Thoracic Spinal Manipulation in Stroke

Inclusion Criteria: * Having chronic stroke, * A Mini-Mental State Examination score of 24 or higher, * Ability to stand independently for 20 seconds or more, * Ability to walk independently for 10 meters, using assistive devices or orthoses if necessary, * Being between 40 and 75 years of age, * Having a Brunnstrom stage of 4 or above Exclusion Criteria: * History of whiplash injury, * Diagnosis of fibromyalgia, * History of spinal manipulation treatment within the previous 2 months, * History of cervical or thoracic fracture or dislocation, * History of cervical or thoracic spine surgery, * Diagnosis of cervical radiculopathy or myelopathy, * Presence of serious spinal pathology, * Presence of any orthopedic or neurological disorder other than stroke, or an unstable cardiac condition, * Presence of a vestibular disorder, * The presence of lower extremity ulceration or amputation, * Alcohol consumption in the last 24 hours, * Posterior circulation stroke involving the basilar artery or cerebellum, * Having experienced an acute lower extremity injury in the last six weeks, * History of lower extremity surgery