Purpose: To identify how post-stroke disability outcomes are assessed in studies that examine racial/ethnic disparities and to map the identified assessment content to the International Classification of Functioning, Disability, and Health (ICF) across the time course of stroke recovery.

Methods: We conducted a scoping review of the literature. Articles published between January 2001 and July 2017 were identified through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion and exclusion criteria.

Results: We identified 1791 articles through database and hand-searching strategies. Of the articles, 194 met inclusion criteria for full-text review, and 41 met inclusion criteria for study inclusion. The included studies used a variety of outcome measures encompassing domains within the ICF: body functions, activities, participation, and contextual factors across the time course of stroke recovery. We discovered disproportionate representation among racial/ethnic groups in the post-stroke disability disparities literature.

Conclusions: A wide variety of assessments are used to examine disparities in post-stroke disability across the time course of stroke recovery. Several studies have identified disparities through a variety of assessments; however, substantial problems abound from the assessments used including inconsistent use of assessments, lacking evidence on the validity of assessments among racial/ethnic groups, and inadequate representation among all racial/ethnic populations comprising the US.

  • Implications for Rehabilitation
  • An enhanced understanding of racial/ethnic disparities in post-stroke disability outcomes is inherently important among rehabilitation practitioners who frequently engage with racial/ethnic minority populations across the time course of stroke recovery.

  • Clinicians should carefully consider the psychometric properties of assessment tools to counter potential racial bias.

  • Clinicians should be aware that many assessments used in stroke rehabilitation lack cultural sensitivity and could result in inaccurate assessment findings.

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Notes/Citation Information

Published in Disability and Rehabilitation, v. 41, issue 15, p. 1835-1845.

The copyright holder has granted the permission for posting the article here.

This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on July 2019, available online: http://www.tandfonline.com/10.1080/09638288.2018.1448467.

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Funding Information

The authors of this manuscript report that we receive funding from the American Heart Association (AHA) Grant [#15SFDRN25870000, 15SFDRN24480016].