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ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.
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Objective:To explore the factors influencing executive functioning after a brain injury and analyze the relationship between executive functioning and other cognitive functions.Methods:Forty-six brain injury survivors were given the Executive Function Performance Task (EFPT) assessment and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The scores and time of the EFPT tasks, and the orientation, perception, visual motor organization, thinking, and attention and concentration results in the LOTCA were observed. Regression analysis compared the males and females, those younger and older than 40, those with more or less than 12 years of education, trauma and stroke survivors, as well as those with left, right and bilateral lesion to isolate the factors most influencing executive functioning.Results:The average EFPT score on the cooking task, the medication score and the total score of the young group were all significantly higher than those of the older group. Their telephone time, medication time and bill payment time were all significantly shorter. Those with more than 12 years of education had average scores on the cooking, bill payment and EFPT significantly higher than those with less than 12 years of education. The average bill paying and total EFPT scores of the brain trauma group were significantly higher than the stroke group′s averages. No significant differences were observed between the different genders or those with different injury sites. Age was the strongest predictor of total EFPT scores. Except for the medication scores, the average scores of the other three tasks and the total score of EFPT were moderately correlated with the visual motor organization, thinking, attention and concentration, and total LOTCA scores, with correlation coefficients ranging from 0.31 to 0.64.Conclusions:Older persons and those will less education tend to have worse executive functioning. Traumatic damage to executive functioning is more serious than that caused by stroke. Executive functioning is closely related to visual-motor organization, and to the ability to think, attend and concentrate.
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Objective:To test the reliability and validity of the Chinese version of the executive function performance test (EFPT) when it is used with persons with a brain injury.Methods:Forty-six brain injury patients comprised the patient group, and forty-nine healthy counterparts formed the normal group. All completed the EFPT, the Flanker task, a color shape task, the speech and visual space 2-back and the Wisconsin Card Sorting Test (WCST). Thirty normal subjects were asked to complete the EFPT again 4 weeks after the first test. Spearman correlation analysis was used for reliability and validity analysis.Results:The EFPT scale showed good internal consistency, as Cronbach′s α coefficient was 0.73 to 0.83. Test-retest reliability was good, as the internal correlation coefficients ranged from 0.50 to 0.85. The results of the EFPT correlated moderately well ( r=0.29-0.57) with the total number of responses, the number of completed collocations, persistent responses and non-persistent errors, as well as with the percentage of the generalized level of the WCST. Moreover, all of the EFPT results correlated moderately well with those of the IADL except for the task of taking medication. Compared with the control group, the brain-injured group got significantly higher sub-test and total scores on the EFPT. Conclusions:The Chinese version of the EFPT has demonstrated adequate reliability and validity with brain-injured Chinese persons. It is a good tool for evaluating the executive functioning of such persons and can reflect any executive dysfunction in their daily living activities.
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Objective To investigate the effect of telerehabilitation on memory disorders. Methods From August, 2010 to April, 2015, 81 patients with memory disorders were randomized into control group (n=26), computer-assisted training group (n=33) and telerehabilita-tion training group (n=22). All the patients accepted medicine to facilitate the recovery of memory. Besides, the computer-assisted training group and the telerehabilitation training group accepted memory-based training programs with cognitive rehabilitation system locally or on network respectively, for six weeks. They were evaluated with Wechsler Memory Scale, Rivermead Behavioural Memory Test-2nd Edition and Rey Auditory Verbal Learning Test before and after training. Results Both computer-assisted and telerehabilitation training groups im-proved in all the assessment after training (t>4.059, P0.05). There was no sig-nificant improvement in the control group after training (t0.05). Conclusion Memory rehabilitation training can significantly im-prove memory abilities, similar with locally or telerehabilitation system.
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Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.
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@# Objective To investigate the characteristic of picture forgetting in closed traumatic brain injury (CTBI) patients during recovery. Methods From October, 2012 to August, 2013, 60 colour slides of target or interference picture were presented to 38 CTBI patients during recovery and 31 matched healthy controls. Their discriminability index (d′) was observed 10 minutes, 30 minutes and 24 hours later. Results Forteen patients failed to attain d′ of 2.0 10 minutes later, and were excluded from further study. The d′ of the other 24 patients was less than that of the controls 10 minutes, 30 minutes and 24 hours later (t>2.044, P<0.05). The d′ in the patients was more of 10 minutes and 30 minutes than that of 24 hours (P<0.05). Conclusion Some patients with CTBI during recovery exhibit impairment in acquisition of pictorial information, and accelerated forgetting is found in the others without impairment.
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Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke dis-function of cognition and memory by stimulating right dorsolateral prefrontal cortex. Methods 40 patients were randomized into the rTMS (n=19) and sham (n=21) groups. The function of cognition and memory were measured before treatment, after treatment and 2 months post-treatment with Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Riv-ermead Behaviour Memory Test (RBMT). Results All scores improved in both groups after treatment and 2 months post-treatment (P<0.001), and improved more in the rTMS group than in the sham group (P<0.01). Conclusion Low-frequency rTMS may improve the func-tion of memory and cognition after stoke.
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Objective To measure the temperature sensation threshold of trunk skin in healthy adults. Methods The threshold of cold sensation, warm sensation, cold pain sensation and heat pain sensation of trunk skin key points (T3, T7 and T11) were measured with Thermal Sensory Analyzer in 123 healthy adults. Results The thresholds of cold, warm, cold pain and heat pain sensations were obtained. The stan-dard deviation of cold and warm threshold was less than that of heat pain. The range of cold sensation threshold was the largest. The heat pain sensation threshold increased with segmental declining and the sensation threshold increased with age. Conclusion Normal reference value should be established variously with the segment and age. The threshold of cold, warm varies less, while the threshold of cold pain and heat pain varies too much.
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@#Objective To investigate the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke disfunction of cognition and memory by stimulating right dorsolateral prefrontal cortex. Methods 40 patients were randomized into the rTMS (n=19) and sham (n=21) groups. The function of cognition and memory were measured before treatment, after treatment and 2 months post-treatment with Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Rivermead Behaviour Memory Test (RBMT). Results All scores improved in both groups after treatment and 2 months post-treatment (P< 0.001), and improved more in the rTMS group than in the sham group (P<0.01). Conclusion Low-frequency rTMS may improve the function of memory and cognition after stoke.
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@#A case with part picture agnosia accompanied other cognitive dysfunctions after hypoxic ischemic encephalopathy was reported.
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@#Objective To compare the efficacy of different models of attention rehabilitation on attention deficits after acquired brain injury. Methods According to the training models, 47 patients with attention deficits were randomly assigned to 3 groups: computer-assisted training group(n=16), face-to-face training group(n=21) and control group(n=10). The training groups were given attention training once a day which sustained 30 minutes for 6 weeks. All patients were tested with the Montreal Cognitive Assessment (MoCA) and the Loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA) before and 6 weeks after the rehabilitation. Results The performance of both the computer-assisted training group and the face-to-face training group significantly improved (P<0.05). The various of the scores was the most in the computer-assisted training group among them (P<0.05). Conclusion The computer-assisted training is a high-effective method for attention deficits.
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@#Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.
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@#Objective To investigate the effect of rehabilitation on memory deficits after acquired brain injury, to compare different training models of memory rehabilitation and to analyze the possible factors affecting memory rehabilitation. Methods 144 patients with acquired brain injury following memory deficits were randomly assigned to computer-assisted training group, face-to-face training group and control group. Both training groups were given memory-based cognitive training program once a day which sustained 30 minutes for 6 or 12 weeks. The instantaneous memory, short-term memory and long-term memory were evaluated and compared before and after training. The effect of gender, age, education, course, site of injury and coma time on training efficacy were analyszed as well. Results 6 weeks and 12 weeks at training, both computer-assisted and face-to-face training groups showed a significant improvement in memory abilities when compared to controls (P<0.01), with the former making more progress (P<0.01). Negative correlation was found between age and memory performance. Conclusion Effectiveness of memory rehabilitation is proven. 12 weeks training can significantly improve memory. Cognitive training using professional equipment is significantly more effective than the face-to-face training and should be recommended.
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@#Objective To analyze the reliability and validity of Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR); To establish diagnostic criteria by EC301-CR for acalculia in order to provide an effective assessment tool clinically. Methods The items of EC301were adjusted. 103 patients with acquired brain injury and 37 normal controls were randomly selected. 24 normal controls randomly selected were retested 6 weeks latter. Results The Cronbach's coefficient, the split-half reliability and the retest reliability coefficients were 0.907, 0.744, and 0.965, respectively. The correlation coefficient within subscales was more than the correlation coefficient between subscales. 4 first-order factors were extracted which accounted for 69.359% of the accumulated variance, which were mental calculation, number transcoding, written calculation and approximation, and understanding of numbers. Control data (n=37) showed that the P10 of EC301-CR was 222.6. Conclusion The critical value of acalculia is 222.6 in EC301-CR test. Psychometric properties analysis shows that EC301-CR is a reliable and validated instrument for acalculia.
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@#Objective To investigate errors and mechanism of acalculia in patients with brain injury.Methods Forty patients with brain injury and forty-eight normal adults who were matched in age and years of education were tested with EC301 standardized battery. Patients were divided into the left-brain damaged (LBD) group (n=20), right-brain damaged (RBD) group (n=9) and bilateral brain damaged (BBD) group (n=11). The data of all subjects were statistical analyzed.Results Both total scores and scores of 27 out of 31 items were remarkable lower in patients than those in the normal control group ( P<0.05). The total scores and items' scores for number sequences, numerical transcodings were significantly lower in LBD group than those in RBD group ( P<0.05). Total scores and each items' score did not significantly differ between BBD group and LBD group, or between BBD group and RBD group ( P>0.05).Conclusion The abilities of number processing and calculation are impaired in patients with brain injury. There is either association or dissociation in terms of performance of acalculia and aphasia in LBD patients. Visuospatial impairment is related to performance of acalculia in RBD patients.
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@#Objective To investigate the thermography characteristics in arterial lesions of lower limbs after type 2 diabetes mellitus.Methods 19 patients with arterial lesions of lower limbs after type 2 diabetes mellitus and 20 matched healthy controls were screened with digital thermography.The arteries of lower limbs of the patients were examined with the Doppler ultrasound.Results The patients' thermography showed abnormal cool regions or significant asymmetry between bilateral lower limbs or significant difference in temperature of bilateral lower limbs compared to the controls.The abnormal finding of thermography could be found in 100% patients,the difference of temperature between bilateral lower limbs could be found in 84% patients,while the abnormal finding of Doppler ultrasound in 89% patients.Conclusion Thermography can be used to screen the arterial lesions of lower limbs after type 2 diabetes mellitus,which is more sensitive than Doppler ultrasound.
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@#Objective To study the effect of lesion level and completeness on activities of daily living(ADL) of patients with spinal cord injury(SCI).Methods The functional status of 313 SCI patients were assessed using the Functional Independence Measurement(FIM),and FIM scores were calculated for statistical analysis with different lesion levels and completeness.Results FIM scores presented significant differences among cervical-level group,thoracic-level group and lumbar-level group(P<0.05～0.01).Patient with a high lesion level had lower FIM score.In the same lesion level group,FIM scores presented significant differences between the incomplete SCI patients and the complete ones(P<0.05～0.01).However,the lumbar lesion patients had no significant differences in FIM score between the complete group and the incomplete group(P>0.05).Conclusion FIM can objectively reflect the ADL level in SCI patients with different lesion level and completeness.
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@# The article describes the development of an Internet-based tele-rehabilitation system for patients with cognitive deficits,including overall idea,design and structure of the system,role-based authorization of operations for the patients and doctors and the procedures for patients' receiving rehabilitation treatment through the system.It is a new and convenient mode for rehabilitation service delivery to patients with cognitive deficits.Implementation of the Internet-based tele-cognitive rehabilitation system is helpful to the patients who live far from hospitals and have difficulty seeing doctors due to physical impairments,and is helpful to solving the problem with lack of medical staffs specialized in cognitive rehabilitation.Furthermore,it will also profit pushing out the spread and development of cognitive rehabilitation in China.
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@#ObjectiveTo determine whether aphasia has effect on the degree of cognitive disorder for the patients with brain injury, so that prognosis can be determined. MethodsThere are 35 cases of patients with brain injury and they are divided into two groups by aphasia screening test with aphasia and without aphasia. Those with cognitial capacity screening examination(CCSE) and the Loewenstein Occupational Therapy Cognitive Assessment Battery(LOTCA) are examined. ResultThe result is that there is significant differences between these two groups of patents. ConclusionThe patients with brain injury who complecated with aphasia had worse cognitive disorder.
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@#The purpose of this study was to provide standards for healthy people performance on a Chinese version of the LOTCA.Fifty four the healthy and twenty five CVA patients participated in this study.The study was conducted in three phases.In phase one,the healthy subjects were assessed with the original version of the LOTCA.In phase two,the subjects who had made mistake in recognition of a typewriter for English in the sub test one,the healthy subjects were assessed with the original version of the LOTCA.In phase two,the subjects who had made mistake in recognition of a typewriter for English in the sub test of Categorization or had not known it at all were reassessed by the revised sub test of Categorization.In phase three,the LOTCA was administered to CVA patients.The results show significant differences between the healthy people and CVA patients.The score on the sub test of Categorization of the original version of LOTCA was much less than perfect,however the results of revised Categorization test was consistent with that from Katz et al.The results also show that years of education were related to perceptual cognitive performance.The LOTCA is a feasible and valuable tool,and is recommended for these individuals who has problems with cognition and perception.