Inclusion Criteria:  Adult and stroke patients (≥ 20 year old). All the participants were those visiting the department of physical medicine and rehabilitation for musculoskeletal complaints.  Exclusion Criteria:  History of malignancy Uncontrolled medical conditions (like systemic rheumatic disease, including rheumatic arthritis and ankylosing spondylitis). Previous major trauma or surgeries, and suprascapular nerve block on either side of the shoulders within the three months. The patients with specific aphasia and poor cognition.