Disparities in Stroke Rehabilitation: Sana Somani, MD, MBBS

The vascular neurology fellow at the University of Maryland Medical Center discussed findings that African American women had the lowest functional performance in stroke rehabilitation.

“What attitudes does the patient have towards these health services? What are the incentives that help them engage in these demanding rehab activities? What are the beliefs these individuals have about health locus of control, which is actually a social learning theory that refers to whether health and its outcomes are under personal control or chance?”

Data from a recent study suggest that women and African American patients have lower functional performance during acute inpatient rehabilitation than men and Caucasian patients after intracerebral hemorrhagic (ICH) strokes. These findings were presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22 by Sana Somani, MD, MBBS, vascular neurology fellow, University of Maryland Medical Center.

Somani and colleagues performed a retrospective analysis of a cohort of 65 ICH patients admitted to the University of Alabama at Birmingham from December 2016 through December 2019. The researchers found that being male was positively associated with Functional Independence Measure (FIM) efficiency (β=1.02; P = .0063) after adjusting for race and ICH score. FIM efficiency was lower in African American patients (β=-0.95; P = .0092) after adjusting for gender and ICH volume. They did not observe any significant differences in ICH volumes and scores with respect to discharge FIM scores.

NeurologyLive spoke with Somani to learn more about the factors that could contribute to African American patients and women benefitting the least from inpatient rehabilitation, with African American women being the most impacted. She also discussed the importance of taking into account patient attitudes toward health services.

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REFERENCE
Somani S, Nanavati H, Xiaohua Z, Lin C. African American women have lower functional performance during acute inpatient rehabilitation after intracerebral hemorrhagic strokes. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P5 073