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Robot-Assisted Therapy for Upper Limb Rehabilitation After Stroke: Umbrella Review

Background: Stroke is a leading cause of long-term upper limb disability, severely impacting patients’ independence and quality of life. Robot-assisted therapy (RAT) has emerged as a promising, high-intensity rehabilitation alternative. However, conclusions from existing systematic reviews on its efficacy are inconsistent and often lack a holistic framework, limiting their use for guiding personalized clinical decisions. Objective: This study aims to systematically synthesize recent evidence on RAT for upper limb rehabilitation after stroke. Guided by the International Classification of Functioning, Disability and Health framework, it moves beyond singular outcomes to provide a multidimensional evaluation across body function, activity, and participation levels. The review aims to provide stratified guidance for clinical decision-making based on patient- and intervention-specific characteristics, thereby supporting evidence-based practice and informing future research. Methods: This study included systematic reviews and meta-analyses published from January 1, 2019, to December 26, 2025, comparing RAT with conventional therapy for upper limb rehabilitation after stroke. Overall, 6 databases, including PubMed, Web of Science, and Embase, were searched. Two reviewers (XZ and LZ) independently performed study selection, data extraction, and quality assessment using the AMSTAR 2 tool. The synthesis integrated outcome measures and subgroup analyses derived from the included studies. Results: This umbrella review included 21 meta-analyses encompassing 535 randomized controlled trials and 27,598 patients across acute, subacute, and chronic stroke stages. According to AMSTAR 2, 17 reviews were high quality, 3 moderate, and 1 critically low. The synthesis demonstrated that RAT was superior in improving upper limb motor function, but no statistically significant advantages were observed in activities of daily living compared to conventional therapy. Subgroup analyses revealed that treatment effects were influenced by stroke stage, upper limb motor impairment level, and robot type. Conclusions: RAT is an effective intervention for improving upper limb motor function after stroke. However, its benefits are primarily observed at the level of body function, with limited evidence for long-term maintenance. The current evidence is constrained by significant outcome heterogeneity and methodological limitations inherent to umbrella reviews. Future research should validate these findings in broader clinical practice, focus on translating functional gains into sustained improvements in daily activities and participation, and include cost-effectiveness evaluations. Trial Registration: PROSPERO CRD42024497183; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024497183

Beyond Preset Identities: How Agents Form Stances and Boundaries in Generative Societies

arXiv:2603.23406v1 Announce Type: new Abstract: While large language models simulate social behaviors, their capacity for stable stance formation and identity negotiation during complex interventions remains unclear. To overcome the limitations of static evaluations, this paper proposes a novel mixed-methods framework combining computational virtual ethnography with quantitative socio-cognitive profiling. By embedding human researchers into generative multiagent communities, controlled discursive interventions are conducted to trace the evolution of collective cognition. To rigorously measure how agents internalize and react to these specific interventions, this paper formalizes three new metrics: Innate Value Bias (IVB), Persuasion Sensitivity, and Trust-Action Decoupling (TAD). Across multiple representative models, agents exhibit endogenous stances that override preset identities, consistently demonstrating an innate progressive bias (IVB > 0). When aligned with these stances, rational persuasion successfully shifts 90% of neutral agents while maintaining high trust. In contrast, conflicting emotional provocations induce a paradoxical 40.0% TAD rate in advanced models, which hypocritically alter stances despite reporting low trust. Smaller models contrastingly maintain a 0% TAD rate, strictly requiring trust for behavioral shifts. Furthermore, guided by shared stances, agents use language interactions to actively dismantle assigned power hierarchies and reconstruct self organized community boundaries. These findings expose the fragility of static prompt engineering, providing a methodological and quantitative foundation for dynamic alignment in human-agent hybrid societies. The official code is available at: https://github.com/armihia/CMASE-Endogenous-Stances

SARE: Sample-wise Adaptive Reasoning for Training-free Fine-grained Visual Recognition

arXiv:2603.17729v2 Announce Type: replace-cross Abstract: Recent advances in Large Vision-Language Models (LVLMs) have enabled training-free Fine-Grained Visual Recognition (FGVR). However, effectively exploiting LVLMs for FGVR remains challenging due to the inherent visual ambiguity of subordinate-level categories. Existing methods predominantly adopt either retrieval-oriented or reasoning-oriented paradigms to tackle this challenge, but both are constrained by two fundamental limitations:(1) They apply the same inference pipeline to all samples without accounting for uneven recognition difficulty, thereby leading to suboptimal accuracy and efficiency; (2) The lack of mechanisms to consolidate and reuse error-specific experience causes repeated failures on similar challenging cases. To address these limitations, we propose SARE, a Sample-wise Adaptive textbfREasoning framework for training-free FGVR. Specifically, SARE adopts a cascaded design that combines fast candidate retrieval with fine-grained reasoning, invoking the latter only when necessary. In the reasoning process, SARE incorporates a self-reflective experience mechanism that leverages past failures to provide transferable discriminative guidance during inference, without any parameter updates. Extensive experiments across 14 datasets substantiate that SARE achieves state-of-the-art performance while substantially reducing computational overhead.
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