Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors

Background: Lokomat-assisted robotic rehabilitation is increasingly used for gait restoration in patients with spinal cord injury (SCI). However, the objective evaluation of treatment effectiveness through biomechanical parameters and machine learning approaches remains underexplored. Methods: This...

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Main Authors: Alexandru Bogdan Ilies, Cornel Cheregi, Hassan Hassan Thowayeb, Jan Reinald Wendt, Maur Sebastian Horgos, Liviu Lazar
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/7/752
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author Alexandru Bogdan Ilies
Cornel Cheregi
Hassan Hassan Thowayeb
Jan Reinald Wendt
Maur Sebastian Horgos
Liviu Lazar
author_facet Alexandru Bogdan Ilies
Cornel Cheregi
Hassan Hassan Thowayeb
Jan Reinald Wendt
Maur Sebastian Horgos
Liviu Lazar
author_sort Alexandru Bogdan Ilies
collection DOAJ
description Background: Lokomat-assisted robotic rehabilitation is increasingly used for gait restoration in patients with spinal cord injury (SCI). However, the objective evaluation of treatment effectiveness through biomechanical parameters and machine learning approaches remains underexplored. Methods: This study analyzed data from 29 SCI patients undergoing Lokomat-based rehabilitation. A dataset of 46 variables including range of motion (L-ROM), joint stiffness (L-STIFF), and muscular force (L-FORCE) was examined using statistical methods (paired <i>t</i>-test, ANOVA, and ordinary least squares regression), clustering techniques (k-means), dimensionality reduction (t-SNE), and anomaly detection (Isolation Forest). Predictive modeling was applied to assess the influence of age, speed, body weight, body weight support, and exercise duration on biomechanical outcomes. Results: No statistically significant asymmetries were found between left and right limb measurements, indicating functional symmetry post-treatment (<i>p</i> > 0.05). Clustering analysis revealed a weak structure among patient groups (Silhouette score ≈ 0.31). Isolation Forest identified minimal anomalies in stiffness data, supporting treatment consistency. Regression models showed that body weight and body weight support significantly influenced joint stiffness (<i>p</i> < 0.01), explaining up to 60% of the variance in outcomes. Conclusions: Lokomat-assisted robotic rehabilitation demonstrates high functional symmetry and biomechanical consistency in SCI patients. Machine learning methods provided meaningful insight into the structure and predictability of outcomes, highlighting the clinical value of weight and support parameters in tailoring recovery protocols.
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spelling doaj-art-bef831cf41be4ac7a1bcc880554f0ec52025-08-20T02:45:37ZengMDPI AGBioengineering2306-53542025-07-0112775210.3390/bioengineering12070752Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive FactorsAlexandru Bogdan Ilies0Cornel Cheregi1Hassan Hassan Thowayeb2Jan Reinald Wendt3Maur Sebastian Horgos4Liviu Lazar5Faculty of Medicine and Pharmacy, University of Oradea, Str. Piata 1 Decembrie nr. 10, 410087 Oradea, RomaniaFaculty of Medicine and Pharmacy, University of Oradea, Str. Piata 1 Decembrie nr. 10, 410087 Oradea, RomaniaSocial Studies Department, King Faisal University, Hofuf 31982, Saudi ArabiaSzpital Św. Wincentego a Paulo w Gdyni, ul. Wójta Radtkego 1, 81-348 Gdynia, PolandFaculty of Medicine and Pharmacy, University of Oradea, Str. Piata 1 Decembrie nr. 10, 410087 Oradea, RomaniaFaculty of Medicine and Pharmacy, University of Oradea, Str. Piata 1 Decembrie nr. 10, 410087 Oradea, RomaniaBackground: Lokomat-assisted robotic rehabilitation is increasingly used for gait restoration in patients with spinal cord injury (SCI). However, the objective evaluation of treatment effectiveness through biomechanical parameters and machine learning approaches remains underexplored. Methods: This study analyzed data from 29 SCI patients undergoing Lokomat-based rehabilitation. A dataset of 46 variables including range of motion (L-ROM), joint stiffness (L-STIFF), and muscular force (L-FORCE) was examined using statistical methods (paired <i>t</i>-test, ANOVA, and ordinary least squares regression), clustering techniques (k-means), dimensionality reduction (t-SNE), and anomaly detection (Isolation Forest). Predictive modeling was applied to assess the influence of age, speed, body weight, body weight support, and exercise duration on biomechanical outcomes. Results: No statistically significant asymmetries were found between left and right limb measurements, indicating functional symmetry post-treatment (<i>p</i> > 0.05). Clustering analysis revealed a weak structure among patient groups (Silhouette score ≈ 0.31). Isolation Forest identified minimal anomalies in stiffness data, supporting treatment consistency. Regression models showed that body weight and body weight support significantly influenced joint stiffness (<i>p</i> < 0.01), explaining up to 60% of the variance in outcomes. Conclusions: Lokomat-assisted robotic rehabilitation demonstrates high functional symmetry and biomechanical consistency in SCI patients. Machine learning methods provided meaningful insight into the structure and predictability of outcomes, highlighting the clinical value of weight and support parameters in tailoring recovery protocols.https://www.mdpi.com/2306-5354/12/7/752spinal cord injuryLokomatrobotic rehabilitationbiomechanical symmetrymachine learninggait training
spellingShingle Alexandru Bogdan Ilies
Cornel Cheregi
Hassan Hassan Thowayeb
Jan Reinald Wendt
Maur Sebastian Horgos
Liviu Lazar
Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
Bioengineering
spinal cord injury
Lokomat
robotic rehabilitation
biomechanical symmetry
machine learning
gait training
title Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
title_full Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
title_fullStr Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
title_full_unstemmed Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
title_short Lokomat-Assisted Robotic Rehabilitation in Spinal Cord Injury: A Biomechanical and Machine Learning Evaluation of Functional Symmetry and Predictive Factors
title_sort lokomat assisted robotic rehabilitation in spinal cord injury a biomechanical and machine learning evaluation of functional symmetry and predictive factors
topic spinal cord injury
Lokomat
robotic rehabilitation
biomechanical symmetry
machine learning
gait training
url https://www.mdpi.com/2306-5354/12/7/752
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