A Rapid Review of Ethical and Equity Dimensions in Telerehabilitation for Physiotherapy and Occupational Therapy
Bibliographic record
Abstract
INTRODUCTION: The rapid adoption of telerehabilitation in physiotherapy and occupational therapy has transformed healthcare delivery, offering new opportunities for patient-centered care. However, its implementation raises critical ethical and equity-related questions that require proactive strategies to ensure fair and responsible practices. This review examines how ethical disparities and equity-related challenges are reflected in the existing literature on telerehabilitation. OBJECTIVE: To investigate the presence of ethical-disparity and equity-related aspects in the provision of telerehabilitation in physiotherapy and occupational therapy as reflected in the literature. DATA SOURCES: A rapid review methodology was employed to explore ethical and equity-related challenges in telerehabilitation. The search included articles published in English and French between 2010 and 2023 from the Medline and Embase databases. STUDY SELECTION: Articles were selected based on their relevance to ethical and equity considerations in telerehabilitation. A total of 1750 sources were initially identified, with 67 articles meeting the eligibility criteria for inclusion in this review. DATA EXTRACTION: Data were extracted based on variables such as age, gender, ethnicity, morbidity, cost, privacy, confidentiality, and autonomy. The data extraction and analysis were guided by the Progress Plus and Metaverse Equitable Rehabilitation Therapy frameworks. DATA SYNTHESIS: The findings were analyzed and discussed using a narrative synthesis approach. The results highlighted key ethical considerations, including adverse events, patient autonomy, and privacy issues. Equity-related aspects were examined, access to rehabilitation services and gender considerations. Disparities in technology access, socioeconomic status, and ethnicity were also identified. CONCLUSIONS: This rapid review highlights the growing relevance of ethical and equity considerations in the design and delivery of telerehabilitation within physiotherapy and occupational therapy. The findings show inconsistent reporting and limited depth in addressing key domains such as patient autonomy, privacy, and adverse events, alongside disparities related to age, gender, socioeconomic status, and geographic access. Although telerehabilitation holds promise for expanding access, particularly in underserved areas, this potential remains unevenly realized. The review underscores the critical need for structured, equity-driven, and ethically grounded frameworks such as the Metaverse Equitable Rehabilitation THerapy (MERTH) framework to guide future implementation, research, and policy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.099 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.024 | 0.020 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".