Open kinetic chain activity will involve Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns from the Proprioceptive Neuromuscular Facilitation (PNF). During the application, participants will lie on their back, and the pattern will be initiated from the opposite direction of the targeted movement. Participants will be encouraged to perform the movement as actively as possible. Assistance will be provided if the participant cannot complete the pattern. No other PNF techniques will be applied. Both patterns will be practiced for 10 repetitions. Resting periods will be provided as needed to prevent fatigue. The entire application is planned to last approximately 5 minutes.

For closed kinetic chain activity of the upper extremity, an activity involving weight shifting onto the hands on a table while standing with the elbows in extension will be used. Participants will be asked to shift weight onto the hemiplegic upper extremity for 30 seconds. After a 30-second rest period, the weight shifting will be repeated for a second time.

PNF Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns will be actively performed on the hemiplegic upper extremity.

This device is a patented, certified, digital measurement device that measures the amount of tissue displacement that occurs per unit force applied by a probe pressed perpendicularly to the skin overlying the muscle. It measures the viscoelastic properties of the muscles. Latissimus Dorsi will be measured from a point 5 cm above the lower corner of the scapula with the shoulder in 80 flexion. Pectoralis Major will be measured three-quarters of the way from the line between the sternum and the nodule prominence. Measurement of the Biceps Brachii and Brachioradialis muscles will be made from the most swollen points of the muscles. For measurement of the Flexor Carpi Radialis muscle, patients will be taken supine, with the forearm supinated and the elbow approximately 40 degrees flexed, at the one-third (approximately) point of the distance between the elbow line and the lateral side of the ulnar styloid. All measurements will be repeated 3 times and the average will be calculated.

It is a standardized assessment used to measure upper extremity motor dexterity. It involves moving blocks from one side of a box to the other within a minute. It is a clinic-friendly standardized assessment that is portable, easy to obtain, simple to administer, and can be administered quickly without a specific setting.

Upper extremity spasticity level of participants will be evaluated with the Modified Ashworth Scale (MAS). In the MAS evaluation, participants were in a supine position, with the arms next to the body and the shoulder in slight abduction. Shoulder adductors, elbow flexors and wrist flexors will be assessed.