Oral Presentation Smart Strokes Annual Scientific Meeting 2025

Rehabilitation after Stroke for Aboriginal and Torres Strait Islander Peoples and Indigenous Peoples Globally: Results of a Scoping Review to Inform Transformation in Rehabilitation (127564)

Meaghan McAllister 1 , Elizabeth Armstrong 2 , Dan McAullay 3 , Dave Parsons 4 , Linda Cresdee 5 , Jane White 6 , Rebecca Clinch 7 , Kerri Colegate 6 , Angela Dos Santos 8
  1. Edith Cowan University & St John of God Midland Public & Private Hospitals, Perth, WA, Australia
  2. University Department of Rural Health South West, Edith Cowan University, Bunbury, WA, Australia
  3. Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia
  4. School of Health Sciences, The University of Notre Dame, Fremantle, WA, Australia
  5. Aboriginal Health Team, St John of God Midland Public & Private Hospitals, Perth, WA, Australia
  6. School of Medical & Health Science, Edith Cowan University, Perth, WA, Australia
  7. Western Australian Acquired Brain Injury Service, North Metropolitan Health Service, Perth, WA, Australia
  8. Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia

Introduction: Indigenous people in colonised countries experience high stroke incidence, and structural and institutional racism exacerbates care inequities. Current rehabilitation services lack responsiveness to Indigenous peoples' unique needs. Transformation in rehabilitation processes, service models, and research is urgently required, reflecting a rights and strengths-based paradigm. To inform this effort, this review examines the current evidence for stroke rehabilitation relating to Aboriginal and Torres Strait Islander peoples and Indigenous peoples globally. It seeks to understand how practices currently engage with decolonisation and Indigenous self-determination in theory and in practice.

Methods: The scoping review methodology follows Joanna Briggs Institute recommendations, enhanced through Indigenous Data Sovereignty principles. An Aboriginal Advisory Group and Aboriginal researchers provided input and governance for the review, ensuring cultural integrity. To reflect the multiple processes of rehabilitation, all evidence sources and study designs were eligible. Critical appraisal used the CONSIDER statement. Extracted data described the breadth and nature of the evidence and how Indigenous ways of knowing and doing were considered. Data synthesis included qualitative content analysis framed by critical decolonial and Indigenist theories.

Results: A comprehensive search strategy revealed 2143 records reflecting grey and published literature. Following duplicate removal and eligibility screening, 130 records were included for appraisal and data extraction. To date, varied clinical and research settings are represented, and study methodologies range from theoretical discussion to randomised controlled trials of therapeutic interventions. Comprehensive results from analysis and synthesis by the team and Advisory Group will be detailed in the presentation.

Conclusion: Responding to calls for transformation, this scoping review presents the first comprehensive synthesis and critical analysis of evidence in stroke rehabilitation with Indigenous peoples.

Relevance to clinical practice or patient experience: This synthesis will equip clinicians with evidence-based and critical insights to challenge practices that perpetuate inequities for Indigenous peoples. The findings will inform clinical reflexiveness, decision-making and support transformation toward decolonised, strengths-based rehabilitation approaches.