Dose, Intensity, and Adherence: The Unsolved Core of Rehabilitation Interventions

Rehabilitation science encompasses diverse modalities—movement, cognitive, hearing, vocal, and mental—each designed to restore function and improve quality of life. Yet, across disciplines, one core question remains unresolved: how much, how often, how hard, and for how long should interventions be applied to achieve optimal outcomes? Despite years of clinical research, effect sizes vary widely even among trials using comparable protocols, underscoring a persistent lack of understanding of dose-response relationships. Recent studies have begun to explore adaptive and individualized dosing strategies, while advances in wearable sensors, digital records, and data-driven approaches now allow objective measurement of treatment exposure. However, standardization of intensity metrics, challenges in patient adherence, and fragmentation across modalities continue to impede translation into routine practice. A coordinated effort is needed to define, measure, and optimize dose as a scientifically grounded variable in rehabilitation.This Research Topic aims to advance the understanding of dose, intensity, and adherence as central determinants of rehabilitation efficacy. It seeks contributions that tackle the dose-response problem through pragmatic and methodological innovation—ranging from dose-finding and dose-escalation trials to adaptive designs and platform studies. The goal is to clarify how therapeutic “exposure” interacts with biological mechanisms such as neuroplasticity, motor learning, and behaviour change, ultimately shaping patient recovery trajectories. By integrating mechanistic insights with robust trial methodologies, this Research Topic aspires to foster reproducible, evidence-based principles for prescribing and reporting rehabilitation dosage to improve intervention fidelity and clinical outcomes.To gather further insights into the optimization of rehabilitation dosing across modalities, we welcome articles addressing, but not limited to, the following themes:- Quantification and modelling of dose-response relationships across rehabilitation domains- Dose-finding, dose-escalation, and adaptive trial methodologies- Integration of digital health data, sensors, and EHRs for objective dose measurement- Behavioural and motivational strategies to enhance adherence and minimize dropout- Factorial trial designs to identify active ingredients of complex interventions- Methodological advancements in standardized reporting using TIDieR and CERT frameworks- Mechanistic research linking dose parameters with neuroplasticity, motor learning, and cognitive change- Implementation and translation of dose-optimized interventions into routine clinical practiceWe welcome original research articles, clinical trial reports, methodological papers, protocol papers, reviews, and perspectives. Topic editors: Shuo-Hsiu (James) Chang, Dávid Líška Source: https://www.frontiersin.org/research-topics/83020/dose-intensity-and-adherence-the-unsolved-core-of-rehabilitation-interventions