Musculoskeletal pain remains the leading cause of disability worldwide, yet rehabilitation delivery models have changed little over time. Multi-session physical therapy is widely assumed to produce superior outcomes, even as healthcare systems face increasing pressures related to cost, access, wait times, and workforce capacity. As value-based care becomes a priority, an important question emerges: how much supervised therapy is truly necessary to achieve meaningful clinical improvement?
In this virtual panel session within the Public Health and Healthcare Management track, Shwetambari Korde presents findings from a systematic review and meta-analysis comparing condensed, exercise-focused physical therapy with traditional multi-session physiotherapy for adults with musculoskeletal pain. The review analyzed randomized controlled trials involving conditions such as knee osteoarthritis, neck pain, shoulder pain, and osteoporotic vertebral fractures, examining outcomes related to pain, physical function, and health-related quality of life.
Across six trials involving more than 2,000 participants, pooled analyses indicate that multi-session care offers only a small short- and mid-term advantage in pain reduction. At longer follow-up intervals, including three and twelve months, differences between single-session and multi-session approaches were not clinically meaningful. Functional outcomes and quality-of-life measures were generally comparable across treatment models. Although the overall certainty of evidence was rated low due to heterogeneity and risk of bias, the consistency of outcome convergence invites a reexamination of conventional rehabilitation intensity.
Beyond the statistical findings, the session explores why condensed care may produce similar results. Emphasis is placed on the central role of patient education, structured home exercise programs, natural recovery trajectories, and the influence of self-efficacy on pain outcomes. The presentation also addresses clinical nuance, highlighting when condensed care may be appropriate, when extended supervision remains beneficial, and how shared decision-making can guide treatment dosage.
Author and Affiliation
Shwetambari Korde, Loma Linda University
For clinicians, researchers, educators, and health system leaders, these findings carry important implications for service delivery design, equity of access, and long-term sustainability in musculoskeletal care. By reframing rehabilitation intensity as a strategic variable rather than a fixed tradition, this research contributes to broader conversations about scalability and high-value healthcare delivery. Learn more about this presentation and register for the SAM International Business Conference at www.samnational.org/conference.