Abstract: Objective To analyze the role of adapted Johns-Hopkins cognitive exam(ACE) in assessing the end of physical restraint in severe patients with cerebral hemorrhage. Methods A total of 91 severe patients with cerebral hemorrhage diagnosed in our hospital were selected from March 2017 to September 2017, who were divided into directional force normal group(38 cases) and directional force abnormal group(53 cases). The normal group was released from restraint, and the abnormal group was continued to be restrained. The incidence of unplanned extubation and cognitive function score were compared between the two groups, and the correlation between orientation and cognition score were analyzed. Results The incidence of unplanned extubation in directional force normal group(0.00%) was significantly lower than that in directional force abnormal group(16.98%, P<0.05). The score of imitation ability, language competence, attention and calculation, memory and cognition in normal group was significantly higher than the abnormal group(all P<0.05). The results of Spearman analysis showed that the patient's directional power was positive correlated with the total score of cognition(r=0.839, P<0.001). Conclusion ACE can provide reference for severe cerebral hemorrhage patients to relieve physical restraint by evaluating cognitive function and directional ability.