Race and gender concordance in digital MSK rehab

Study overview

Race, ethnicity, and gender concordance between patients and providers has been studied in traditional healthcare settings, but less is known about its role in digital rehabilitation. This study evaluated whether concordance between patients and physical therapists affected engagement, satisfaction, and clinical outcomes in Sword’s digital MSK care program.

The analysis included more than 71,000 patients. Researchers assessed completion, text interactions, satisfaction, pain, anxiety, depression, and activity impairment across concordant and nonconcordant patient-therapist pairings.

Key findings

Concordance was associated with engagement differences in some groups

The study found that race and gender concordance was associated with higher completion for some groups, suggesting that provider-patient matching may influence engagement even in digital care.

Clinical outcomes remained broadly strong

The study evaluated pain, anxiety, depression, and activity impairment, helping distinguish whether concordance affected participation, outcomes, or both.

Digital interactions were part of the care relationship

Because the program includes asynchronous communication, the study helps show that relationship-centered care still matters in a digital model.

The study adds nuance to health equity strategy

The findings do not suggest that concordance is the only path to equitable care. They do suggest that identity, communication, and therapeutic relationship deserve attention in digital rehabilitation.

Why this study matters

This study is important because digital care is sometimes framed as purely technological. In reality, human relationships still shape engagement, trust, and care experience.

For Sword’s clinical library, this study supports a more mature health equity story. It shows that digital care can be studied not only by outcomes, but by the interpersonal factors that may influence whether people complete care and feel supported.

Read the full study