Rehabilitation studies that have been conducted during the acute stroke phase suggest that a change of 6 to 7 points (or 10%) in the Fugl-Meyer score is clinically meaningful because it advances the patient to the next stage of motor recovery.30,31 However, the magnitude of change in the Fugl-Meyer score that is necessary to produce real-world effects for patients during long-term recovery may be smaller, especially for those with severe impairment. The improvements that were detected over a period of 36 weeks in our study provide evidence of potential long-term benefits of rehabilitation and challenge the widely held clinical belief that gains in motor function are not possible for long-term stroke survivors.30 Moreover, the gains made by patients in the two active-treatment groups that were apparent during the 36-week study period may have occurred as incremental motor improvement was incorporated into the patient's daily routine.