Stroke is a leading cause of long- term disability in the United States, affecting an estimated 6.4 million Americans. Long-term disability is often associated with per- sistent impairment of an upper limb.2 Despite the development of many programs for recovery after stroke, the effectiveness of rehabilitation in im- proving functioning and quality of life for patients with deficits more than 6 months after a stroke has not been definitively shown. Robotic reha- bilitation devices have the potential to deliver high- intensity, reproducible therapy. Advances in robot- ics and an increased understanding of the latent neurologic potential for stroke recovery led to our initiation of this multicenter, randomized, con- trolled trial, called the Veterans Affairs (VA) Ro- botic-Assisted Upper-Limb Neurorehabilitation in Stroke Patients study, to determine whether a reha- bilitation protocol using the MIT–Manus robotic system (Interactive Motion Technologies),3 as com- pared with a program based on conventional re- habilitative techniques or usual care, could im- prove functioning and quality of life of stroke survivors with long-term upper-limb deficits.