This multicenter, randomized, controlled trial evaluated the effectiveness of robot-assisted therapy for patients with long-term (6 months or more) moderate-to-severe upper-limb impairment after a stroke. The study involved 127 patients, randomly assigned to receive either intensive robot-assisted therapy, intensive comparison therapy, or usual care. The primary outcome was motor function improvement measured by the Fugl-Meyer Assessment at 12 weeks, while secondary outcomes included scores on the Wolf Motor Function Test and the Stroke Impact Scale. At 12 weeks, robot-assisted therapy did not significantly improve motor function compared to usual care or intensive comparison therapy, but it showed significant improvement in the Stroke Impact Scale scores. Secondary analyses over 36 weeks revealed that robot-assisted therapy significantly improved Fugl-Meyer scores and Wolf Motor Function Test times compared to usual care, but not to intensive comparison therapy. The study concluded that while robot-assisted therapy did not provide significant short-term benefits, it showed potential long-term benefits in improving motor function and quality of life for patients with long-term upper-limb impairments after stroke.This multicenter, randomized, controlled trial evaluated the effectiveness of robot-assisted therapy for patients with long-term (6 months or more) moderate-to-severe upper-limb impairment after a stroke. The study involved 127 patients, randomly assigned to receive either intensive robot-assisted therapy, intensive comparison therapy, or usual care. The primary outcome was motor function improvement measured by the Fugl-Meyer Assessment at 12 weeks, while secondary outcomes included scores on the Wolf Motor Function Test and the Stroke Impact Scale. At 12 weeks, robot-assisted therapy did not significantly improve motor function compared to usual care or intensive comparison therapy, but it showed significant improvement in the Stroke Impact Scale scores. Secondary analyses over 36 weeks revealed that robot-assisted therapy significantly improved Fugl-Meyer scores and Wolf Motor Function Test times compared to usual care, but not to intensive comparison therapy. The study concluded that while robot-assisted therapy did not provide significant short-term benefits, it showed potential long-term benefits in improving motor function and quality of life for patients with long-term upper-limb impairments after stroke.