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Exploring equity in telehealth interventions in physiotherapy: A meta-epidemiological study
Junior Vitorino Fandim1, Lidia Carballo-Costa2, Paloma Santana3
1Master's & Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
Brazilian Journal of Physical Therapy
|July 20, 2026
Summary
Evidence for equity-focused telehealth in physiotherapy is uncertain. While some interventions show benefits for disadvantaged groups, robust data on reducing health inequities is limited, and PROGRESS factors are often not fully integrated.
Area of Science:
- Physiotherapy research
- Health equity
- Telehealth interventions
Background:
- Telehealth has expanded in physiotherapy, raising questions about its equitable application.
- The PROGRESS Plus framework offers a tool to assess factors influencing health equity.
- Understanding equity in telehealth is crucial for inclusive healthcare delivery.
Purpose of the Study:
- To evaluate the equity focus of telehealth interventions in physiotherapy research.
- To apply the PROGRESS Plus framework to analyze equity dimensions in published trials.
- To identify trends and gaps in telehealth research concerning health equity.
Main Methods:
- A systematic search of PEDro, CENTRAL, and PubMed databases (Jan 2020-Dec 2023) for relevant randomized controlled trials.
- Selection, extraction, and assessment of trial characteristics and PROGRESS Plus factors.
- Descriptive analysis of data and hypothesis testing for social gradient hypotheses.
Main Results:
- 94 trials were included: 45 equity-focused and 49 equity-oriented.
- Equity-focused trials showed favorable outcomes in 62%, addressing place of residence, race/ethnicity, and vulnerable populations.
- Most trials (86%) showed no social gradients; only 12% demonstrated a reduction in health inequities.
Conclusions:
- Evidence for equity-focused telehealth in physiotherapy remains uncertain, with varied reported benefits.
- Telehealth equity-oriented trials often lack differential effects but may benefit disadvantaged groups.
- Systematic integration of PROGRESS factors across the research lifecycle is often lacking in telehealth equity studies.
