# Sensor-Derived Trunk Stability and Gait Recovery: Evidence of Neuromechanical Associations Following Intensive Robotic Rehabilitation

## TL;DR

This study shows that improved trunk stability during robotic rehabilitation is strongly linked to better gait recovery in neurological patients.

## Contribution

The study identifies trunk stability as a key biomechanical driver of gait recovery in neurological rehabilitation.

## Key findings

- Trunk flexion–extension and lateral flexion were strongly correlated with gait speed, stride length, and cadence.
- Robotic rehabilitation significantly improved hip and trunk kinematics in neurological patients.
- Sensor-derived trunk stability metrics serve as a biomarker for functional gait recovery.

## Abstract

What are the main findings?
Sensor-derived trunk stability metrics were strongly correlated with improvements in gait speed, stride length, and rhythm after intensive robotic rehabilitation.Enhanced proximal trunk control emerged as a key biomechanical driver of lower-limb coordination and overall gait recovery in neurological patients.

Sensor-derived trunk stability metrics were strongly correlated with improvements in gait speed, stride length, and rhythm after intensive robotic rehabilitation.

Enhanced proximal trunk control emerged as a key biomechanical driver of lower-limb coordination and overall gait recovery in neurological patients.

What are the implications of the main findings?
Objective sensor-based assessment of trunk stability can serve as a biomarker of functional recovery and guide individualized rehabilitation strategies.Integrating trunk stability monitoring into robotic rehabilitation systems may enhance the precision and effectiveness of neurological gait restoration.

Objective sensor-based assessment of trunk stability can serve as a biomarker of functional recovery and guide individualized rehabilitation strategies.

Integrating trunk stability monitoring into robotic rehabilitation systems may enhance the precision and effectiveness of neurological gait restoration.

This quantitative observational study with pre–post design aimed to examine joint-specific kinematic adaptations and the relationship between trunk stability and spatiotemporal gait parameters following intensive robotic rehabilitation. A total of 12 neurological patients completed 16 sessions of gait training using the Tecnobody Smart Gravity Walker. Pre- and post-training kinematic data were collected for bilateral hip and knee flexion–extension, trunk flexion–extension, trunk lateral flexion, and center-of-gravity displacement. Waveforms were normalized to 100% stride. Paired t-tests assessed pre–post differences, and correlations examined associations between trunk stability and gait performance. Significant increases were found in right hip flexion–extension (t = 3.44, p < 0.001), trunk flexion–extension (t = 9.49, p < 0.001), and center-of-gravity displacement (t = 15.15, p < 0.001), with reduced trunk lateral flexion (t = –8.64, p < 0.001). Trunk flexion–extension correlated with gait speed (r = 0.74), step length (r = 0.68), and stride length (r = 0.71); trunk lateral flexion correlated with cadence (r = 0.66) and stride length (r = 0.70). Intensive robotic rehabilitation improved trunk and hip kinematics, supporting trunk stability as an important biomechanical correlate of gait recovery. Sensor-derived metrics revealed strong neuromechanical coupling between postural control and locomotion in neurological patients.