A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain.

Methods

We randomly assigned participants 45 to 85 years of age with knee pain, osteoarthritis, and meniscal tear to one of four groups: home exercise (3-month home-exercise program), home exercise plus text messages to encourage exercise adherence, home exercise plus text messages plus sham physical therapy (in-clinic sham manual therapy and sham ultrasound therapy), and home exercise plus text messages plus standard physical therapy (supervised strengthening, functional, and stretching exercises and manual therapy).

我们将年龄在45至85岁之间，患有膝关节疼痛、骨关节炎和半月板撕裂的参与者随机分配到四个小组：家庭锻炼组（为期三个月的家庭锻炼计划）、家庭锻炼加短信鼓励锻炼依从性组、家庭锻炼加短信加假物理治疗组（在诊所进行的假手法治疗和假超声治疗）以及家庭锻炼加短信加标准物理治疗组（在监督下进行的力量、功能和伸展锻炼以及手法治疗）。

The primary outcome was the change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscore (range, 0 to 100, with higher scores indicating more pain) between baseline and 3 months, with adjustment for trial site, baseline KOOS pain subscore, and radiographic grade.

主要结果是膝关节损伤和骨关节炎结果评分（KOOS）疼痛子评分（范围，0至100，分数越高表示疼痛越严重）在基线和3个月之间的变化，对试验地点、基线KOOS疼痛子评分和放射学等级进行了调整。

Results

A total of 879 participants underwent randomization (mean [±SD] age, 59.2±7.8 years).

共有879名参与者接受了随机分组（平均年龄[±标准差]为59.2±7.8岁）。

The difference in the 3-month change in the KOOS pain subscore between home exercise and home exercise plus text messages was -0.1 points (98.3% confidence interval[CI], -3.8 to 3.7) and between home exercise and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.3 to 6.2); the difference between home exercise plus text messages and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.4 to 6.5).

在家庭锻炼和家庭锻炼加短信干预之间，KOOS疼痛子量表3个月变化的差异为-0.1分（98.3%置信区间[CI]，-3.8至3.7），家庭锻炼和家庭锻炼加短信干预加标准物理治疗之间的差异为2.5分（98.3% CI，-1.3至6.2）；家庭锻炼加短信干预和家庭锻炼加短信干预加标准物理治疗之间的差异为2.5分（98.3% CI，-1.4至6.5）。

Adverse events were generally nonserious and evenly distributed overall across groups.

不良事件通常是非严重的，并且总体上在各组之间分布均匀。

Conclusions

For patients with degenerative meniscal tear and knee pain, the addition of physical therapy or text messages to encourage adherence to home exercises was not superior in reducing pain to a home-exercise program alone.

对于患有退行性半月板撕裂和膝关节疼痛的患者，添加物理治疗或鼓励遵守家庭锻炼的短信到家庭锻炼计划中，并不比单独的家庭锻炼计划在减少疼痛方面更有效。

(Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and others; TeMPO ClinicalTrials.gov number, NCT03059004.).

该研究由国家关节炎、肌肉骨骼和皮肤疾病研究所等资助；TeMPO临床试验的注册号为NCT03059004。