A proposed formula for rehabilitation outcomes: Programming, communication, and adherence as multiplicative determinants of goal attainment

Abstract

Background: Rehabilitation science has produced robust models for tissue loading, therapeutic alliance, and patient adherence independently. However, no unified theoretical formula has been proposed to describe how these domains interact to determine rehabilitation outcomes. Purpose: This paper proposes a mathematical formula for rehabilitation outcomes — Rehabilitation Outcome = Programming × Communication × Adherence — and argues that this structure more accurately reflects clinical reality than additive or single-domain models. Key Argument: Drawing on established formulas in risk management and organisational change science, this paper demonstrates that each variable in the proposed formula is distinct, independently owned, and capable of nullifying the overall rehabilitation outcome when absent. Programming consists of load management and clinical decision-making. Communication describes the therapist’s soft skills and therapist-client interface and its role in translating technical plans into executable action. Adherence, owned by the client, determines whether any clinical intervention produces real-world results. Conclusion: The Rehabilitation Formula offers clinicians a diagnostic lens to identify which variable is responsible for poor outcomes, and a conceptual framework for designing more complete, patient-centred care. Future research should focus on operationalising, validating, and create a weight for each variable within this model.