Racial Differences in Poststroke Rehabilitation Utilization and Functional Outcomes

Objective: To examine racial differences in poststroke rehabilitation utilization and functional outcomes. Design: Observational follow-up study. Setting: Designated stroke center. Participants: Stroke survivors (N=162; 106 whites and 56 blacks) surveyed at 1 year poststroke. Intervention: Not applicable. Main Outcome Measures: Twenty-question measure of activities of daily living (ADL) and instrumental activities of daily living (IADL) performance, life participation, and driving. One-year follow-up data collected from stroke survivors as part of the Stroke Education and Prevention-South Carolina Project were examined for racial disparities in rehabilitation utilization and functional outcomes. Results: Analyses revealed no significant differences between blacks and whites for rehabilitation utilization. In multivariate comparisons controlling for stroke severity, blacks were less likely to report independence in overall functional performance and domain-specific measures of toileting, wanting, transportation, laundry, and shopping. Blacks also reported less independence in driving at 1-year follow-up. Conclusions: Blacks were less likely to report independence in performing ADL and IADL at 1 year poststroke after controlling for stroke severity. Racial disparities were reported in ADL and IADL performance despite a lack of racial differences in rehabilitation utilization. Future studies are needed to further understand the reason for this disparity in reported functional independence. (C) 2015 by the American Congress of Rehabilitation Medicine