Individualized Exercise Prescription With a Data-driven Approach in Individuals With Stroke

Seventeen wearable sensors (Inertial Measurement Units, IMUs) were attached to the participants' bodies in accordance with the Xsens user manual to collect kinematic data. The extracted data included the pelvis tilt angle (°), oblique angle (°), and rotation angle (°); hip flexion angle (°) and abduction angle (°); knee bending angle (°); as well as ankle flexion angle (°) and abduction angle (°), which were used for further analysis. These data were converted into standardized gait cycles (101 time points) for statistical parametric mapping (SPM1D) analysis, and the deviation time from the normal reference was compared to determine whether there were changes in deviation timing before and after the treatment.

Twelve Electromyography (EMG) sensors were placed on the left and right sides of the gluteus maximus, gluteus medius, quadriceps, hamstrings, tibialis anterior, and gastrocnemius muscles to measure Maximum Voluntary Contraction (MVC). In addition, the timing of each muscle activiation during gait cycle will be extracted to compared before and after training. This includes identifying the onset (activation start) and offset (activation end) of each muscle relative to specific phases of the gait cycle, such as the stance and swing phases.

The lower extremity motor subscale of the Fugl-Meyer assessment (FMA-LE) was used to measure the level of lower extremity motor recovery after stroke. Quality of reflexes, coordination and voluntary movements of the paretic leg was assessed using a 0-to-34-point scale. Higher FMA-LE score indicated a better level of motor recovery.

Berg Balance Scale (BBS) was adopted to measure functional balance performance. The scale consists of 14 items, each rating a participant's ability to maintain stability in a specified functional task on a 5 point (0-4) scale. The maximal score of BBS is 56 and minimum is 0, with a higher score indicating better balance performance.

The Chinese version of the subjective Index of physical and Social Outcome (SIPSO) questionnaire assesses the extent to which individuals with disabilities are able to function physically and socially to their own satisfaction. It is a 5 point (0-4) scale, the maximal score of SIPSO is 40 and minimum score is 0, with a higher score indicating better physical and social integration.

The Short Physical Performance Battery (SPPB) is a tool used to assess lower extremity function and physical performance in older adults. It includes three components:

Balance Tests: Measures ability to maintain balance in different stances. Gait Speed: Assesses walking speed over a short distance. Chair Stand Test: Evaluates leg strength by timing how quickly one can stand from a seated position multiple times.

The maximum score is 12 and the minimum score is 0, a higher score indicates better physical performance and functional ability.

The Trunk Impairment Scale (TIS) is an assessment tool used to evaluate trunk control and stability. It is primarily used for individuals with neurological conditions, such as stroke. The scale measures:

Static Sitting Balance: Ability to maintain a stable sitting position. Dynamic Sitting Balance: Ability to maintain balance while moving. Coordination: Assesses coordinated trunk movements. It has a maximum score of 23 and minimum score of 0. The higher the score, the better the trunk control, stability, and coordination.

ABILOCO is a questionnaire designed to assess locomotion and daily-life ability in individuals. It evaluates a person's capacity to perform various mobility tasks, ranging from simple to complex. The ABILOCO scale typically ranges from a minimum score of 0 to a maximum score of 59, where higher scores indicate better locomotion ability and greater independence in performing mobility tasks.

The Timed Up and Go (TUG) test was used to assess functional mobility, balance, and fall risk. Participants were instructed to stand up from a standard chair (45cm-height), walk a distance of 3 meters, turn around, walk back to the chair, and sit down. The total time taken to complete the task was recorded in seconds using a stopwatch. A shorter completion time indicates better functional mobility, while longer times may reflect impaired mobility or increased fall risk.