本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(23)02630-2

摘要内容如下：

背景

对于肌肉骨骼问题，远程康复是否被认为不如亲自护理有效。我们的目的是确定对于慢性膝关节疼痛，物理治疗视频会议咨询是否不劣于面对面咨询。

方法

在这项非劣效性随机对照试验中，我们招募了来自27家澳大利亚诊所的初级保健物理治疗师。使用计算机生成的模块，患有与骨关节炎一致的慢性膝关节疼痛的参与者被随机分配（1:1，由物理治疗师和诊所分层）面对面或远程康复（即视频会议）物理治疗师咨询。参与者和理疗师被暴露于分组任务中。在3个月的时间里，两组都进行了5次关于强化、体育活动和教育的咨询。主要结果是随机分组后3个月时的膝关节疼痛（数字评分量表为0-10）和身体功能（使用西安大略大学和麦克马斯特大学骨关节炎指数为0-68）。使用所有可用数据，通过改良意向治疗进行初步分析。该试验已在澳大利亚和新西兰临床试验注册中心（ACTRN12619001240134）注册。

调查结果

在2019年12月10日至2022年6月17日期间，有394名成年人登记，其中204人被分配到现场护理，190人被分配到远程康复。招募了15名初级保健物理治疗师。在3个月时，383名（97%）参与者提供了主要结果的信息，两组均报告疼痛改善（亲自护理的平均变化2.98，SD 2.23，远程康复的平均变化3.14，SD 1.87）和功能改善（分别为10.20，11.63和10.75，9.62）。远程康复在疼痛（平均差异0.16，95%CI-0.26~0.57）和功能（1.65，-0.23~3.53）方面无劣势。报告不良事件的参与者人数在两组间相似（40[21%]为亲自护理，35[19%]为远程康复），且无严重不良事件。

解释

对于慢性膝关节疼痛，物理治疗师的远程康复并不劣于亲自护理。

英文原文如下：

Abstracts

BACKGROUND  Telerehabilitation whether perceived as less effective than in-person care for musculoskeletal problems. We aimed to determine if physiotherapy video conferencing consultations were non-inferior to in-person consultations for chronic knee pain.

METHODS  In this non-inferiority randomised controlled trial, we recruited primary care physiotherapists from 27 Australian clinics. Using computer-generated blocks, participants with chronic knee pain consistent with osteoarthritis were randomly assigned (1:1, stratified by physiotherapist and clinic) in-person or telerehabilitation (ie, video conferencing) physiotherapist consultations. Participants and physiotherapists were unmasked to group assignment. Both groups had five consultations over 3 months for strengthening, physical activity, and education. Primary outcomes were knee pain (on a numerical rating scale of 0-10) and physical function (using the Western Ontario and McMaster Universities osteoarthritis index of 0-68) at 3 months after randomisation. Primary analysis was by modified intention-to-treat using all available data. This trial is registered with the Australian and New Zealand Clinical Trials Registry, ACTRN12619001240134.

FINDINGS  Between Dec 10, 2019, and June 17, 2022, 394 adults were enrolled, with 204 allocated to in-person care and 190 to telerehabilitation. 15 primary care physiotherapists were recruited. At 3 months, 383 (97%) participants provided information for primary outcomes and both groups reported improved pain (mean change 2·98, SD 2·23 for in-person care and 3·14, 1·87 for telerehabilitation) and function (10·20, 11·63 and 10·75, 9·62, respectively). Telerehabilitation was non-inferior for pain (mean difference 0·16, 95% CI -0·26 to 0·57) and function (1·65, -0·23 to 3·53). The number of participants reporting adverse events was similar between groups (40 [21%] for in-person care and 35 [19%] for telerehabilitation) and none were serious.

INTERPRETATION  Telerehabilitation with a physiotherapist is non-inferior to in-person care for chronic knee pain.

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