2025 Spring Edition
Feature Publication: Highlighting Disparities in Cognitive Rehabilitation Research for People with Brain Injury
Jessica Kersey PhDOTR/L, Patricia Garcia PsyD. HSPPAssistant Professor of Neurology Assistant Emily Evans PTPhD, Zaccheus J. Ahonle Ph.D.CRC , Pooja Jethani OTOTDMSOTR , Juan Carlos Arango-Lasprilla Ph.D. , Devina Kumar PhDMScPT , Anthony H. Lequerica Ph.D., Gloria M. Morel Valdes PsyD, Paige Salinas MSMHALCSW CBIST-AP , Devan Parrott PhD Associate Professor of Underrepresentation of Participants from Marginalized Racial and Ethnic Groups: A Secondary Analysis of the Cognitive Rehabilitation Literature, Archives of Rehabilitation Research and Clinical Translation (2025), doi: https://doi.org/10.1016/j.arrct.2025.100431
A new study, led by Jessica Kersey, PhD, OTR/L from Washington University School of Medicine, sheds light on the troubling underrepresentation of individuals from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials for traumatic brain injury (TBI). The research, which was supported by a BI-ISIG Task Force grant awarded to the BI-ISIG Culture and Diversity Task Force, highlights critical disparities in research that could exacerbate inequities in access to rehabilitation and outcomes for marginalized populations.
The study is a secondary analysis of the 2019 Cicerone et al. cognitive rehabilitation review, focusing specifically on the racial and ethnic demographics of participants in the included studies. Of the 65 studies that met the inclusion criteria, only 27 reported demographic information. In the majority of those studies, White non-Hispanic individuals were overrepresented. The study found that recruitment strategies and eligibility criteria commonly used in these trials—such as language requirements, literacy and education level thresholds, and exclusions for comorbid conditions—often disproportionately exclude people from racially and ethnically marginalized groups.
Dr. Kersey’s findings call for a deeper investigation into how recruitment and sampling strategies in TBI rehabilitation trials may inadvertently contribute to disparities. This research is a crucial step in understanding how these barriers can be addressed to improve inclusivity in future clinical trials. The study emphasizes the importance of making cognitive rehabilitation research more representative and accessible, ultimately aiming to reduce healthcare disparities for marginalized communities.
As this work came out of the Culture and Diversity Task Force, it reinforces the Task Force’s commitment to fostering diversity in research and practice. Further studies will be necessary to explore solutions that ensure better representation and equal access to rehabilitation outcomes for all individuals, regardless of race or ethnicity.
