The Flow State Scale for Rehabilitation Tasks: A New Flow Experience Questionnaire for Stroke Patients

Abstract Importance: Flow can be described as a subjective state that people report when they fully engage in an activity and experience pleasure, satisfaction, and enjoyment. Flow experiences are measured to determine the extent to which patients engage in therapy activities. Several flow questionnaires are used in neurorehabilitation. However, none have been validated for patients with (sub)acute stroke. Objective: To develop and validate a new flow questionnaire for patients with (sub)acute stroke. Design: Single-center prospective cohort study. Setting: Neurorehabilitation unit of the Neurocenter of the Luzerner Kantonsspital in Lucerne, Switzerland. Participants: Fifty patients with (sub)acute stroke. Outcomes and Measures: Development of the Flow State Scale for Rehabilitation Tasks (FSSRT) and determination of the psychometric properties of the FSSRT (internal consistency, test–retest reliability, structural and construct validity) in (sub)acute stroke patients. Results: The FSSRT showed good internal consistency and excellent test–retest reliability. Composed of four components—concentration, pleasure, movement control, and absorption—the FSSRT correlated significantly negatively with the Hospital Anxiety and Depression Scale, indicating good divergent validity. Conclusions and Relevance: The FSSRT is a reliable and valid questionnaire measuring flow experience in patients with (sub)acute stroke. This questionnaire can be easily used in occupational therapy as well as in physical therapy and gives therapists important information about the flow experience of patients during therapy to adjust the therapy accordingly. Plain-Language Summary: Measuring flow experience, or the extent to which patients engage in therapy activities, in the context of occupational therapy and physical therapy is a new approach. This study confirmed that the Flow State Scale for Rehabilitation Tasks questionnaire is reliable and valid for measuring the flow experience of patients after (sub)acute stroke. Occupational therapists and physical therapists can use the FSSRT to optimally adjust the therapy program and increase patient engagement during therapy.