Inclusion Criteria- diagnosis of shoulder pain secondary to altered alignment and/or neuro-muscular movement patterns post-stroke;
- medically stable and 2-24 months post onset of stroke;
- between stages of 2-5 of the Chedoke-McMaster stages of upper extremity motor recovery;
- not currently receiving any other active neuro-rehabilitation intervention to promote stroke recovery;
- cognitively able to provide informed consent, follow specific testing commands, and communicate their level of pain during assessment and treatment.
Exclusion Criteria- a history of shoulder pain prior to the onset of the stroke;
- shoulder pain which is secondary to any history of trauma, fractures, arthritis or joint instability of the neck, spine, ribs, or shoulder girdle before or after the stroke; possible rotator cuff tears;
- shoulder-hand syndrome; thalamic or central pain; spinal cord pathology; osteoporosis;
- any medical condition which may affect the ability to participate in an active rehabilitation exercise program (i.e., uncontrolled hypertension or angina).