OBJECTIVE: To compare single and multiple physiotherapy sessions to improve pain, function, and quality of life (QoL) in patients with musculoskeletal disorders (MSKDs). DATA SOURCES: AMED, Cinahl, SportsDiscus, Medline, Cochrane Register of Clinical Trials, Physiotherapy Evidence Database, and reference lists. STUDY SELECTION: Randomized controlled trials (RCTs) comparing single and multiple physiotherapy sessions for MSKDs. DATA EXTRACTION: Two reviewers extracted data and assessed risk of bias and certainty of evidence using Cochrane Risk of Bias tool 2.0 and Grading of Recommendation Assessment, Development, and Evaluation. DATA SYNTHESIS: Six RCTs (n = 2090) were included (conditions studied: osteoporotic vertebral fracture, neck, knee, and shoulder pain). Meta-analyses with low-certainty evidence showed a significant pain improvement at 6 months in favor of multiple sessions compared with single session interventions (3 RCTs; n = 1035; standardized mean difference (SMD) 0.29; 95% CI 0.05 to 0.53; p = 0.02) but this significant difference in pain improvement was not observed at 3 months (4 RCTs; n = 1312; SMD 0.39; 95% CI -0.11 to 0.89; p = 0.13) and at 12 months (4 RCTs; n = 1266; SMD -0.05; 95% CI -0.49 to 0.39; p = 0.82). Meta-analyses with low-certainty evidence showed no significant differences in function at 3 (4 RCTs; n = 1583; SMD 0.05; 95% CI -0.11 to 0.21; p = 0.56), 6 (4 RCTs; n = 1538; SMD 0.06; 95% CI -0.12 to 0.23; p = 0.53) and 12 months (4 RCTs; n = 1528; SMD 0.08; 95% CI -0.08 to 0.25; p = 0.30) and QoL at 3 (4 RCTs; n = 1779; SMD 0.08; 95% CI -0.02 to 0.17; p = 0.12), 6 (3 RCTs; n = 1206; SMD 0.03; 95% CI -0.08 to 0.14; p = 0.59), and 12 months (4 RCTs; n = 1729; SMD -0.03; 95% CI -0.12 to 0.07; p = 0.58). CONCLUSIONS: Low certainty meta-analyses found no clinically significant differences in pain, function, and QoL between single and multiple physiotherapy sessions for MSKD management for the conditions studied. Future research should compare the cost-effectiveness of those different models of care.

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