Lowenstein Occupational Therapy Cognitive Assessment Research Articles

Early functional factors for predicting outcome of independence in daily living after stroke: a decision tree analysis.

This study aimed to investigate the predictive functional factors influencing the acquisition of basic activities of daily living performance abilities during the early stages of stroke rehabilitation using classification and regression analysis trees. The clinical data of 289 stroke patients who underwent rehabilitation during hospitalization (164 males; mean age: 62.2 ± 13.9 years) were retrospectively collected and analysed. The follow-up period between admission and discharge was approximately 6 weeks. Medical records, including demographic characteristics and various functional assessments with item scores, were extracted. The modified Barthel Index on discharge served as the target outcome for analysis. A "good outcome" was defined as a modified Barthel Index score ≥ 75 on discharge, while a modified Barthel Index score < 75 was classified as a "poor outcome." Two classification and regression analysis tree models were developed. The first model, predicting activities of daily living outcomes based on early motor functions, achieved an accuracy of 92.4%. Among patients with a "good outcome", 70.9% exhibited (i) ≥ 4 points in the "sitting-to-standing" category in the motor assessment scale and (ii) 32 points on the Berg Balance Scale score. The second model, predicting activities of daily living outcome based on early cognitive functions, achieved an accuracy of 82.7%. Within the "poor outcome" group, 52.2% had (i) ≤ 21 points in the "visuomotor organization" category of Lowenstein Occupational Therapy Cognitive Assessment, (ii) ≤ 1 point in the "time orientation" category of the Mini Mental State Examination. The ability to perform "sitting-to-standing" and visuomotor organization functions at the beginning of rehabilitation emerged as the most significant predictors for achieving successful basic activities of daily living on discharge after stroke.

EFFECT OF BRIGHT LIGHT ON THE COGNITIVE AND OCCUPATIONAL PERFORMANCE OF ELDERLY PEOPLE UNDERGOING HEMODIALYSIS: INITIAL DATA FROM CLINICAL TRIAL

INTRODUCTION: Chronic kidney disease (CKD) has no expectation of cure, therefore, the treatment is based on maintaining the chronic state of the disease, through renal replacement therapies, such as hemodialysis or kidney transplant. The CKD can compromise occupational performance, since the beginning of hemodialysis, adaptation to new life habits is required. OBJECTIVE: To analyze the effects of bright light on occupational performance of elderly people with end-stage renal disease (ESRD) on hemodialysis in the state of Ceará, aiming at its impact on the quality of life of these patients. METHOD: Randomized, placebo-controlled clinical trial with and qualitative-quantitative approach, with the use of bright light or placebo light in their homes for 30 minutes, for 4 weeks in the afternoon. From this perspective, the evaluation instruments were used before and after the light: The Dynamic Lowenstein Occupational Therapy Cognitive Assessment – for Geriatric Population (DLOTCA-G) adapted version for the Portuguese language. The sample consisted of 26 elderly people on dialysis, and the collection period comprised the months of August 2022 to May 2023. RESULTS: They were 69% (18/26) male and between 60 and 94 years old. The analysis of the impacts of such equipment on these individuals' memory, mental operations and visual-motor skills revealed that the bright light group had better results than the placebo group (linear regression, p&lt;0.001). CONCLUSIONS: Bright light exposure therapy proved to be very beneficial, especially for the memory and mediation of these elderly people, thus reflecting on the improvement of their quality of life.

Effect of Antipsychotic Drugs on the Cardiac Function of Patients with Schizophrenia and Analysis of Echocardiogram Results

Objective: To explore and analyze the effect of antipsychotic drug treatment on the cardiac function of patients with schizophrenia. Methods: From January 2021 to December 2022, 30 patients with schizophrenia were divided into three groups, group A (n = 10), group B (n = 10), and group C (n = 10), by random number table. Patients in group A were treated with risperidone, patients in group B were treated with quetiapine, and patients in group C were treated with aripiprazole. The Positive and Negative Syndrome Scale (PANSS) and Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) scores, electrocardiogram results, and echocardiogram results were compared among the three groups. Results: There were no significant differences in PANSS and LOTCA scores among the three groups after treatment (P &gt; 0.05). Electrocardiogram showed that the incidence of prolonged QT interval in group C was higher than that in groups A and B (P &lt; 0.05); echocardiogram showed that the left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) in group C were lower than those in group A and group B (P &lt; 0.05). Conclusion: Risperidone, quetiapine, and aripiprazole can improve the symptoms and cognitive function in patients with schizophrenia. Aripiprazole has a greater impact on cardiac function, as evidenced on electrocardiogram and echocardiogram. Therefore, close monitoring must be done to ensure drug safety.

Reliability and Validity of the Spanish Version of the Executive Function Performance Test (EFPT) in Assessing People in Treatment for Substance Addiction.

Assessing people's executive function (EF) during addiction treatment makes it possible to design individualized occupational goals. To determine the reliability and validity of the Spanish version of the Executive Function Performance Test (EFPT) in the occupational assessment of people being treated for substance addiction. Cross-sectional, observational study to determine the EFPT's internal consistency as well as its convergent and discriminant validity with complementary tests. A public, free addiction treatment center operated by Madrid Salud (Madrid City Council, Spain). Fifty-two people referred to an occupational therapy department for evaluation and intervention. Inclusion was based on Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) criteria for substance abuse or dependence; the exclusion criterion consisted of any circumstances that made it difficult for a person to understand or perform the test. The EFPT, other occupational tests (Allen Cognitive Level Screen-5, Lowenstein Occupational Therapy Cognitive Assessment), and a battery of neuropsychological EF tests. The EFPT had an unequivocal unifactorial structure and showed strong correlations between its components and adequate consistency with the scales and the complete test. As expected, the EFPT correlated with the neuropsychological tests with a considerable effect size (-.40 < r < -.60). The EFPT's psychometric properties are adequate to assess the EF of people being treated for substance addiction from an occupational perspective using real activities of daily living (ADLs). The results show that the EFPT can be used to assess performance of ADLs without needing to use tests from disciplines other than occupational therapy. Further studies in different sociocultural settings are needed to generalize the results.

Relationship between Basic Neurological Cognition and Social Cognition among Allen Cognitive Disability Levels of Acquired Brain Injury.

(1) Background: There are various cognitive, perceptual, and social problems associated with acquired brain injury (ABI). The Allen cognitive impairment level indicates the degree of cognitive function required for everyday activities. Until recently, there have been no studies on the relationship between basic neurological cognition and social cognitive function according to the Allen cognitive level (ACL). The aim of this study is to identify the relationship between basic neurological and social cognition among Allen cognitive disability levels of ABI. (2) Methods: Thirty-four patients with ABI were identified. Cartoon Intention Inference Task (CIIT), Social Behavior Sequence Task (SBST), Korean version Mimi-Mental Status Examination (K-MMSE), and Lowenstein Occupational Therapy Cognitive Assessment (LOTCA)-tests were administered to examine the differences in neurological and social cognitive functions according to each participant’s Allen Cognitive Level Screening (ACLS). (3) Results: There were significant differences between K-MMSE, LOTCA, CIIT and SBST results among Allen cognitive levels (p < 0.05). There was a linear correlation between K-MMSE (r = 0.778, p < 0.01), LOTCA-total score (r = 0.627, p < 0.01), LOTCA-orientation (r = 0.470, p = 0.01), LOTCA-thinking operation (r = 0.341, p < 0.05), CIIT (r = 0.817, p < 0.05), and SBST (r = 0.376, p < 0.05) and ACL. Stepwise multivariate regression showed that the subscales affecting the ACLS score were SBST (β = 0.239, p = 0.000) and K-MMSE (β = 0.068, p = 0.001). The explanatory power of this regression equation, R2, was 0.767. (4) Conclusions: A significant difference was found in neurological and social cognitive function according to the ACL level of the ABI patient. In addition, there was a linear correlation between the ACLS scores of the ABI patients and the underlying neurological cognitive function and social cognition. The higher the overall functional cognitive level (i.e., the group with higher ACLS scores), and the lower the degree of help required in daily life, the higher both the neurological cognition level and social cognitive level were determined to be.

Effectiveness of Virtual Reality Based Cognitive Rehabilitation on Cognitive Function, Motivation and Depression in Stroke Patients

Background/Objectives: The aim of this study was to investigate the effects of virtual reality cognitive training on cognitive function, rehabilitation motivation, and depression in patients with sub-acute stroke.Method/Statistical Analysis: Total 22 patients with sub-acute stroke were included in our study. All stroke patients were classified either into experimental group (n = 11) or control group (n = 11). The experimental group performed virtual reality cognitive training on each session during 30 min/day, and control group conducted conventional cognitive therapy on each session during 30 min/day. The outcome measures were the LOTCA (Lowenstein Occupational Therapy Cognitive Assessment), VQ (Volitional questionnaire), BDI (Beck Depression Inventory) before and after intervention.Findings: The both groups showed significant improvements in cognitive function before and after intervention (p .05). In comparisons for change score between the two groups, the experimental group showed a significant greater improvements in cognitive function and rehabilitation motivation than control group (p<.05).Improvements/Applications: These findings suggest that virtual reality cognitive training may have a effects of the improvements of cognitive function and rehabilitation motivation than conventional cognitive therapy in sub-acute stroke.

A randomized trial of stereotactic versus conventional radiotherapy in young patients with low-grade brain tumors: occupational therapy-based neurocognitive data.

BackgroundRadiotherapy for brain tumors in young patients is not only associated with improved survival but also long-term neurocognitive sequelae. We aimed to compare group differences in the executive neurocognitive outcomes in young patients with low-grade brain tumors treated with stereotactic conformal radiotherapy (SCRT) and conventional RT (ConvRT) techniques.MethodsThis a phase 3 randomized trial that enrolled 200 young patients with benign brain tumors and low-grade gliomas. Patients were randomly allocated (1:1) to either SCRT or ConvRT arms and treated to a dose of 54 Gy in 30 fractions over 6 weeks. Lowenstein Occupational Therapy Cognitive Assessment battery was performed at preradiotherapy baseline, 6 months, and annually thereafter until 5 years. Executive functions measures included orientation, visual perception, spatial perception, motor praxis, visuomotor organization, thinking operations, and attention and concentration. The trajectory of these parameters was compared between the treatment arms over 5 years.ResultsTwo hundred patients were enrolled in the study (SCRT: 104 and ConvRT: 96). The median age was 13 years (interquartile range: 9–17); mean total neurocognitive scores over 5 years were significantly superior in SCRT arm as compared to ConvRT (difference in slope: 2.27, P = .024). Outcomes improved in the SCRT arm vis-à-vis ConvRT for the subdomain of visuomotor organization (difference in slope: 0.66, P < .001). Visuomotor organization scores significantly improved in majority of the substratification groups. Spatial perception improved in craniopharyngioma patients with SCRT technique as opposed to ConvRT.ConclusionsSCRT achieved superior outcomes compared to ConvRT in certain executive neurocognitive functional domains. We provide high level of evidence in favor of SCRT. Trial Registration. ClinicalTrials.gov Identifier: NCT00517959.

A Pilot Investigation of Computerized Cognitive Rehabilitation for Post-Stroke Patients: Cognitive Function and Satisfaction

The aim of this pilot study was to investigate the effects of computerized cognitive rehabilitation on patients after they had each experienced an acute stroke and evaluate the association between rehabilitation satisfaction and age. Eighteen patients who had each experienced an acute stroke participated in the study. They were assigned to two groups: the experimental group (n = 12) and control group (n = 6). Interventions were performed with each group for 30 minutes per day, five times per week, for four weeks. The experimental group engaged in computerized cognitive rehabilitation, and the control group participated in traditional cognitive rehabilitation. In addition, both groups engaged in traditional cognitive rehabilitation for four weeks according to an established schedule. The Lowenstein Occupational Therapy Cognitive Assessment test (LOTCA) was performed to measure cognitive function. The Visual Analog Satisfaction Scale (VASS) was used to measure satisfaction with cognitive rehabilitation—specifically, overall satisfaction, therapeutic effects, interest, and intention to reuse. After the interventions, total cognitive function scores for both groups were significantly improved compared to scores before the interventions. However, the experimental group showed significant improvement in more sub-items of cognitive function compared to the control group. There was no significant difference in satisfaction between the two groups after the interventions. In the experimental group, overall satisfaction and interest in computerized cognitive rehabilitation were significantly lower among elderly participants when compared to middle-aged participants. Computerized cognitive rehabilitation may have a positive effect on cognitive function improvement. However, computerized cognitive rehabilitation programs must be developed to meet the specific characteristics and needs of elderly stroke patients.

The Effects of Motor and Cognitive Impairments on Daily Living Activities and Quality of Life in Children with Autism

ABSTRACTAutistic children have problems in cognitive and motor skills areas. This study investigated the effects of motor and cognitive problems on daily living activities and quality of life in autistic children. Thirty-two autistic children were included in the study. Thirty typically developing children were selected as the control group. The Bruininks Oseretsky Test of Motor Proficiency, Lowenstein Occupational Therapy Cognitive Assessment, Pediatric Evaluation Disability Inventory, Child Health Questionnaire were used to assess motor proficiency, cognitive abilities, daily living activities and quality of life, respectively. This study shows cognitive and motor impairment negatively affects daily living activities in children with autism.

Cognitive assessment: A challenge for occupational therapists in Brazil.

Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life.ObjectiveThe aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice.MethodsThe instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed.ResultsThe search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment).ConclusionThere are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice.

The effects of a Korean computer-based cognitive rehabilitation program on cognitive function and visual perception ability of patients with acute stroke.

[Purpose] The purpose of this study is to investigate the effects of a Korean computer-based cognitive rehabilitation program (CBCR) on the cognitive function and visual perception ability of patients with acute stroke. [Subjects] The subjects were 30 patients with acute stroke. [Methods] The subjects were randomly assigned to either the experimental group (EG) or the control group (CG). The EG subjects received CBCR with the CoTras program. The CG subjects received conventional cognitive rehabilitation. All subjects participated in a standard rehabilitation program according to a daily inpatient treatment schedule. In addition to standard rehabilitation, the subjects received 20 sessions (5 days a week for 4 weeks) of CBCR or conventional cognitive rehabilitation for 30 min. To compare the two groups, the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and Motor-free Visual Perception Test-3 (MVPT-3) were performed. [Results] Both groups showed significant improvement in LOTCA and MVPT-3. Furthermore, there were significant differences in LOTCA and MVPT-3 between the two groups. [Conclusion] CBCR with CoTras may contribute toward the recovery of cognitive function and visual perception in patients with acute stroke.

코그팩 프로그램이 알츠하이머 치매노인의 인지 및 일상생활동작에 미치는 영향

Purpose : The purpose of this study was to evaluate the influence of Lowenstein Occupational Therapy Cognitive Assessment(LOTCA) and Activities of Daily Living(ADL) by CogPack program in elderly with Alzheimer's dementia. Method : The subjects of this study, elderly diagnosed with Alzheimer's dementia, 8 patients were picked up, who were agreed with this research. Cognitive training for 6 weeks, which consisted of 3 times per week, 30 min of memory, attention and performance with cogpack program. Cognitive and ADL measured by LOTCA and FIM. The SPSS Ver. 14.0 statistical program was used for data processing. The significance level for statistical inspection was set as 0.05. Result : In comparison of LOTCA was significantly correlated in the pre and post test but FIM was not significantly correlated in the pre and post test. Conclusion : Therefore, the CogPack program is useful to improve the LOTCA in elderly with Alzheimer's dementia.

Performance of patients with frontotemporal lobar degeneration on artistic tasks: A pilot study.

Several studies have addressed visuospatial and executive skills in artistic activities in Frontotemporal Lobar Degeneration (FTLD) and Alzheimer's disease (AD).ObjectiveTo investigate the performance of FTLD patients compared to controls on two artistic tasks.MethodsFour FTLD patients with mean age of 57 (8.7) years and schooling of 12.2 (4.5) years plus 10 controls with mean age of 62.9 (8.6) years and schooling of 12.3 (4.6) years, were assessed using the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and by a three-stage artistic protocol including visual observation, copying and collage, based on a Sisley painting.ResultsFTLD patients had lower scores than controls on Visuospatial Perception, Copy, Collage, Examiner's Observation, and Total, showing distinct patterns of performance according to FTLD sub-type: semantic PPA, nonfluent PPA and bvFTD.ConclusionFTLD patients presented impairment in the visuospatial and executive skills required to perform artistic tasks. We demonstrated that the application of the instrument as a complimentary method for assessing cognitive skills in this group of patients is possible. Further studies addressing larger and more homogeneous samples of FTLD patients as well as other dementias are warranted.

Correlations among impairment, daily activities and thinking operations after stroke

We investigated the hypothesis that ADL tests dependent on cortical functions could be used to assess outcome in stroke patients. 27 right-handed stroke patients were evaluated on National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), Instrumental Activities of Daily Living (IADL) Scale and thinking process items of Lowenstein Occupational Therapy Cognitive Assessment (LOTCA). Correlations between thinking process subtests of LOTCA and different items of NIHSS such as consciousness, arm movement, aphasia, ataxia and inattention was significant. Spearman correlation of thinking process and BI tasks showed no relationship, although Structured Riska of thinking process evaluation was correlated to both self-care and mobility areas of the BI. Thinking process was strongly related to IADL total score (p = 0.004). The total NIHSS correlated significantly with BI and IADL total scores. Higher-order functions, such as categorization, sorting and reasoning, are related to IADL performance which depends on complicated cognitive abilities. In contrast, the BI depends heavily on motoric function, and does not correlate with higher-order functions. Further confirmation is needed, but our data suggest that commonly used IADL tests could serve to as valid, reliable tests of cognitive impairment and recovery in stroke victims.

Dynamic Lowenstein Occupational Therapy Cognitive Assessment–Geriatric Version (DLOTCA–G): Assessing Change in Cognitive Performance

We studied the internal consistency reliability and construct validity of the new Dynamic Lowenstein Occupational Therapy Cognitive Assessment-Geriatric Version (DLOTCA-G), a dynamic version of the Lowenstein Occupational Therapy Cognitive Assessment-Geriatric Version (LOTCA-G), and examined the properties of the mediation system. Participants included 61 clients hospitalized after stroke in three rehabilitation centers (mean age = 77.6 yr, standard deviation [SD] = 6.2) and 52 healthy control participants (mean age = 77.8 yr, SD = 6.4). All participants were assessed with the DLOTCA-G. Internal consistency reliability showed moderate to high α coefficient levels in all domains (αs = .68-.85) except the Memory domain (α = .26). Both groups benefitted from mediation, but the stroke clients needed more concrete levels of mediation (Levels 3-5). The addition of mediation to the LOTCA-G is effective in providing insights into clients' cognitive status and learning potential. Our findings are similar to the results of the validation study for the DLOTCA for adults and support the use and benefits of the dynamic version.

Dynamic Lowenstein Occupational Therapy Cognitive Assessment: Evaluation of Potential to Change in Cognitive Performance

We studied the psychometric properties of the dynamic version of the Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA) and examined the most frequent level of mediation used for planning for intervention. Participants included 83 clients hospitalized after first stroke (mean age = 57.7, standard deviation = 8.33) and 45 healthy control participants. All were assessed with the DLOTCA after providing informed consent. Interrater reliability showed high correlations between all pairs of raters. Internal consistency reliability showed moderate to high αs (.602-.813) for all domains except Visual Perception. We found significant differences between the groups of participants before mediation; both benefited from mediation, showing moderate to high effect sizes. Stroke clients needed higher levels of mediation. The DLOTCA is effective in providing insight into whether participants need mediation and the level and type of assistance they require. The DLOTCA provides guidance for planning intervention for people with cognitive disabilities.

The correlation of independency in activities of daily living performance with cognitive status and the intensity of neurological impairment in right-handed stroke patients

We aimed to investigate whether test performance in neurological and cognitive areas is able to predict daily task performance in stroke patients and if the two selected measures of stroke severity and cognitive function could be used as valid tools to predict functional outcomes after stroke. We assessed 27 stroke patients (hemorrhagic and infarct) through Barthel Index (BI), Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and National Institute of Health Stroke Scale (NIHSS) in the first 6 months after stroke. The correlation of intensity of neurological impairment (NIHSS score) and ADL performance (BI score) was significant (P < 0/05), but we found no relation between general cognitive function (the total score of LOTCA) and individual independence (total score of BI). Although ADL performance areas associated with some cognitive components. The dependency after stroke is more affected by physical symptoms of stroke than by cognitive disorders. Moreover, the intensity of neurological impairment could be a better explanation for a patient's inability to perform basic ADL independently. Low direct relations in total scores of NIHS scale and BI was found, but LOTCA is not appropriate for prediction of independency in basic ADL performance after stroke. Nevertheless, further studies and confirmation are needed.

An investigation of the factors affecting handwriting skill in children with hemiplegic cerebral palsy*

Purpose. This study investigated the effects of sensory-perceptual-motor and cognitive functions on handwriting skill in primary-school children with left-hemiplegic cerebral palsy, compared with that of their healthy peers.Methods. The study included 26 children aged 8–12 years with left hemiplegic cerebral palsy and 32 typically developing children of similar age with dominant right hand. The Minnesota Handwriting Assessment was used to evaluate handwriting skill. The Bruininks–Oseretsky Test of Motor Proficiency was used to assess motor performance. Cognitive function was assessed by the Lowenstein Occupational Therapy Cognitive Assessment. The Ayres Southern California Sensory Integration Tests were used to assess visual perception, kinaesthesia and graphesthesia.Results. Statistically significant differences were found between the two groups in sensory-perceptual-motor and cognitive function and handwriting skill (p < 0.05). There were also significant correlations between handwriting parameters and upper-extremity speed and dexterity, proprioception, bilateral coordination, visual and spatial perception and, visual-motor organisation in children with cerebral palsy (p < 0.05).Conclusions. The results showed that left-hemiplegic children with cerebral palsy whose right sides were dominant were significantly less competent at handwriting than their right-dominant, healthy peers. It was found that the impairment in proprioception seen in the non-hemiplegic side in children with cerebral palsy, and also the impairment in bilateral coordination, speed and dexterity of the upper extremities, visual and spatial perception, visual-motor organization, and tactile-sensory impairments negatively affected their handwriting skills. In the treatment approaches for children with hemiplegic cerebral palsy, comprehensive sensory-perceptual-motor assessments that involve both extremities must be performed in detail at the earliest possible stage, in order to minimize the existing problems with early-treatment policies. Developing the sensory-perceptual-motor and cognitive function of hemiplegic children would thus be possible, and they would be able to develop handwriting skill as a tool for their academic lives as healthy peers.

Management of patients with cognitive impairment after stroke: A survey of Australian occupational therapists

Cognitive impairment is a common and often debilitating consequence of stroke. The current practice patterns of Australian occupational therapists who work in this area are not clearly known. The aim of this study was to investigate the theoretical approaches, assessments, interventions and research evidence used by Australian occupational therapists who work with patients who have cognitive impairment poststroke. A self-administered, purpose-designed online survey was used. Survey responses were received from 102 occupational therapists. The client-centred approach was the most commonly used theoretical approach, with 81.3% and 72% using it often or all of the time with inpatients and outpatients, respectively. Assessments that were most frequently used were the Mini Mental State Examination (63.7% of participants), the Lowenstein Occupational Therapy Cognitive Assessment (45.1%), the Functional Independence Measure (57.8%, and the Assessment of Living Skills and Resources (10.0%). Interventions involving functional activities were used more frequently than compensatory techniques, such as diaries, alarms, or other electronic devices, and paper and pencil remedial exercises. Few (16%) participants used computer programs specifically designed for cognitive rehabilitation. Although 60.8% of the participants reported using research literature when making decisions about interventions, a higher percentage reported relying on their past experience (88.3%) and colleagues' opinions (77.4%). This study provides an insight into the current practices of Australian occupational therapists who work with people who have cognitive impairment after stroke. Client-centredness is emphasised in current practice; however, the use of research evidence to inform practice appears to be limited.