. Sleep quality and dysmnesia were evaluated again after 3 months of intervention. Results Among the 647 elderly people, the incidence of sleep disorders was 38. 8% , and of dysmnesia was 78. 4%. Dysmnesia was significantly more prevalent among subjects who also had sleep disorders. After three months of intervention, instant recall scores had declined in the control group while scores on 7 kinds of memory function had improved significantly in the memory intervention group. Scores on 10 measures of memory and sleep quality improved in the sleep plus memory intervention group. Compared to the control group, scores on 9 kinds of memory improved significantly in the memory intervention group and scores on 11 kinds of memory improved in the sleep plus memory intervention group. Compared to the memory intervention group, scores on 5 kinds of memory had improved significantly in the sleep plus memory intervention group. Conclusions The occurrence of dysmnesia in elderly people is influenced by sleep quality. Memory training can improve their memory function, but sleep intervention combined with memory training is even more effective.