The Model of Goal-Oriented Neuroplastic Rehabilitation (MGONR) for Acquired Brain Injury: A Practice-Derived Conceptual Framework Informed by Longitudinal Clinical Evidence

Long-term rehabilitation after acquired brain injury (ABI) must support participation, autonomy, and quality of life alongside impairment reduction. This article introduces the Model of Goal-Oriented Neuroplastic Rehabilitation (MGONR), a practice-derived and theory-informed framework. MGONR proposes that personally meaningful goals, when operationalised and supported by positive commitment, may organise repeated goal-directed behaviour and create favourable conditions for experience-dependent learning and functional adaptation. The framework is informed by three empirical components. A five-year analysis (2019–2023) included 62 participants with ABI and examined 253 general life goals and 1,122 specific rehabilitation goals. A 2023–2024 assessment examined the association between self-evaluated goal achievement and QOLIBRI scores in 47 participants. A supplementary analysis of routine QOLIBRI assessments (2022–2025) examined annual patterns and within-person change. Mean self-evaluated goal achievement increased across the five years. Self-evaluated goal achievement showed a positive, non-significant trend towards higher perceived quality of life (F(1, 42) = 3.81, p = 0.058, partial η² = 0.083). Among 25 participants assessed in both 2022 and 2025, reconstructed QOLIBRI Total and QOLIBRI-OS scores increased significantly, with medium within-person effect sizes. These findings provide initial clinical and behavioural grounding for MGONR but do not demonstrate neuroplastic change or validate all pathways of the model.