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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.

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.

Last updated: Aug 15, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. 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.

observational

Şevgin Ö, Uzun K, Safran E · Journal of clinical medicine (2026)

Participants: N/A
Duration: 6 weeks
Intervention: Floss-band procedure with additional active shoulder movement added to conventional physiotherapy, three times weekly for 6 weeks.
Outcome: Shoulder Pain and Disability Index (SPADI), Pittsburgh Sleep Quality Index (PSQI), Visual Analog Scale (VAS) pain, shoulder flexion, abduction, internal rotation, external rotation.
Effect Size: SPADI difference: -20.87 to -28.34 points; PSQI difference: -2.48 to -3.87 points; VAS difference: -2.33; flexion +32.68°, abduction +29.13°, internal rotation +16.35°, external rotation +15.95°.
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).

Result:

PubMed: 42589911DOI: 10.3390/jcm15155807

Mechanism Graph

Floss-band compression may reduce tissue tension and improve joint mobility.
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Active shoulder movement during banding enhances range of motion and neuromuscular activation.
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Additional treatment time and therapist interaction may contribute to placebo effects.
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Result: Improved pain, function, and sleep quality.

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.