Loewenstein Occupational Therapy Cognitive Assessment Research Articles

Abstract TP78: Characteristics of Verbal and Non-Verbal Cognitive Function in Post-Stroke Aphasia Based on Language-Cognition Neuropsychological Processing Model

Introduction: Post-stroke aphasia (PSA) patients have different levels of phonetic, lexical, semantic, syntactic, and other linguistic domain impairment, and accompanied by non-verbal cognitive impairment. However, the association between verbal and non-verbal cognitive functions is not fully understood.In this study, we used the Chinese Aphasia Language Battery (CALB) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) to fully evaluate the characteristics of verbal and non-verbal cognitive function impairment in PSA patients. Methods: A total of 105 stroke patients were recruited in this study. Language and non-linguistic cognitive impairments were evaluated by CALB and LOTCA, respectively. Patients in the PSA group were subdivided into the fluent aphasia group (FAG) and the non-FAG group. Potential confounders were adjusted in the analysis of covariance. Partial correlation analysis between the subscores of CALB and LOTCA was also performed. Results: This study showed that PSA patients had worse speech analysis ability, vocabulary processing ability, semantic processing ability, syntactic structure conversion ability, and non-verbal cognitive performance(P<0.001). Moreover, the scores of phonetic decoding, phonetic vocabulary production, noun category classification, total LOTCA, orientation, visual perception, motor use, and thinking operation were lower in the non-FAG compared with the FAG (p<0.05). The total score of LOTCA was positively correlated with the aphasia quotient (r=0.637, P<0.001) and scores of speech analysis ability, vocabulary processing ability, semantic processing ability, and syntactic structure conversion ability (r>0; P<0.0005). Conclusions: Based on the language-cognition neuropsychological processing model, this study adopted a comprehensive verbal and non-verbal cognitive assessment set of tests, and found that PSA patients have extensive phonological, lexical, semantic, syntactic, and grammatical processing disorders. Moreover, PSA patients often have more extensive and serious non-verbal cognitive impairments, and the severity of aphasia is significantly positively correlated with the degree of nonverbal cognitive impairment.

Impact of propofol and sevoflurane anesthesia on cognition and emotion in gastric cancer patients undergoing radical resection.

Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer. However, there is a debate concerning their differential effects on cognitive function, anxiety, and depression in patients undergoing this procedure. To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function, anxiety, depression, and organ function in patients undergoing radical resection of gastric cancer. A total of 80 patients were involved in this research. The subjects were divided into two groups: Propofol group and sevoflurane group. The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment (LOTCA), and anxiety and depression were assessed with the aid of the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Hemodynamic indicators, oxidative stress levels, and pulmonary function were also measured. The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group. Additionally, the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group. The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group. Moreover, the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group. Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer. Propofol anesthesia has a minimal effect on patients' pulmonary function, consequently enhancing their postoperative recovery. Sevoflurane anesthesia causes less impairment on patients' cognitive function and mitigates negative emotions, leading to an improved postoperative mental state. Therefore, the selection of anesthetic agents should be based on the individual patient's specific circumstances.

High-Frequency Repetitive Transcranial Magnetic Stimulation on Overall Cognition in Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-analysis.

The aim of the study is to comprehensively assess the recovery effects of high-frequency repetitive transcranial magnetic stimulation in patients with poststroke cognitive impairment. Six English and four Chinese databases were searched for relevant studies published up to January 2022. Randomized controlled trials of patients with poststroke cognitive impairment treated with high-frequency repetitive transcranial magnetic stimulation were included. Included studies were assessed for the risk of bias through the Cochrane Intervention Systematic Review Manual 5.1.0. The meta-analysis was performed using RevMan 5.4 software. The PRISMA 2020 guidelines were followed. Sixty-one randomized controlled trials (4012 patients) were included. Montreal Cognitive Assessment Score, Mini-Mental State Examination score, event-related potential P300 (P300) amplitude, Loewenstein Occupational Therapy Cognitive Assessment score, and total effective rate of cognitive function were higher in the high-frequency repetitive transcranial magnetic stimulation group than in the control group at the end of the treatment period, and scores of Alzheimer Disease Assessment Scale-Cognitive Subscale and P300 latency were lower in the high-frequency repetitive transcranial magnetic stimulation group than in the control group. Fifty studies had selected the dorsolateral prefrontal cortex as the stimulation site for high-frequency repetitive transcranial magnetic stimulation. Compared with nonrepetitive transcranial magnetic stimulation or sham repetitive transcranial magnetic stimulation, high-frequency repetitive transcranial magnetic stimulation not only improves the overall cognitive function of poststroke cognitive impairment patients but also has better rehabilitation results.

Visual communication technology on identifying consumers with functional cognitive impairment

BackgroundPatients with cognitive impairment have great inconvenience in their cognitive, recognition, and activity abilities, specifically manifested in memory disorders, attention disorders, perception disorders, and learning disabilities, which greatly hinder their communication, communication, and life activity abilities. The use of actively oriented intervention treatment methods in research has an improved effect on patients.Subjects and MethodsFirstly, 48 patients with cognitive impairment in a certain hospital were selected and randomly divided into a control group of 24 cases and an experimental group of 24 cases. Secondly, medication treatment, nursing, and rehabilitation treatment were taken, and the experimental group was supplemented with music therapy and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). The trial lasted for 8 weeks. Finally, SPSS23.0 was used for data analysis and t-test.ResultsThere was no significant difference in basic information and cognitive impairment between the two groups before intervention (P>0.05). After 8 weeks of intervention treatment, the total LOTCA score of the experimental group was significantly better than that of the control group (P<0.001). The results showed that cognitive impairment improved after rehabilitation treatment, and there was a lack of time observation intervention for subsequent life cognition and motor function.ConclusionsThe use of music therapy as an adjunctive therapy in research has significantly improved the condition of patients with cognitive impairment but has not significantly improved their life skills, motor function, etc. The research sample still has limitations and the intervention time is short. Further research is needed to follow up and explore treatment methods, treatment time, and other aspects.AcknowledgementZhongnan University of Economics and Law Graduate Research Innovation (No.202311106).

Transcranial Direct Current Stimulation for Global Cognitive Functioning and Ability in Daily Life Activities in Poststroke Cognitive Impairment: A Systematic Review and Meta-analysis.

The aim of the study is to determine the efficacy of transcranial direct current stimulation on global cognition and ability in daily life activities of patients with poststroke cognitive impairment. Nine electronic databases were searched from their respective inceptions through January 2022. We included the randomized controlled trials that used transcranial direct current stimulation for poststroke cognitive impairment and included at least one global cognitive function or ability in daily life activities outcome indicators. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Twenty-two studies (1198 participants) were included. Most studies had no significant bias in the quality of the methodology. Meta-analyses found that compared with the control group, transcranial direct current stimulation increased Montreal cognitive assessment, Mini-mental state examination, Loewenstein occupational therapy cognitive assessment, total effective rate of cognition, modified Barthel Index, and decreased P300 latency (all P < 0.05). These results showed transcranial direct current stimulation can improve cognitive function and ability in daily life activities in poststroke cognitive impairment. The transcranial direct current stimulation may have a significant rehabilitation effect on global cognitive functioning and ability in daily life activities of patients with poststroke cognitive impairment.

Validation study of the Chilean version of the Dynamic Loewenstein Occupational Therapy Cognitive Assessment (DLOTCA)

Resumen Objetivo Validar la traducción al español chileno de la décima versión en inglés de la Dynamic Loewestein Occupational Therapy Cognitive Assessment para ser utilizado en la población chilena. Método Se realizó la tradución de el DLOTCA al español chileno. Se realizó un pilotaje para la aplicación del instrumento, para lo cual se reclutó a 40 personas adultas con una media de 42,7 años, con diversos daños cerebrales y compuesto por un 70% de mujeres y un 30% de hombres. Para evaluar la confiabilidad del instrumento se calculó el Alfa de Cronbach como medida de Consistencia Interna, aplicando 3 perspectivas, “Fiabilidad Ítem-Total”, “Fiabilidad Ítem-Dominio”, y “Fiabilidad Dominio-Total”. Para medir la Factibilidad se identificó el porcentaje de ítems no contestados por la muestra, y el porcentaje de ítems que es identificado en las pruebas cognitivas como comprendido. Resultados La fiabilidad Ítem-Total arrojó un Alpha de Cronbach 0,953, lo que se traduce en excelente confiabilidad. La fiabilidad Ítem-Dominio, estuvo mayormente entre excelente y buena, existiendo una fiabilidad débil para los factores “orientación temporal” y “percepción visual”. La fiabilidad Dominio-Total arrojó un Alpha de Cronbach 0,810 lo que se traduce en una buena confiabilidad. Finalmente, con relación a la factibilidad, los participantes respondieron el 100% de los ítems, evidenciando la accesibilidad de la traducción. Conclusiones El DLOTCA traducido al español chileno; presenta una alta confiabilidad, lo que permite obtener resultados con muy bajos sesgos, convirtiéndose en un instrumento que puede ser utilizado de manera pertinente en la población chilena.

Comparing the effects of olfactory-based sensory stimulation and board game training on cognition, emotion, and blood biomarkers among individuals with dementia: A pilot randomized controlled trial.

Olfactory dysfunction can indicate early cognitive decline and is associated with dementia symptoms. We developed an olfactory-based sensory stimulation program and investigated its effects on cognition and emotion, and board game training were used as a comparison. In this parallel design pilot study, 30 participants with mild to moderate dementia were equal randomly assigned to the control (CONT), olfactory stimulation with cognitive training (OS), and board game (BG) groups. Two participants were withdrawn from CONT and OS groups, respectively. The intervention was a 12-week program with one 30-min session twice a week. We employed a blood-based biomarker technique and several cognitive and psychological tests to measure basal and after-intervention values. No significant differences were observed between the groups after intervention, as measured using the Mini-Mental State Examination, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Top International Biotech Smell Identification Test, and Geriatric Depression Scale (GDS). The results showed that the OS group had a lower plasma Tau level than the other groups following intervention, whereas the CONT group had a significantly increased plasma amyloid ß1-42 level. OS participants had a lower concentration ratio of plasma Tau and amyloid Aß1-42 and showed more stable or improved cognition, olfactory function, and mood state. Both the OS and BG groups had a higher percentage of participants with stable or improved cognition and emotion. Taken together, these results suggest that olfactory-based sensory stimulation can be a beneficial intervention for patients with dementia.Clinical trial registration[Clinicaltrials.gov], identifier [NCT05168098].

Efficacy of Intermittent Theta-Burst Stimulation and Transcranial Direct Current Stimulation in Treatment of Post-Stroke Cognitive Impairment.

The efficacy of intermittent theta-burst stimulation (iTBS) and transcranial direct current stimulation (tDCS) combined with cognitive training in the treatment of post-stroke cognitive impairment (PSCI) requires further investigation. We randomly assigned 60 patients with PSCI to receive iTBS (n = 21), tDCS (n = 19), or cognitive training alone (n = 20). Cognitive function was evaluated by the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and the performance of activities of daily living (ADL) was assessed with the modified Barthel Index (MBI). Of these patients, 14 participated in the functional near-infrared spectroscopy (fNIRS) measurement. After six weeks of treatment, cognitive function improved in all three groups of PSCI patients. Compared with patients receiving only cognitive training, the cognitive function of patients in the iTBS combined with cognitive training (p = 0.003) and tDCS combined with cognitive training groups (p = 0.006) showed greater improvement. The cognitive improvement from tDCS was related to the activation of the frontopolar cortex (FPC), while the improvement of cognition by iTBS was based on the activation of the stimulation site (the dorsolateral prefrontal cortex) and some distant regions. Both iTBS and tDCS in addition to cognitive training appear to improve cognitive function and quality of life of patients with PSCI, compared to cognitive training alone. tDCS improved cognitive function by improving the patient's valuation, motivation, and decision-making substructures, while iTBS improved patients' assessment and decision-making abilities, improving cognitive control and, ultimately, overall cognitive function.

Application Effect of Dexmedetomidine and Dezocine in Patients Undergoing Lung Cancer Surgery under General Anesthesia and Analysis of Their Roles in Recovery Time and Cognitive Function.

Objective To explore the application influence of dexmedetomidine (DEX) and dezocine in patients undergoing lung cancer surgery under general anesthesia and analysis of their roles in recovery time and cognitive function. Methods A total of 120 patients who accepted thoracoscopic pulmonary wedge resection in our hospital from November 2021 to April 2022 were selected and randomly divided into group A (n =60) and group B (n =60). DEX combined with dezocine-assisted anesthesia was performed to group A, and the equal dose of normal saline was administered to group B, so as to compare their inflammatory influence level, brain function, arterial blood gas index, and cognitive function. Results Compared with group B, group A obtained significantly lower intraoperative and postoperative inflammatory factor levels (P < 0.001), better postoperative brain function and arterial blood gas index (P < 0.001), and lower Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) scores after surgery (P < 0.001). Combining DEX with dezocine-assisted general anesthesia can improve the inflammatory factors level of patients undergoing lung cancer surgery and maintain their brain function and oxygen saturation, so that they have better postoperative cognitive function. Therefore, such anesthesia modality should be promoted in practice.

Cognitive status is associated with performance of manual wheelchair skills in hospitalized older adults

Purpose To examine the relationship between manual wheelchair skills and cognitive function in hospitalized older adults. Methods The observational study included older adults who used a manual wheelchair following hip/knee surgery. Participants underwent a series of tests to evaluate manual wheelchair skills and cognitive performance. Four items appearing on the Wheelchair Skills Test: brake handling (locking/unlocking), a 10-metre forward roll, a 2-metre backward roll and rotating in place, were used to evaluate manual wheelchair skills. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), the Clock Drawing Test, and the Loewenstein Occupational Therapy Cognitive Assessment. The relationship between wheelchair skills and cognitive scores was assessed by a series of univariate linear regression analyses. Results Fifty older adults, aged 65–85, participated in the study. The MoCA-7 (orientation) explained 19.3% of the variance related to the turn in place wheelchair skill, 18.8% of the variance related to the two-metre backwards roll and 31.9% of the variance related to the 10-metre forward roll. The addition of gender (to the MoCA-7) increased the explained variance related to the 10-metre forward roll and turn in place skills to 38.5% and 28.5%, respectively. As for the brakes handling skill test, gender explained 18.3% of the variance. The addition of the CDT (to gender) increased the explained variance for the brakes handling skill to 31.4%. Conclusions Because cognitive impairments negatively affect the performance of wheelchair skills, rehabilitation therapists may need to adjust wheelchair mobility training methods for cognitively impaired older adults. Implication for rehabilitation Given the prevalence of older adults with cognitive impairments who use manual wheelchairs, it is critical to better understand the relationship between cognition and wheelchair skills. Poor results reported on the cognitive tests, specifically, visual attention and orientation, were found to be associated with poor performance of four manual wheelchair skills. Rehabilitation therapists should consider the cognitive status of older adults when teaching manual wheelchair skills, specifically in new users. Future studies should examine whether a customized preparation program, enhancing visuospatial orientation, can benefit manual wheelchair control in older adults.

Effects of Training with a Brain-Computer Interface-Controlled Robot on Rehabilitation Outcome in Patients with Subacute Stroke: A Randomized Controlled Trial.

IntroductionStroke is always associated with a difficult functional recovery process. A brain–computer interface (BCI) is a technology which provides a direct connection between the human brain and external devices. The primary aim of this study was to determine whether training with a BCI-controlled robot can improve functions in patients with subacute stroke.MethodsSubacute stroke patients aged 32–68 years with a course of 2 weeks to 3 months were randomly assigned to the BCI group or to the sham group for a 4-week course. The primary outcome measures were Loewenstein Occupational Therapy Cognitive Assessment (LOCTA) and Fugl-Meyer Assessment for Lower Extremity (FMA-LE). Secondary outcome measures included Fugl-Meyer Assessment for Balance (FMA-B), Functional Ambulation Category (FAC), Modified Barthel Index (MBI), serum brain-derived neurotrophic factor (BDNF) levels and motor-evoked potential (MEP).ResultsA total of 28 patients completed the study. Both groups showed a significant increase in mean LOCTA (sham: P < 0.001, Cohen’s d = − 2.972; BCI: P < 0.001, Cohen’s d = − 4.266) and FMA-LE (sham: P < 0.001, Cohen’s d = − 3.178; BCI: P < 0.001, Cohen’s d = − 3.063) scores. The LOCTA scores in the BCI group were 14.89% higher than in the sham group (P = 0.049, Cohen’s d = − 0.580). There were no significant differences between the two groups in terms of FMA-B (P = 0.363, Cohen’s d = − 0.252), FAC (P = 0.363), or MBI (P = 0.493, Cohen’s d = − 0.188) scores. The serum levels of BDNF were significantly higher within the BCI group (P < 0.001, Cohen’s d = − 1.167), and the MEP latency decreased by 3.75% and 4.71% in the sham and BCI groups, respectively.ConclusionTraining with a BCI-controlled robot combined with traditional physiotherapy promotes cognitive function recovery, and enhances motor functions of the lower extremity in patients with subacute stroke. These patients also showed increased secretion of BDNF.Trial RegistrationChinese clinical trial registry: ChiCTR-INR-17012874.

The Correlation Between Computerized Cognitive Tests Scores With Functional Cognitive Tests in People With Multiple Sclerosis

Objectives: In order to rehabilitate cognitive disorders, it is necessary to carefully evaluate cognitive function. Given the variety of assessments, including computerized and functional tests, the aim of this study was to determine whether computerized test scores really reflect a person’s functional ability. In this study, we measured the correlation between computerized and functional evaluation results Methods: In this cross-section study, 45 people (9 males and 36 females) with multiple sclerosis with an Expanded Disability Score (EDSS) of 1 to 5 were recruited. To assess their cognitive function, the CANTAB tests (SOC, DMS, and SSP tests) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery were used. The data were then processed with SPSS software v. 22. Results: The results showed that the CANTAB test is well correlated with the LOTCA battery. A high correlation was observed between LOTCA’s “visual perception” with delayed matching to sample (r=0.909), LOTCA’s “spatial perception” with spatial span test (r=0.907), LOTCA’s “visual organization” with stocking of Cambridge (r=0.961), and “mental operations” in LOTCA with “stocking of Cambridge” (r=0.835). Discussion: Due to the very good convergence of these two tests, in many cases, computerized tests can be used instead of functional tests.

Impact of Psychosocial Occupational Therapy Combined with Anodal Transcranial Direct Current Stimulation to the Left Dorsolateral Prefrontal Cortex on the Cognitive Performance of Patients with Schizophrenia: A Randomized Controlled Trial.

BackgroundThe most common cognitive dysfunctions in patients with schizophrenia are information processing, memory, and learning. Based on the hypothesis of rehabilitation and brain stimulation in memory and learning, adding a form of neuromodulation to conventional rehabilitation might increase the effectiveness of treatments.AimsTo explore the effects of psychosocial occupational therapy combined with anodal Transcranial Direct Current Stimulation (tDCS) on cognitive performance in patients with Schizophrenia.MethodsTwenty-four patients diagnosed with schizophrenia were randomized into the experimental and control groups. We used The Cambridge Neuropsychological Test Automated Battery (CANTAB) and the Loewenstein Occupational Therapy Cognitive Assessment battery (LOTCA) to assess spatial recognition, attention, visual memory, learning abilities, and high-level cognitive functions like problem-solving. All participants received customized psychosocial occupational therapy activities. Furthermore, the experimental group received 12 sessions of active anodal tDCS for 20 minutes with 2 mA intensity on the left dorsolateral prefrontal cortex (DLPFC) while the patients in the sham group received sham tDCS.ResultsCombining tDCS to conventional psychosocial occupational therapy resulted in a significant increase in spatial memory, visual learning, and attention.ConclusionsAnodal tDCS on the left DLPFC improved visual memory, attention, and learning abilities. Contrary to our expectations, we could not find any changes in complex and more demanding cognitive functions.

Multilevel Clustering-Evolutionary Random Support Vector Machine Cluster Algorithm-Based Functional Magnetic Resonance Imaging in Diagnosing Cerebral Ischemic Stroke

This study was to explore the value of the blood oxygenation level dependent-functional magnetic resonance imaging (BOLD-fMRI) image classification based on the multilevel clustering-evolutionary random support vector machine cluster (MCRSVMC) algorithm in the diagnosis and treatment of patients with cognitive impairment after cerebral ischemic stroke (CIS). The MCRSVMC algorithm was optimized using a clustering algorithm, and it was compared with other algorithms in terms of accuracy (ACC), sensitivity (SEN), and specificity (SPE) of classifying the brain area images. 36 patients with cognitive impairment after CIS and nondementia patients were divided into a control group (drug treatment) and an intervention group (drug + acupuncture) according to different treatment methods, with 18 cases in each group. The changes in regional homogeneity (ReHo) of BOLD-fMRI images and the differences in scores of the Montreal Cognitive Assessment Scale (MoCA), scores of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and scores of Functional Independence Measure (FIM) between the two groups of patients were compared before and after treatment. The results revealed that the average classification ACC, SEN, and SPE of the MCRSVMC algorithm were 84.25 ± 4.13%, 91.07 ± 3.51%, and 89 ± 3.96%, respectively, which were all obviously better than those of other algorithms ( P &lt; 0.01 ). When the number of support vector machine (SVM) classifiers and the number of important features were 410 and 260, respectively, the classification ACC of MCRSVMC algorithm was 0.9429 and 0.9092, respectively. After treatment, the MoCA score, LOTCA score, and FIM score of the patients in the intervention group were higher than those of the control group ( P &lt; 0.05 ). The ReHo values of the right inferior temporal gyrus and right inferior frontal gyrus of patients in the intervention group were much higher than those of the control group ( P &lt; 0.05 ). It indicated that the classification ACC, SEN, and SPE of the magnetic resonance imaging (MRI) based on the MCRSVMC algorithm in this study were greatly improved, and the acupuncture method was more effective in the treatment of patients with cognitive dysfunction after CIS.

The effects of computer-assisted cognitive rehabilitation on cognitive impairment after stroke: A systematic review and meta-analysis.

To determine the effectiveness of computer-assisted cognitive rehabilitation in improving cognitive function in patients with post-stroke cognitive impairment. In recent years, computer-assisted cognitive rehabilitation has been accepted as a good substitute or supplement for traditional cognitive rehabilitation. Some clinical randomised controlled trials have been carried out, but no relevant systematic evaluations have been performed. Therefore, we conducted a systematic review of studies involving computer-assisted cognitive rehabilitation to provide evidence-based data for its promotion and application. Nine databases (Cochrane Library, PubMed, Web of Science, Embase, OVID, Wanfang Data, CNKI, VIP and SinoMed databases) were systematically searched. Randomised controlled trials that assessed computer-assisted cognitive rehabilitation for patients with post-stroke cognitive impairment were included. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis, including the assessment of heterogeneity. We follow the PRISMA 2020guidelines. Thirty-two studies comprising 1837 participants were included. Compared with conventional therapy alone, the addition of computer-assisted cognitive rehabilitation significantly improved the global cognition of patients, evaluated using the Montreal cognitive assessment, mini-mental state examination and Loewenstein occupational therapy cognitive assessment (p<.01 for all tests). The therapy also significantly improved activities of daily living, assessed using the Barthel index, modified Barthel index and functional independence measure (p<.05 for all tests). Computer-assisted cognitive rehabilitation significantly improved the cognitive function and activities of daily living of patients with post-stroke cognitive impairment. Computer-assisted cognitive rehabilitation can be a valuable technique for cognitive rehabilitation after stroke. It is advantageous for improving patient cognition and restoring the overall functional state of patients. Moreover, the research findings can provide suggestions and inspiration for researchers to implement the proposal, which is conducive to the design of more rigorous and high-quality randomised controlled trials.

Effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients.

The aim of the study was to explore the effect of acupuncture combined with rehabilitation on cognitive and motor functions in poststroke patients. All patients were divided into Group A and Group B based on different interventions (Group A: acupuncture + conventional rehabilitation, Group B: conventional rehabilitation alone). Acupuncture was conducted once a day, five times a week for 8 weeks, and rehabilitation (including physical therapy and occupational therapy) was conducted for 2 hr per session, once a day, five times a week for 8 weeks. Mini-mental State Examination (MMSE) and Fugl-Meyer Assessment (FMA) were used to assess the motor and cognitive functions at baseline and the end of 8 weeks. After the intervention, FMA and MMSE scores were improved significantly in the two groups (p <.05), compared with the scores prior to intervention. After 8 weeks of intervention, a statistically significant difference in the FMA and MMSE scores was observed between the Group A and the Group B. The results suggested that the combined intervention is more effective than the conventional rehabilitation alone in improving cognitive and motor functions in poststroke patients.

Associations between vitamin E, oxidative stress markers, total homocysteine levels, and physical activity or cognitive capacity in older adults

This study examined the associations between vitamin E, oxidative stress markers, total homocysteine levels, and physical activity or cognitive capacity in older adults. One hundred and six older adults (62 men, 44 women) within the age range of 56–81 years participated. The Global Physical Activity Questionnaire and the Loewenstein Occupational Therapy Cognitive Assessment were used to assess physical activity and cognitive function, respectively. Vitamin E (e.g., α-tocopherol and γ-tocopherol), oxidative stress markers (e.g., total antioxidant capacity and nitric oxide), and total homocysteine were estimated. There were significant associations between physical activity (high versus moderate versus poor) and all biomarkers (all p = 0.000, and p = 0.010 for γ-tocopherol). While total homocysteine and total antioxidant capacity were significantly associated with cognitive capacity (p = 0.000), vitamin E levels (e.g., α-tocopherol and γ-tocopherol) and nitric oxide (p = 0.354, 0.103 and 0.060, respectively) were not related to cognitive capacity in older adults. This study concludes that physical activity was associated with Vitamin E, oxidative stress markers, total homocysteine, and cognitive capacity in older adults. Although cognitive capacity was associated with total homocysteine and total antioxidant capacity, it was unrelated to vitamin E levels and nitric oxide in older adults.

SIGNIFICANCE OF COGNITIVE ASSESSMENT IN RELATION TO OCCUPATIONAL THERAPY PRACTICE, AN EXPLORATORY STUDY FOR PAKISTAN OCCUPATIONAL THERAPY GUIDELINES

BACKGROUND AND AIMS Cognition is defined as the ability to perceive process and comprehend the information from the surrounding. Impairment in cognitive skills can significantly affect individual’s performance. The objective of the study is to identify the commonly used cognitive assessment tools by occupational therapist and determine its significance in occupational therapy practice. METHODOLOGY A total of 150 participants were enrolled in the cross-sectional survey that was responded by occupational therapist working in pediatric domain specifically in outpatient rehabilitation setting. The self-structured questionnaire was validated by factor analysis through SPSS. RESULTS: The findings of this study revealed that 96% of occupational therapists performed cognitive assessment out of which only 9.6% occupational therapist administer standardized assessments due to incompetency and lack of resources the rest use informal mode of assessments. Mini mental state examination (MMSE) is found to be most common cognitive assessment tool while tools like Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) is rarely used though it is very significant for Activities of daily living (ADL) cognition CONCLUSION It was concluded that the need of cognitive assessment in pediatric setting is an integral component in occupational therapy process for authentic evaluation and effective intervention plan. The curriculum must promote efficient training of standardize assessment and resources should be provided for better outcome and prognosis.

Cognitive function and alcohol use disorder: Path analysis for a cross-sectional study in Taiwan

Objective: Alcohol has cognitive impacts on patients with alcohol use disorder (AUD). In this study, we intended to study cognitive impairments in patients with AUD and their potential interrelationships. Methods: We enrolled 60 patients with AUD or alcohol intoxication in Taiwan. The severity of alcohol use was assessed using a copy for severity of alcohol dependence questionnaire (SADQ). Cognitive function was evaluated using Stroop color and word test, continuous performance test-identical pairs, trail making test, visual alternating and divided attention subscales of computerized everyday attention test, visual elevator subscale of test of everyday attention, Benton judgment of line orientation test, spatial perception subscale of visual object perception test, visual motor organization subscale of Loewenstein occupational therapy, thinking operations subscale of Loewenstein occupational therapy cognitive assessment, digit symbol coding subscale of Wechsler adult intelligence scale-third edition, as well as symbol digit modalities test. Moreover, we used a structural equation modeling (SEM) to link age, duration of alcohol use, SADQ, and cognitive impairments. Results: Patients with AUD had significantly impairments of “attention” (p

Understanding the impact of cognitive impairment and disease severity on activities of daily living in MS patients with different disability levels

ObjectivePhysical impairments seen in people with multiple sclerosis (PwMS) affect the level of independence in activities of daily living (ADL). However, physical problems are insufficient to explain some debilitating conditions experienced by PwMS in daily life, especially in activities that require high cognitive ability. The aim of this study was to investigate the impact of cognitive impairment and disease severity on ADL in MS patients with different disability levels. MethodsSeventy PwMS were enrolled and divided into three groups according to their disability status. Cognitive functions were assessed with the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and independence level in ADL was assessed with Functional Independence Measure (FIM). ResultsThere were significant differences between groups in FIM and FIM motor (FIMm) scores (p < 0.001), however no significant differences were found between groups in terms of FIM cognitive (FIMc) and LOTCA scores (p = 0.195 and p = 0.348 respectively). There was a moderate positive correlation between FIM and LOTCA total scores (p < 0.001) for overall sample. While there was a low correlation between LOTCA and FIMm (p = 0.008), high correlation was found between LOTCA and FIMc (p < 0.001). ConclusionAlthough most of the limitations in ADL can be explained by the severity of the disability in MS, the ability to perform ADL including cognitive skills was found to be similar for all disability levels. Cognitive problems should be taken into consideration as well as motor problems in the process of planning treatment programs for PwMS with any levels of disability.