Outcome measures used in stroke rehabilitation in India: A scoping review

Abstract

Background: Stroke is one of the prevalent noncommunicable diseases in India. In stroke rehabilitation, valid and reliable outcome measurements help in evaluating treatment effectiveness, systematic program evaluation, and justifying reimbursement. Measuring outcomes is construed as a good practice in the field of rehabilitation. Objectives: The purpose of this scoping review was to identify and review the outcome measures used in stroke rehabilitation in India to provide an up-to-date understanding of the nature of outcome measures used, their cultural relevance, linguistic relevance, and validity. Study Design: This is a descriptive scoping review. Methods: The scoping review framework proposed by Arksey and O'Malley in 2005 was used in this review. Following the development of review questions, relevant studies were identified, suitable studies were selected and critically reviewed, and the data were charted, collated, and summarized to generate themes. Results: Thirty-three studies identified 46 outcome measures. Most of the outcome measures used in stroke rehabilitation research in India were ordinal scales and body structure/function assessments. Reliability and validity scores of the identified scales ranged from 0.37–1.00 to 0.65–0.96, respectively. Modified Rankin Scale and Barthel Index were the most used outcome measures. Only two of the identified measures were developed in India. Conclusion: There is a dearth of culturally sensitive stroke-related outcome measures in India in all domains. The authors suggest that researchers in India exert caution when selecting and using outcome measures developed in foreign countries as the review identified only two translated and validated cognitive scales and one performance measure specific to the Indian population.