Valutazione cinematica e cinetica di laboratorio in popolazioni sane e speciali

Traditional biomechanical assessments often rely on single-parameter or maximal outcome measures, which may limit the ability to describe neuromuscular control strategies, coordination patterns, and functional adaptations. This thesis hypothesized that assessment approaches using dynamic tasks, bilateral execution, and the integration of kinetic, kinematic, and electromyographic variables provide a more sensitive and functionally meaningful evaluation of human movement in clinical and athletic populations. A series of experimental studies was conducted in individuals with autism spectrum disorder (ASD), persons with multiple sclerosis (PwMS), athletes after anterior cruciate ligament reconstruction (ACL-R), rhythmic gymnastics athletes, volleyball players, and longitudinal case studies. Postural control was assessed using static and dynamic balance tasks under unilateral and bilateral conditions, with synchronized center of pressure and surface electromyography recordings. Locomotion was evaluated through angle–angle diagrams synchronized with EMG to examine inter-joint coordination and neuromuscular organization. Neuromuscular performance was assessed via force–time profile analysis during strength and jump tasks, including unilateral and bilateral maximal voluntary isometric contractions (MVC), handgrip assessments, and bilateral Drop Vertical Jump evaluations. Reliability was quantified using intraclass correlation coefficients (ICC), and sensitivity and specificity using Receiver Operating Characteristic (ROC) analysis, alongside inferential statistics for between-group and task-related differences. Dynamic balance tasks, especially under bilateral conditions, were more sensitive than static or unilateral assessments in detecting postural and neuromuscular alterations (p < 0.05), with high reliability in bilateral dynamic conditions (ICC = 0.86–0.95). Angle–angle diagrams synchronized with EMG showed high sensitivity and specificity in identifying gait coordination alterations in ASD and PwMS (ROC AUC = 94.4%), revealing changes not captured by conventional kinematic metrics (p < 0.05). Longitudinal observations confirmed that these integrated measures detect gradual functional adaptations. Force–time profile analysis demonstrated that bilateral MVC tests were more sensitive and reliable (ICC = 0.89–0.94) than unilateral tests in detecting subtle neuromuscular alterations (p < 0.05) and highlighted phase-specific asymmetries and compensatory strategies during drop vertical jump and strength tasks (p < 0.05). These findings support integrated, task-specific biomechanical assessments as methodological proposals for accurately describing and interpreting neuromuscular strategies, alterations, and adaptations, beyond traditional measures. Such approaches provide flexible, context-dependent frameworks applicable across a continuum from clinical to healthy populations, offering a solid basis for individualized functional assessment, rehabilitation planning, performance monitoring, and future developments in biomechanical assessment.