Editorial: Novel rehabilitation approaches for non-communicable diseases in the era of precision medicine

Abstract

Non-communicable diseases remain the dominant cause of long-term disability and health-service utilisation worldwide (World Health Organization, 2025a). Their trajectories are shaped by multimorbidity, fluctuating symptoms, and progressive functional limitations-features that challenge rehabilitation models built on standardised protocols and averaged responses (World Health Organization, 2017). While rehabilitation has long been recognised as a core component for the management of noncommunicable diseases (World Health Organization, 2025b), its operationalisation has often lagged behind advances in disease stratification and outcome prediction (Fernandes et al., 2023;Fernandes et al., 2022). In contrast, precision medicine has promoted the integration of biological, phenotypic, behavioural, and contextual information to improve risk stratification, predict outcomes, and personalise care (Lip & Padmanabhan, 2025;Naithani et al., 2021). However, translating these principles into rehabilitation is not simply a matter of adding biomarkers or technology. It requires aligning intervention selection, intensity, timing, and delivery with the person's evolving capacity, goals, and living context, in an active cooperation to maximize the outcomes of the intervention The Research Topic, Novel Rehabilitation Approaches for Non-Communicable Diseases in the Era of Precision Medicine, brings together fourteen contributions, including work by Anghelescu et al., Bertuccio et al., Chen et al., Dan et al., Fernandes et al., Guo et al., Huang et al., Li et al., Micheluzzi et al., Yepez et al., Zhang et al., Zhao et al., Zhencheng and Aiguo, and Zhu et al., suggesting that precision in rehabilitation should be understood not as a replacement of existing paradigms, but as an expansion of the operational space in which precision medicine principles are enacted, tested, and adapted over time.Across the contributions, precision appears less as a discrete technology and more as a guiding logic for aligning interventions with individual variability. In this context, precision rehabilitation can be understood as a dynamic, person-centred process that translates precision medicine principles into rehabilitation practice. It involves the ongoing integration of biological risk profiles, functional assessment, behavioural and contextual determinants, and lived experience to support adaptive decision-making, intervention tailoring, and meaningful participation across rehabilitation trajectories.In musculoskeletal rehabilitation, for example, the focus shifts from generic endorsements of exercise toward comparative and stratified approaches that consider symptom profiles, functional priorities, feasibility, and delivery context. Rather than asking whether exercise is effective, the underlying question becomes which modality, delivered in which format, is most appropriate for a given person at a given point in time.This reframing reflects a broader movement away from protocol-centred care toward adaptive intervention design.Predictive modelling further illustrates this operational expansion of precision. The increasing use of machine learning and composite biomarkers highlights how routinely collected data can be leveraged to identify individuals at higher risk of pain, functional decline, or adverse outcomes. From a rehabilitation perspective, the value of such models lies not only in prediction but also in their potential to inform the timing, intensity, and prioritisation of interventions. Precision, in this sense, is not an endpoint but a decisionsupport process that must remain interpretable, clinically meaningful, and responsive to change.An additional dimension that emerges across these contributions is temporality. Precision rehabilitation is inherently dynamic, as individuals with non-communicable diseases move through phases of stability, exacerbation, recovery, and adaptation. Interventions that are appropriate at one point in the disease or rehabilitation trajectory may become ineffective or burdensome at another. This highlights the need for longitudinal assessment frameworks and adaptive intervention models that can evolve alongside functional status, goals, and contextual constraints. In this sense, precision is not a static classification, but a continuous process of recalibration over time. Advances in artificial intelligence-supported assessment and biomarker-oriented frameworks illustrate how greater measurement granularity can support adaptive decision-making across disease trajectories. These developments point toward a future in which assessment is not a static gateway to intervention, but a continuous feedback mechanism guiding rehabilitation over time.These shifts also have important implications for the role of rehabilitation professionals.Precision-oriented approaches reposition clinicians not as implementers of fixed protocols, but as integrators of biological, functional, behavioural, and experiential At the population level, large-scale analyses linking inflammatory markers to long-term mortality among people with coexisting non-communicable diseases further demonstrate how precision approaches can inform prognostic profiling. For rehabilitation, such insights may support more nuanced decisions regarding intervention intensity, monitoring, and long-term follow-up, particularly in the context of multimorbidity.However, these advances also raise important questions regarding equity, interpretability, and implementation across diverse health systems.As precision-oriented rehabilitation approaches mature, challenges of implementation and equity become increasingly salient. Data-intensive models, digital delivery platforms, and advanced assessment tools risk exacerbating existing disparities if access, literacy, and contextual variability are not explicitly addressed. Ensuring that precision rehabilitation contributes to more equitable outcomes will require deliberate attention to implementation science, co-design with end users, and alignment with the realities of diverse health systems.Collectively, the contributions to the research topic suggest that precision rehabilitation should be understood as an integrative and adaptive process rather than a fixed model.Rather than supplanting precision medicine, rehabilitation expands its operational domain by translating predictive and stratification insights into dynamic, person-aligned action. This expansion requires moving beyond single outcomes and isolated innovations toward multidimensional assessment, adaptive dosing over time, meaningful engagement of individuals, and equity-aware implementation.Looking ahead, progress in precision rehabilitation will depend not only on technological novelty but, equally, on integration and patient-engagement. Future research should prioritise frameworks that connect biological, functional, behavioural, contextual, and experiential data. It should also develop assessment systems capable of guiding real-time adaptation, and test interventions within the complexity of real-world practice. By doing so, rehabilitation can fulfil its role as a critical translational space-where precision principles are not only predicted, but lived, negotiated, and refined in partnership with people living with non-communicable diseases.

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