Effects of 3D Shoulder Mobilization Compared to Passive-Active Exercises on Pain and Arm Function in Post-Stroke Hemiplegic Shoulder Pain

Dewi Suci Mahayati (Department of Physiotherapy, Faculty of Health Sciences, Universitas 'Aisyiyah Yogyakarta, Indonesia)
Noor Sadhono Kurniaji (Department of Physiotherapy, Faculty of Health Sciences, Universitas 'Aisyiyah Yogyakarta, Indonesia)

FISIO MU: Physiotherapy Evidences
Vol. 7 No. 3 (2026): Movement to Recovery: Contemporary Physiotherapy in Practice

Introduction: Hemiplegic Shoulder Pain (HSP) is a common musculoskeletal complication in post-stroke patients and significantly restricts rehabilitation and functional independence. 3D shoulder mobilization is an intervention currently being developed to address pain and improve arm function compared to conventional passive-active shoulder exercises. Both interventions have been widely used clinically, but no studies have compared their effectiveness. To investigate the effects of 3D shoulder mobilization and passive-active shoulder exercises on pain relief and arm functional ability in post-stroke patients. Methods: This study used an experimental design. A purposive random sampling technique was used to select participants, with the sample size determined based on previous literature. Participants were randomly allocated into two groups. Interventions were administered six times over a 3-week period. Functional ability and pain intensity were measured using the Visual Analog Scale (VAS) and Shoulder Pain and Disability Index (SPADI) questionnaires before (pretest) and after (post-test) the intervention. Within-group differences (pretest vs. post-test) were analyzed using the Wilcoxon signed-rank test, while between-group differences were analyzed using the Mann-Whitney U test. Results: The statistical test results for each group showed a significant decrease in pain intensity and an increase in functional ability. Result for the Intervention Group are VAS p=0.001; SPADI pain scale p=0.001; and SPADI disability scale p=0.007 and for the Control Group are VAS p=0.001; SPADI pain scale p=0.001; and SPADI disability scale p=0.011. Comparison of the two groups showed equivalent results in both post-intervention groups, with no statistically significant differences in results between the Intervention Group and the Control Group (VAS p=0.063; SPADI pain scale p=0.134; and SPADI disability scale p=0.340). Conclusion: 3D shoulder mobilization and passive-active shoulder exercises are both effective in reducing post-stroke HSP in the short term. However, a 3-week (6-session) intervention is not sufficient to provide significant functional improvements in the arm.