Adding a floss-band procedure with active shoulder movement to conventional physiotherapy improves shoulder pain and sleep quality in chronic hemiplegic shoulder pain patients.
In a randomized controlled trial of 40 adults with chronic hemiplegic shoulder pain, adding a floss-band procedure with active shoulder movement to conventional physiotherapy significantly improved SPADI scores (by 20.87-28.34 points) and PSQI scores (by 2.48-3.87 points) compared to physiotherapy alone. Secondary outcomes including VAS pain and shoulder range of motion also favored the experimental group. All results remained significant after Holm correction.
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Adding a floss-band procedure with active shoulder movement to conventional physiotherapy improves shoulder pain and sleep quality in chronic hemiplegic shoulder pain patients. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Adding a floss-band procedure with active shoulder movement to conventional physiotherapy improves shoulder pain and sleep quality in chronic hemiplegic shoulder pain patients.
This conclusion is most relevant to: Adults aged 30-55 years, at least 6 months post-stroke, with hemiplegic shoulder pain (VAS ≥3), restricted shoulder motion, active flexion and abduction ≥90°, and Modified Ashworth Scale score 0 (non-spastic)..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Effects of Adding a Floss-Band Procedure with Additional Active Shoulder Movement to Conventional Physiotherapy in Selected Patients with Chronic Hemiplegic Shoulder Pain: A Randomized Controlled Trial. (Journal of clinical medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Floss-band compression may reduce tissue tension and improve joint mobility.
- ▸Active shoulder movement during banding enhances range of motion and neuromuscular activation.
- ▸Additional treatment time and therapist interaction may contribute to placebo effects.
- ▸Result: Improved pain, function, and sleep quality.
Who Might Benefit
Evidence fit by population:
- ▸Adults aged 30-55 years, at least 6 months post-stroke, with hemiplegic shoulder pain (VAS ≥3), restricted shoulder motion, active flexion and abduction ≥90°, and Modified Ashworth Scale score 0 (non-spastic).
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸The experimental procedure included additional movement, treatment time, therapist interaction, and novelty, so the specific effect of tissue flossing or band compression cannot be isolated.
- ▸The study population was younger, higher-functioning, and non-spastic, limiting generalizability to broader stroke populations.
- ▸Only short-term outcomes were assessed; long-term effects are unknown.
Frequently Asked Questions
What is the floss-band procedure used in this study?▼
The floss-band procedure involves wrapping a floss band around the shoulder and performing active shoulder movements while the band is in place, as an adjunct to conventional physiotherapy.
How much improvement in shoulder pain was observed?▼
The experimental group showed a reduction in SPADI scores by 20.87 to 28.34 points compared to the control group, and VAS pain improved by 2.33 points on average.
Did the floss-band procedure improve sleep quality?▼
Yes, the PSQI score improved by 2.48 to 3.87 points in the experimental group compared to the control group, indicating better sleep quality.
Who can benefit from this treatment?▼
This study suggests benefit for younger, higher-functioning stroke patients with chronic hemiplegic shoulder pain who have no spasticity and at least 90° of active shoulder flexion and abduction.
References
- 1.Şevgin Ö, Uzun K, Safran E. “Effects of Adding a Floss-Band Procedure with Additional Active Shoulder Movement to Conventional Physiotherapy in Selected Patients with Chronic Hemiplegic Shoulder Pain: A Randomized Controlled Trial..” Journal of clinical medicine, 2026. PMID: 42589911 DOI: 10.3390/jcm15155807