A perspective on neuromechanical biomarkers for neurorehabilitation: towards reliable assessment in research and clinical practice

Effective neurorehabilitation necessitates a reliable assessment of the patient’s sensorimotor status. Such assessment guides clinical decision-making and supports the evaluation of novel interventions. Yet, despite technological progress, it remains limited to clinical scales that are mostly based on subjective scoring systems and measurement protocols with poor reproducibility. Research on neuromechanical biomarkers—metrics of movement derived from kinematic, kinetic and physiological data—has demonstrated significant potential to advance towards more reliable assessment. However, their clinical validation and practical adoption remain limited, impeding the development of more objective, standardized, and clinically relevant measurement of movement. This article consolidates expert perspectives from a multidisciplinary workshop held at the 2024 International Conference on NeuroRehabilitation in La Granja (Spain), focusing on the development of reliable assessment tools useful in clinical practice. The emerging central topic is the urgent need for assessment tools that are grounded in validated measurements. To address this, we structure the discussion around three pillars: standardization, to ensure methodological consistency; transferability, to support generalization across populations and technologies; and shareability, to enable collaboration, validation, and scaling. For each pillar, we outline current challenges and potential steps towards them, proposing a roadmap for developing assessment frameworks that are suitable for real-world use.