ABSTRACT NUMBER: ESOC2026A2387 UNDERSTANDING TASK CHALLENGE IN STROKE REHABILITATION TO SUPPORT OPERATIONALISATION: AN INTERDISCIPLINARY CONCEPT ANALYSIS

Abstract Background and aims Task challenge is widely recognised as fundamental to effective stroke rehabilitation, yet is inconsistently defined, operationalised, and reported. This conceptual ambiguity limits intervention design, replication, and evidence synthesis, and understanding of dose–response relationships in stroke recovery. We aimed to clarify how task challenge is conceptualised in stroke rehabilitation research and to provide a framework to support future operationalisation and evaluation. Methods We undertook a principle-based interdisciplinary concept analysis. A mulit-database systematic search identified peer-reviewed literature addressing task challenge or related constructs in stroke rehabilitation research literature. Forty-two papers were purposively selected for high informational value. Guided by epistemological, pragmatic, linguistic, and logical principles, we used iterative immersion, analytical questioning, coding, constant comparison, and synthesis to identify antecedents, defining attributes, and outcomes of task challenge. Results Task challenge was conceptualised as a multifaceted, multidimensional, and dynamic interaction between the task, the person’s ability, and their subjective experience. Three interrelated facets were identified: nominal challenge (task demands), functional challenge (demands relative to ability), and perceived challenge (experienced effort or difficulty). Functional and perceived challenge were central to optimal challenge, and associated with enhanced recovery, engagement, and positive emotional responses after stroke. Across disciplines, challenge was rarely explicitly defined, and inconsistent terminology reduced conceptual clarity and reporting precision. Conclusions This analysis provides a stroke-specific conceptual framework of task challenge. Clarifying its multifaceted, multidimensional, and dynamic nature provides a foundation to support future operationalisation, improve intervention design and reporting, and enable more precise investigation of dose–response mechanisms in stroke rehabilitation trials. Conflict of interest Nada Signal: Nothing to disclose. Emma Gomes: Nothing to disclose. Gemma Alder: Nothing to disclose. Felicity Bright: Nothing to disclose.