Inequity in research evaluations of virtual exercise programs for adults with mobility limitations: a scoping review

OBJECTIVE: To describe the reported integration of inclusion, diversity, equity, and accessibility considerations into virtual exercise programs for adults with mobility limitations, and identify considerations for optimizing participation among underrepresented groups. METHODS: We conducted a scoping review and consultation. Eligible studies evaluated virtual exercise programs targeting mobility among people with mobility limitations. The PROGRESS-Plus framework guided data extraction of equity-related factors. A content analysis was conducted using data from one focus group with six individuals, including adults with mobility limitations and program providers. RESULTS: All 36 included studies applied at least one exclusion criterion, often related to health status or lack of digital access. Eligibility criteria based on PROGRESS-Plus factors resulted in excluding at least 814 individuals. Participants were predominantly white older women. Age was the most frequently reported equity factor, followed by sex/gender, health condition, and disease duration. Seven studies described strategies to promote inclusion, such as technological assistance or flexible class schedules. The consultation identified considerations related to advertisement, eligibility, and accessibility, to increase participation among underrepresented groups. CONCLUSION: Adults with mobility limitations may not have equitable access to participate in virtual exercise studies. Proactive inclusion strategies are needed to ensure virtual exercise interventions support diverse community-dwelling adults.