Osteopathic Manual Treatment for Hemiplegic Shoulder Pain and Upper Extremity Function in Stroke Patients

Inclusion Criteria: * Patients must be at least 18 years or older to participate in the study * Presence of shoulder pain on the side of the body affected by stroke * Patients must have a diagnosis of a first-time stroke within the past 5 years * Stroke type must be subcortical, brainstem, and/or right-MCA stroke. Participants with multiple stroke types within the first-time diagnosis may be included Exclusion Criteria: * Presence of an active systemic or localized infection requiring antibiotic therapy * Presence of fracture in the area being treated * Presence of open wound in the area being treated * Presence of rheumatoid arthritis * Presence of known active malignancy * Presence of shoulder pain on the affected side within 3 months prior to stroke * Patients with left-MCA stroke diagnosis who demonstrate the presence of aphasia based on the Mississippi Aphasia Screening Test (MAST) * Patients who demonstrate hemispatial visual neglect based on screening motor-free visual perception test (MFVPT) * Patients already receiving any type of manual therapy by a certified therapist through their standard-of-care treatment * Patients who do not wish to participate * Patients who are not fit as judged by the study team * Patients who lack the capacity to consent for enrollment in the study based on the University of California San Diego Brief Assessment of Capacity to Consent