ORTHOPAEDIC MANUAL PHYSICAL THERAPY FOR POST-STROKE SHOULDER PAIN: TWO CASE REPORTS INCLUDING CLINICAL ASSESSMENTS AND PARTICIPANTS' EXPERIENCES.

Objective: To descriptively evaluate Orthopaedic Manual Physical Therapy - a novel intervention for post-stroke shoulder pain - by use of clinical assessments and the participants' experiences. Design: Two case reports. Methods: Two individuals with mild to moderate upper extremity impairments and persistent post-stroke shoulder pain, underwent Orthopaedic Manual Physical Therapy for 12 weeks. The intervention comprised a thorough clinical examination, joint mobilization, stretching, and exercises targeting the affected structures and incorrect movement patterns. Participants were clinically assessed pre- and post-intervention and followed up 4-5 months later. They also answered interviews about their experiences of the intervention and perceived effects. Results: After Orthopaedic Manual Physical Therapy, both participants showed decreased pain intensity during movements and increased range of motion. One of the participants also experienced decreased resistance to passive movements, improved motor function, grip strength, and upper extremity daily activities after the intervention and at follow-up. Interviews revealed that the participants tolerated the therapy well and were satisfied with the intervention and long-lasting results. Conclusion: Orthopaedic Manual Physical Therapy may be a useful method to reduce post-stroke shoulder pain in persons with mild to moderate upper extremity paresis after stroke. To confirm the results, further studies are warranted.