Equity and Ethics in Telerehabilitation: Toward Personalized Approaches in Physiotherapy and Occupational Therapy

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 must be addressed 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. Methods: 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 2020 from the Medline and Embase databases. Articles were selected based on their relevance to ethical and equity considerations in telerehabilitation. A total of 1,556 sources were initially identified, with 57 articles meeting the eligibility criteria for inclusion in this review. 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. A narrative synthesis approach was used to analyze and discuss the findings. The results highlighted key ethical considerations, including adverse events, patient autonomy, and privacy issues. Equity-related aspects were examined with a significant focus on age demographics, access to rehabilitation services, and gender considerations. Disparities in technology access, socioeconomic status, and ethnicity were also identified. Conclusions: The review underscores the importance of addressing ethical and equity-related issues in telerehabilitation to ensure a socially just, responsible, and inclusive approach to care. Additionally, it highlights the potential for telerehabilitation to offer personalized interventions that cater to individual patient needs, further advancing equitable and patient-centered rehabilitation practices.