A scoping review of outcome and outcome measure sets for adults with spinal cord injury, stroke, and traumatic brain injury.
Snigdha Widge, Ahlam Zidan, Alyson Kwok and 4 others
Stroke, spinal cord injury, and traumatic brain injury patients share 54% of their rehabilitation outcome priorities, yet only 3% of the recommended measures are used across all three conditions.
Clinicians treating all three groups are measuring the same things with different tools.
Key findings
154% of meaningful outcomes were shared across stroke, SCI, and TBI, but only 3% of the 275 recommended outcome measures were used across all three conditions.
2Quality of life was the only outcome recommended for more than one population and the most frequently reported overall (n = 8).
3People with lived experience were involved in only 35% of the included studies, and no measures were identified for accessible environments, social structures, or social communication despite these being recommended for all three conditions.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a mapping of what has been recommended, not an appraisal of whether those recommendations are methodologically sound — the authors did not assess the quality of the included sets. The literature was dominated by stroke studies (30 of 48), so the overlap figures likely understate how much TBI and SCI share with stroke. The grouping of outcomes into 'meaningful outcomes' required interpretive judgement and may have introduced inconsistencies, particularly given variability in how outcomes were defined across studies. PWLE involvement was inconsistently reported across the included studies, limiting the ability to assess how deeply patients shaped the recommendations. No included study evaluated implementation of outcome sets in real-world clinical settings, so the practical feasibility of adopting these measures is untested.
Declared interests
The authors declare no conflicts of interest. The project was funded by the Canadian Institutes of Health Research (CIHR).
The easy way to misread this
Do not read the 54% outcome overlap as evidence that the same measures can be swapped between stroke, SCI, and TBI patients. The review found that only 3% of measures are actually shared, and the authors note that condition-specific measures may be appropriate in some contexts. The overlap is in what should be measured, not in the tools used to measure it.
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