Somatic Dysfunction in Patients With Acute Cerebrovascular Disease

Inclusion Criteria: * adults ≥18 years Admission diagnosis: * ischemic stroke OR * transient ischemic attack (TIA). A prior history of TIA but without stroke may be enrolled. * Neurologic stability or lack of significant deterioration (i.e. ∆ NIHSS\<4) for at least 24 hours (defined by clinical documentation and/or communication with provider team(s)) in stroke subjects * Able to sit upright, lie supine, and when able lateral recumbent left/right positions with assist independently or with minimal person assist * Anticipated length of stay greater \> or = 2 days for ischemic stroke. TIA patients average length of stay is \< 2 days, and can be enrolled in the study. Exclusion Criteria: * Acute skeletal fracture or known dislocation; history of pathologic (osteoporotic or neoplastic) skeletal fracture of thoracic cage, hip/pelvis/sacrum, or vertebral column * Prior history of ICH, ischemic stroke, confirmed by imaging and/or clinical evaluation. Patients with imaging showing "chronic stroke" who have never received a diagnosis of stroke and/or have not been previously symptomatic may still be enrolled, based on the Investigator's clinical judgement. * Spinal column support brace (e.g. cervical collar) * Anticipated neurosurgical intervention during hospitalization: decompressive hemicraniectomy, hematoma evacuation (defined by clinical documentation and/or communication with provider team(s)) * Current endotracheal intubation (\*note: extubated patients can be evaluated for eligibility) * History of spinal cord injury with residual neuromuscular or sensory disability * History of recent trauma within the past 30 days * Known ligament, musculotendinous, or bone lesion * Clinical condition that would interfere with execution of movement or palpatory diagnostic testing, e.g. chronic pain * History of spinal surgery