A Rapid Review of Ethical and Equity Dimensions in Telerehabilitation for Physiotherapy and Occupational Therapy

Mirella Veras, Jennifer Sigouin, Louis-Pierre Auger, Claudine Auger, Sara Ahmed, Zachary Boychuck, Sabrina Cavallo, Martine Lévesque, Stacey Lovo, William C. Miller, Michelle Nelson, Nahid Norouzi-Gheidari, Jennifer O’Neil, Kadija Perreault, Reg Urbanowski, Lisa Sheehy, Hardeep Singh, Claude Vincent, Rosalie H. Wang, Diana Zidarov, Anne Hudon and Dahlia Kairy ()
Additional contact information
Mirella Veras: Department of Physical Therapy, Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
Jennifer Sigouin: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
Louis-Pierre Auger: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
Claudine Auger: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
Sara Ahmed: Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
Zachary Boychuck: Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
Sabrina Cavallo: École de Readaptation, Faculté de Médecine, Université de Montréal, Montreal, QC H3N 1X7, Canada
Martine Lévesque: École de Readaptation, Faculté de Médecine, Université de Montréal, Montreal, QC H3N 1X7, Canada
Stacey Lovo: School of Rehabilitation Science, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
William C. Miller: Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
Michelle Nelson: Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
Nahid Norouzi-Gheidari: Clinical Research Unit, Montreal Neurological Institute/Hospital, Montreal, QC H3A 2B4, Canada
Jennifer O’Neil: École des Sciences de la Réadaptation, Faculté des Sciences de la Santé, University of Ottawa, Ottawa, ON K1S 5S9, Canada
Kadija Perreault: Faculty of Medicine, School of Rehabilitation Sciences, Université Laval, Québec, QC G1V 0A6, Canada
Reg Urbanowski: Rady Faculty of Health Sciences, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
Lisa Sheehy: Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada
Hardeep Singh: Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada
Claude Vincent: Faculty of Medicine, School of Rehabilitation Sciences, Université Laval, Québec, QC G1V 0A6, Canada
Rosalie H. Wang: Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada
Diana Zidarov: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
Anne Hudon: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada
Dahlia Kairy: Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, QC H3S 1M9, Canada

IJERPH, 2025, vol. 22, issue 7, 1-20

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.

Keywords: telehealth; telerehabilitation; e-health; digital health; physiotherapy; occupational therapy; ethics; equity; rapid review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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