Ethics and Equity Challenges in Telerehabilitation for Older Adults: Rapid Review

The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. This rapid review explores the ethical and equity concerns associated with telerehabilitation for older adults, fo...

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Published inJMIR aging Vol. 8; p. e69660
Main Authors Veras, Mirella, Auger, Louis-Pierre, Sigouin, Jennifer, Gheidari, Nahid, Nelson, Michelle LA, Miller, William C, Hudon, Anne, Kairy, Dahlia
Format Journal Article
LanguageEnglish
Published Canada JMIR Publications 13.08.2025
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ISSN2561-7605
2561-7605
DOI10.2196/69660

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Abstract The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. 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. 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. 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. This review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
AbstractList The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care.BackgroundThe integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care.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.ObjectiveThis 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.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.MethodsConducted 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.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.ResultsFrom 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.This review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.ConclusionsThis review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
Abstract BackgroundThe integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. ObjectiveThis 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. MethodsConducted 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 ResultsFrom 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. ConclusionsThis review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
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 CINAHLResults: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.
The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. 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. 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. 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. This review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
Author Auger, Louis-Pierre
Gheidari, Nahid
Veras, Mirella
Hudon, Anne
Nelson, Michelle LA
Kairy, Dahlia
Sigouin, Jennifer
Miller, William C
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ContentType Journal Article
Copyright Mirella Veras, Louis-Pierre Auger, Jennifer Sigouin, Nahid Gheidari, Michelle LA Nelson, William C Miller, Anne Hudon, Dahlia Kairy. Originally published in JMIR Aging (https://aging.jmir.org).
2025. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Copyright © Mirella Veras, Louis-Pierre Auger, Jennifer Sigouin, Nahid Gheidari, Michelle LA Nelson, William C Miller, Anne Hudon, Dahlia Kairy. Originally published in JMIR Aging (https://aging.jmir.org) 2025
Copyright_xml – notice: Mirella Veras, Louis-Pierre Auger, Jennifer Sigouin, Nahid Gheidari, Michelle LA Nelson, William C Miller, Anne Hudon, Dahlia Kairy. Originally published in JMIR Aging (https://aging.jmir.org).
– notice: 2025. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: Copyright © Mirella Veras, Louis-Pierre Auger, Jennifer Sigouin, Nahid Gheidari, Michelle LA Nelson, William C Miller, Anne Hudon, Dahlia Kairy. Originally published in JMIR Aging (https://aging.jmir.org) 2025
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Keywords rehabilitation
digital health
review
telehealth
telerehabilitation
older adults
aging
geriatric
ethics
equity
virtual care
Language English
License Mirella Veras, Louis-Pierre Auger, Jennifer Sigouin, Nahid Gheidari, Michelle LA Nelson, William C Miller, Anne Hudon, Dahlia Kairy. Originally published in JMIR Aging (https://aging.jmir.org).
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Snippet The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses...
Background:The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which...
Abstract BackgroundThe integration of technology in rehabilitation is transforming health care delivery for older adults, especially through...
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SubjectTerms Adaptive technology
Aged
Aged, 80 and over
Augmented reality
Chronic illnesses
Cognitive ability
Communication
COVID-19
Demographics of Users, Social & Digital Divide
Diabetes
Empowerment
Equity
Equity and Digital Divide
Ethics
Ethics, Privacy, and Legal Issues
Health education
Health Equity - ethics
Humans
Inclusion
Internet access
Internet Access and Digital Technology Use in an Elderly Population
Mental health
Middle Aged
Monitoring systems
Morbidity
Multimedia
Older people
Pandemics
Quality of life
Review
Reviews on Aging
Sensors
Systematic review
Telemedicine
Telemedicine - ethics
Telerehabilitation
Telerehabilitation - ethics
Text messaging
Usability and Technology Use Studies with Elder Subjects
Video teleconferencing
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Title Ethics and Equity Challenges in Telerehabilitation for Older Adults: Rapid Review
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