Hannah G Withers , Joanne V Glinsky , Jackie Chu , Matthew D Jennings , Ian Starkey , Rachel Parmeter , Max Boulos , Jackson J Cruwys , Kitty Duong , Ian Jordan , David Wong , San Trang , Maggie Duong , Hueiming Liu , Alison J Hayes , Tara E Lambert , Joshua R Zadro , Catherine Sherrington , Christopher Maher , Barbara R Lucas , Lisa A Harvey
{"title":"远程物理治疗与面对面物理治疗对肌肉骨骼疾病同样有效（REFORM）：随机试验。","authors":"Hannah G Withers , Joanne V Glinsky , Jackie Chu , Matthew D Jennings , Ian Starkey , Rachel Parmeter , Max Boulos , Jackson J Cruwys , Kitty Duong , Ian Jordan , David Wong , San Trang , Maggie Duong , Hueiming Liu , Alison J Hayes , Tara E Lambert , Joshua R Zadro , Catherine Sherrington , Christopher Maher , Barbara R Lucas , Lisa A Harvey","doi":"10.1016/j.jphys.2024.02.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Question</h3><p>Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions?</p></div><div><h3>Design</h3><p>Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis.</p></div><div><h3>Participants</h3><p>A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney.</p></div><div><h3>Intervention</h3><p>One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of –15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks.</p></div><div><h3>Results</h3><p>The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (–3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. Whilst non-inferiority margins were not set for the secondary outcomes, the 95% CI of the mean between-group difference ruled out clinically meaningful differences.</p></div><div><h3>Conclusion</h3><p>Remotely delivered physiotherapy with support via phone, text and an app is as good as face-to-face physiotherapy for the management of musculoskeletal conditions.</p></div><div><h3>Trial registration</h3><p>ACTRN12619000065190.</p></div>","PeriodicalId":49153,"journal":{"name":"Journal of Physiotherapy","volume":"70 2","pages":"Pages 124-133"},"PeriodicalIF":9.7000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1836955324000171/pdfft?md5=a66382525909748e4819ca0fb1a906ff&pid=1-s2.0-S1836955324000171-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Remotely delivered physiotherapy is as effective as face-to-face physiotherapy for musculoskeletal conditions (REFORM): a randomised trial\",\"authors\":\"Hannah G Withers , Joanne V Glinsky , Jackie Chu , Matthew D Jennings , Ian Starkey , Rachel Parmeter , Max Boulos , Jackson J Cruwys , Kitty Duong , Ian Jordan , David Wong , San Trang , Maggie Duong , Hueiming Liu , Alison J Hayes , Tara E Lambert , Joshua R Zadro , Catherine Sherrington , Christopher Maher , Barbara R Lucas , Lisa A Harvey\",\"doi\":\"10.1016/j.jphys.2024.02.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Question</h3><p>Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions?</p></div><div><h3>Design</h3><p>Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis.</p></div><div><h3>Participants</h3><p>A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney.</p></div><div><h3>Intervention</h3><p>One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting.</p></div><div><h3>Outcome measures</h3><p>The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of –15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks.</p></div><div><h3>Results</h3><p>The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (–3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. 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Remotely delivered physiotherapy is as effective as face-to-face physiotherapy for musculoskeletal conditions (REFORM): a randomised trial
Question
Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions?
Design
Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis.
Participants
A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney.
Intervention
One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting.
Outcome measures
The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of –15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks.
Results
The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (–3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. Whilst non-inferiority margins were not set for the secondary outcomes, the 95% CI of the mean between-group difference ruled out clinically meaningful differences.
Conclusion
Remotely delivered physiotherapy with support via phone, text and an app is as good as face-to-face physiotherapy for the management of musculoskeletal conditions.
期刊介绍：
The Journal of Physiotherapy is the official journal of the Australian Physiotherapy Association. It aims to publish high-quality research with a significant impact on global physiotherapy practice. The journal's vision is to lead the field in supporting clinicians to access, understand, and implement research evidence that will enhance person-centred care. In January 2008, the Journal of Physiotherapy became the first physiotherapy journal to adhere to the ICMJE requirement of registering randomized trials with a recognized Trial Registry. The journal prioritizes systematic reviews, clinical trials, economic analyses, experimental studies, qualitative studies, epidemiological studies, and observational studies. In January 2014, it also became the first core physiotherapy/physical therapy journal to provide free access to editorials and peer-reviewed original research. The Australian Physiotherapy Association extended their support for excellence in physiotherapy practice by sponsoring open access publication of all Journal of Physiotherapy content in 2016. As a result, all past, present, and future journal articles are freely accessible, and there are no author fees for publication.
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