Ethics and Equity Challenges in Telerehabilitation for Older Adults: Rapid Review
Bibliographic record
Abstract
Background: The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. Objective: This rapid review explores the ethical and equity concerns associated with telerehabilitation for older adults, focusing on challenges such as internet access, technology adoption, and digital literacy. Methods: Conducted according to Cochrane Rapid Review guidelines, this review used the Metaverse Equitable Rehabilitation Therapy framework, focusing on equity and ethics. Studies included telerehabilitation services for adults aged 55 years and older, published between 2010 and 2023. Screening was conducted independently by 2 researchers using Rayyan (Qatar Computing Research Institute, Hamad Bin Khalifa University), with full-text review by additional team members. Searches were performed in Medline and CINAHL. Results: From 323 papers retrieved, 49 studies met the inclusion criteria. The included studies were published between 2013 and 2023. Disparities in socioeconomic status, geographic location, and racial and ethnic backgrounds were found to impact telerehabilitation use. Additionally, ethical concerns around privacy, security, and autonomy were often inadequately addressed. Conclusions: This review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".