Objective To characterize the vascular cognitive impairment of stroke patients with different injury sites (right or left cerebral hemisphere) and pathological type (hemorrhage or infarct). Methods A total of 119 stroke patients were assessed with regard to their cognitive functions using the LOTCA within one week of admis-sion, and comparison was made among patients in terms of VCI characteristics, injury site, and pathological type. Results In patients with left hemisphere injury, there found no significant difference between those with cerebral in-farct and hemorrhage with regard to the total score of LOTCA, but the score of perception of those with hemorrhage was lower than those with infarct(P<0.05). in patients with right hemisphere injury, both total score of LOTCA and the subscore were not significantly different between those with infarct and hemorrhage(P>0.05). In patients with infarct in left hemisphere, the total score of LOTCA was lower than those with infarct in right hemisphere(P<0.05), but the scores of orientation and thinking operation were lower than those with infarct in right hemisphere(P<0.001 or <0.01). In patients with hemorrhage in the left hemisphere, the total score of LOTCA was not significantly different from those with hemorrhage in right hemisphere, but the scores of orientation and perception were lower than thosewith hemorrhage in right hemisphere(P<0.001 or <0.01). Conclusions More attention with regard to perception training should be paid to those with cerebral hemmorhage than those with cerebral infarct. In patients with cerebral infarct, more attention with regard to orientation and thinking operation training should be paid to those with infarct in left side, while for those with cerebral hemorrhage, more attention with regard to orientation and perception training should be paid to the left hemisphere insult.

Objective To observe the effects of individual occupational therapy on cognitive impairment of elderly with stroke. Methods 60 elderly stroke patients with cognitive impairment were divided into treatment group (n=30) and control group (n=30). All the patients accepted routine rehabilitation, and the treatment group accepted individual occupational therapy in addition. They were evaluated with Mini-mental State Examination (MMSE) and modified Barthel index (MBI) before and after treatment. Results The score of MMSE increased significantly in the treatment group after treatment (P<0.001), but was not different significantly in the control group (P>0.05). The score of MBI increased significantly in both groups after treatment (P<0.05), and increased more in the treatment group than in the control group (P<0.001). Conclusion Individual occupational therapy can improve the cognitive function and the activities of daily living for the elderly stroke patients with cognitive impairment.

Objective To observe the effect of the health education and skills training for caregivers on health status of stroke patients and their family caregivers. Methods Hospitalized stroke patients were divided into the intervention group (n=38) and the control group (n= 36). Both groups received rehabilitation training for 1 month in hospital. The family caregivers of intervention group received Timing It Right education and skills training in addition. All the patients were assessed with the European Stroke Scale (ESS), Mini-Mental State Examination (MMSE), simple Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI), and the caregivers were assessed with the General Health Questionnaire (GHQ-12) before and 3 months after intervention. Results The scores of ESS, FMA, MBI improved more in intervention group than in the control group after intervention (P<0.05), as well as their caregivers in the items of playing a useful part, under stress, overcoming difficulties, enjoying normal activities, facing up to problems, feeling unhappy and depressed, lossing confidence, thinking of self as worth of GHQ-12 (P<0.05). Conclusion Health education and skills training for family caregivers can improve the health of caregivers, and further improve the function outcome of stroke patients.

Objective To explore the effects of acupuncture and individualized occupational therapy on the rehabilitation of patients with unilateral spatial neglect ( USN ) after stroke.Methods Stroke patients with hemiplegia were evaluated by neuropsychological tests,including line bisection,a cancellation test,clock drawing,and figure and shape copying.Sixty-nine right hemispheric stroke patients identified with USN were randomly assigned to 3 groups:20 patients as a control group received conventional rehabilitation therapy ; another 22 patients as an occupational group received type-specific individualized occupational therapy combined with conventional rehabilitation therapy; the remaining 23 patients as an acupuncture combined with occupational therapy group received acupuncture in addition to both conventional rehabilitation therapy and occupational therapy.These three groups were evaluated with neuropsychological tests and the modified Barthel index (MBI) before and after treatment.Results ①MBI scores in the occupational therapy group and the combined group were significantly higher after treatment,but no significant difference was observed in the control group.②The increased MBI scores in the combined and occupational groups were higher than those in the control group.At the same time the increase in MBI scores in the combined group was significantly greater than in the occupational therapy group.③The assessment results with both line bisection and cancellation tests in all three groups were significantly different after treatment.The line bisection results in the occupational therapy group and the combined group were significantly better than in the control group.The cancellation test results in the combined group were significantly better than in the control group.Conclusion These findings show that acupuncture combined with occupational therapy can have a positive effect on neglect recovery and greatly improve the daily life of USN patients.