arXiv:2512.14329v2 Announce Type: replace-cross Abstract: Dynamic prediction of locomotor capacity after stroke could enable more individualized rehabilitation, yet current assessments largely provide static impairment scores and do not indicate whether patients can perform specific tasks such as slope walking or stair climbing. Here, we present a wearable-informed data-physics hybrid generative framework that reconstructs a stroke survivor's locomotor control from wearable inertial sensing and predicts task-conditioned post-stroke locomotion in new environments. From a single 20 m level-ground walking trial recorded by five IMUs, the framework personalizes a physics-based digital avatar using a healthy-motion prior and hybrid imitation learning, generating dynamically feasible, patient-specific movements for inclined walking and stair negotiation. Across 11 stroke inpatients, predicted postures reached 82.2% similarity for slopes and 69.9% for stairs, substantially exceeding a physics-only baseline. In a multicentre pilot randomized study (n = 21; 28 days), access to scenario-specific locomotion predictions to support task selection and difficulty titration was associated with larger gains in Fugl-Meyer lower-extremity scores than standard care (mean change 6.0 vs 3.7 points; $p

arXiv:2512.14329v1 Announce Type: cross Abstract: Dynamic prediction of locomotor capacity after stroke is crucial for tailoring rehabilitation, yet current assessments provide only static impairment scores and do not indicate whether patients can safely perform specific tasks such as slope walking or stair climbing. Here, we develop a data-physics hybrid generative framework that reconstructs an individual stroke survivor's neuromuscular control from a single 20 m level-ground walking trial and predicts task-conditioned locomotion across rehabilitation scenarios. The system combines wearable-sensor kinematics, a proportional-derivative physics controller, a population Healthy Motion Atlas, and goal-conditioned deep reinforcement learning with behaviour cloning and generative adversarial imitation learning to generate physically plausible, patient-specific gait simulations for slopes and stairs. In 11 stroke survivors, the personalized controllers preserved idiosyncratic gait patterns while improving joint-angle and endpoint fidelity by 4.73% and 12.10%, respectively, and reducing training time to 25.56% relative to a physics-only baseline. In a multicentre pilot involving 21 inpatients, clinicians who used our locomotion predictions to guide task selection and difficulty obtained larger gains in Fugl-Meyer lower-extremity scores over 28 days of standard rehabilitation than control clinicians (mean change 6.0 versus 3.7 points). These findings indicate that our generative, task-predictive framework can augment clinical decision-making in post-stroke gait rehabilitation and provide a template for dynamically personalized motor recovery strategies.