This comprehensive review aims to systematically synthesize the current evidence on the application of biomechanical technologies across the spectrum of rheumatic diseases. It seeks to evaluate how these technologies contribute to the objective assessment of pathomechanics, inform computational modeling of joint function, and guide the development of targeted, biomechanically-informed therapeutic interventions. The ultimate goal is to assess the validity and clinical utility of these approaches in improving patient-centered outcomes such as physical function, fall risk, and quality of life.

A broad synthesis of the literature was conducted, focusing on peer-reviewed studies that employ biomechanical assessment technologies and interventions in rheumatic diseases. The review examines instrumented measures of tissue properties, advanced imaging modalities, functional testing protocols, and three-dimensional gait analysis. It also critically evaluates computational models, particularly finite element analysis, used to simulate joint contact mechanics and the biomechanics of inflammation. Furthermore, the review synthesizes evidence on the efficacy of rehabilitation strategies, including resistance training, aquatic therapy, orthotics, and proprioceptive training—that are grounded in biomechanical principles. The analysis links these objective measures to clinical and patient-centered outcomes, addressing methodological challenges and clinical translation.

Biomechanical technologies provide objective, quantifiable data that strongly correlate with disease activity, structural progression, and functional outcomes. Instrumented measures like the MyotonPRO and shear wave elastography reliably detect alterations in muscle and tendon stiffness in conditions such as rheumatoid arthritis and ankylosing spondylitis, with changes linked to disease duration and physical function. Advanced imaging, including MRI-based scoring and displacement-encoded techniques, quantifies synovitis, bone edema, and tissue strain, revealing biomechanical stiffening that correlates with clinical measures. Finite element models demonstrate that rheumatoid arthritis leads to significantly increased joint stress and displacement compared to healthy joints, providing a mechanistic basis for orthotic design and surgical planning. Biomechanical parameters, such as reduced gait speed and muscle weakness, are strong predictors of falls and disability. Rehabilitation interventions based on these principles, including maximal strength training and aquatic therapy, significantly improve muscle strength, physical function, and health-related quality of life without exacerbating disease activity.

The integration of biomechanical technologies into rheumatology provides a robust framework for personalized management by enabling precise quantification of functional impairments and pathomechanical drivers. These tools offer critical insights that complement traditional clinical assessments and inform targeted therapeutic strategies. However, standardization of protocols, validation of computational models, and effective clinical translation remain significant challenges. Future directions should focus on emerging technologies such as wearable sensors, multi-scale modeling, and artificial intelligence to enhance predictive accuracy, enable continuous monitoring, and facilitate the delivery of individualized, biomechanically-informed care to improve long-term patient outcomes.