Physical therapy ·
Review of 189 trials favors shockwave for frozen shoulder pain; CMS finalizes 2027 pay cut and remote monitoring limits
Listen to this post
read by AI voices · all episodesTHE SHORT READ
A BMJ network meta-analysis of 189 randomized trials found moderate-certainty evidence that extracorporeal shockwave therapy probably reduces short-term adhesive capsulitis pain compared with usual care. The Centers for Medicare & Medicaid Services (CMS) finalized the 2027 physician fee schedule, cutting the conversion factor and limiting remote therapeutic monitoring. Other studies addressed hybrid digital care for low back pain, the timing of physical therapy around lumbar stenosis surgery and supervised scoliosis exercise.
THE DETAILS
- Research Nov 4, 2026The systematic review and network meta-analysis pooled 189 randomized trials with 12,988 participants and 59 interventions for adhesive capsulitis. Moderate-certainty evidence showed extracorporeal shockwave therapy probably reduced short-term pain compared with usual care (mean difference -1.97 on a 0 to 10 scale), and manipulation under anesthesia combined with intra-articular steroid injection probably improved short-term flexion (mean difference 33.29 degrees). The authors said the absence of reported adverse events should not be interpreted as evidence of absence of harm.
- Payment Nov 4, 2026The Centers for Medicare & Medicaid Services (CMS) released the calendar year 2027 physician fee schedule final rule on Nov. 4, setting the conversion factor at $32.63 for clinicians not in qualifying alternative payment models, a projected 2.31% decrease, and $32.95 for qualifying participants, a 1.83% decrease. CMS finalized policies limiting remote therapeutic monitoring to established patients and requiring a separately reportable initiating visit. It delayed until Jan. 1, 2029, a requirement that remote monitoring be paid only when performed by clinical staff employed by the practice.
- Technology Nov 4, 2026The component network meta-analysis in npj Digital Medicine included 56 reports of 46 studies with 6,717 participants, 80% with chronic low back pain. Compared with no intervention, combined digital and in-person exercise reduced short-term disability (mean difference -15.75; 95% credible interval -22.79 to -8.80), as did digital exercise with physiotherapy (mean difference -13.17), and combined exercise also improved pain intensity (mean difference -1.76; 95% credible interval -2.62 to -0.87). The authors reported no serious adverse events and said multicomponent hybrid interventions appear safe and may provide clinically meaningful improvements for chronic low back pain.Sources: npj Digital Medicine, PubMed
- Research Nov 7, 2026The registry-based cohort study in Physical Therapy used the Swedish National Spine Surgery Registry to compare physical therapy pathways among 7,969 patients who had surgery for lumbar spinal stenosis. Compared with patients who had physical therapy before and after surgery, those with only presurgery physical therapy had higher odds of reaching meaningful and acceptable outcomes at 1 year (odds ratio 1.39 to 1.56), while those with only postsurgery physical therapy had higher pain intensity and worse gait function. The authors said presurgery physical therapy may be beneficial to consider and additional postsurgery physical therapy may not be warranted for all.
- Research Nov 1, 2026The randomized trial in The Bone & Joint Journal, which recruited at a tertiary scoliosis center, compared supervised Schroth-based physiotherapeutic scoliosis-specific exercise (physiotherapist-led sessions plus daily home exercises) against self-directed exercise in braced adolescents with idiopathic scoliosis. At 24 months, supervised exercise produced a greater reduction in major Cobb angle, a co-primary end point (adjusted between-group difference -3.23 degrees; 95% CI -3.51 to -2.96; P < .001), which did not reach the prespecified minimal clinically important difference. Radiological status did not differ significantly in the intention-to-treat analysis, and there was no sustained clinically meaningful quality-of-life benefit, the authors said.
- Payment Nov 4, 2026The Centers for Medicare & Medicaid Services (CMS) finalized its 2027 home health payment rule Nov. 4, which CMS estimates will raise aggregate Medicare payments to home health agencies 2.4%, or $415 million, according to Home Health Care News. The rule includes a temporary 3% downward adjustment to the national standardized payment rate, the outlet said. CMS said the rule recalibrates the case-mix weights, updates functional impairment levels and changes the Home Health Quality Reporting Program.Sources: CMS, Home Health Care News
The weekly innovation roundup for physical therapy, published every Sunday for the week before; every item links to its sources. Latest physical therapy news · All specialties