{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T16:45:31Z","timestamp":1793378731828,"version":"4.5.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Contemporary stroke rehabilitation protocols traditionally emphasise session frequency and treatment duration over intervention intensity\u2014yet emerging evidence suggests we may be preparing patients for therapeutic marathons when their brains demand neuroplastic sprints. Across neuroscientific, behavioural, and clinical domains, convergent data indicate that repetition density, metabolic load, engagement, and temporal compression\u2014not cumulative minutes\u2014constitute the biologically meaningful drivers of neuroplastic and myoplastic adaptation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This Perspective re-examines current rehabilitation paradigms through an intensity-centred lens, synthesising mechanistic evidence, clinical trials, and cross-cultural implementation models to determine whether high-intensity paradigms can more efficiently exploit neuroplastic windows and muscle adaptation dynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Evidence was integrated from intensity-focused RCTs, high-repetition upper limb training, HIIT-based protocols, constrained-duration boot-camp models, and comparative observations from West-Cameroon intensive programmes. Mechanistic principles of threshold-dependent plasticity, critical timing windows, and therapeutic momentum were analysed alongside real-world feasibility data from low-resource systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across studies and contexts, high-intensity protocols\u20144\u20136\u202fh\/day for 3\u20134\u202fweeks\u2014consistently produced functional gains equivalent or superior to those achieved through conventional 1\u20132\u202fh sessions over 12\u201316\u202fweeks. Both neural and peripheral muscle plasticity responded more robustly to concentrated stimulation than to prolonged low-density regimens. Family-integrated programmes amplified therapeutic density and sustained momentum, demonstrating that intensity can be achieved without advanced technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rehabilitation effectiveness depends less on session duration than on the biological potency of stimulation delivered per unit time. Intensity-centred models align more closely with known mechanisms of neuroplasticity and muscle adaptation, offering a more efficient, scalable, and context-responsive pathway to post-stroke recovery. Future research should formalise intensity indices, determine minimal effective thresholds, and evaluate phenotype-specific dosing strategies to support the evolution toward precision rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1697186","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:55:53Z","timestamp":1769064953000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Intensity over duration in neurological rehabilitation: exploring evidence for optimised recovery paradigms"],"prefix":"10.3389","volume":"16","author":[{"given":"Ibrahim Npochinto","family":"Moumeni","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Physical Medicine, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang","place":["Dschang, West Region, Cameroon"]},{"name":"Department of Physical Medicine and Osteopathy, Regional Hospital of Bafoussam","place":["Bafoussam, West Region, Cameroon"]},{"name":"Institute for Applied Neurosciences and Functional Rehabilitation (INAREF)","place":["Odza-Yaound\u00e9, Cameroon"]},{"name":"Franco-African Center for Applied Rehabilitation and Health Sciences (CFARASS)","place":["Foumbot, West Region, Cameroon"]},{"name":"Department of Geriatrics and Gerontology, Sorbonne Universit\u00e9, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Boulevard de l\u2019H\u00f4pital","place":["Paris, France"]},{"name":"Private Practitioner","place":["Paris, France"]},{"name":"Faculty of Health Sciences, University of Parakou","place":["Parakou, Benin"]},{"name":"French-Speaking African Society for Neurorehabilitation (SAFNeR)","place":["Parakou, Benin"]},{"name":"UREKIM \u2013 Research Unit in Physiotherapy and Physical Medicine, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang","place":["Dschang, West Region, Cameroon"]},{"name":"Centre de Recherche en Sant\u00e9 Humaine et D\u00e9veloppement des M\u00e9dicaments (CRESHDEM), Faculty of Medicine and Pharmaceutical Sciences, University of Dschang","place":["Dschang, West Region, Cameroon"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1016\/S0140-6736(11)60325-5","article-title":"Stroke rehabilitation","volume":"377","author":"Langhorne","year":"2011","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.npg.2020.11.002","article-title":"Plasticit\u00e9 c\u00e9r\u00e9brale: r\u00e9g\u00e9n\u00e9ration? r\u00e9paration? r\u00e9organisation? ou compensation? 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