Participants undergoing reverse shoulder arthroplasty will receive a standard conventional rehabilitation program starting at postoperative 6 th week . The patient will receive treatment 5 days a week for 6 weeks, for a total of 30 sessions. The program consists of passive, active-assisted, and active/resisted exercises.

Exercises Included:

Passive / Assisted

• Scapular mobilization
• Scapular clock
• Passive external rotation with a stick Passive → Active-Assisted
• Active-assisted flexion and abduction with a stick
• Glenohumeral joint mobilization Active / Light Resistance
• Scapular retraction
• Light-resistance strengthening of biceps, triceps, and serratus anterior using a theraband Active / Resistance
• Theraband-based resisted biceps, triceps, and serratus anterior strengthening
• Continuation of glenohumeral mobilization
• Flexion and abduction above 90°
• Posterior capsule stretching

Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period.

Additional Exercises:

Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise

After randomization and baseline assessments, participants will undergo a standard 6-week postoperative shoulder rehabilitation program, consisting of range-of-motion exercises, scapular stabilization training, and progressive strengthening. No additional depressor muscle-specific exercises will be applied.

Pain intensity will be assessed using the Visual Analog Scale, a 10-cm line ranging from "no pain" to "worst imaginable pain." The distance from the "no pain" anchor to the participant's mark will be measured in millimeters (0-100 mm), with higher scores indicating higher pain intensity.

The DASH is a 30-item self-administered questionnaire assessing upper-extremity functional limitations. Items are scored 1-5 and converted to a 0-100 scale, where higher scores indicate greater disability.

Active shoulder flexion, abduction, external rotation, and internal rotation will be measured using a standard goniometer. Results will be recorded in degrees (°).

The ASES score includes pain and functional assessments, yielding a total score between 0 and 100. Higher scores represent better shoulder function.