Gomes, EmelineAlder, GemmaBright, FelicitySignal, Nada2025-04-152025-04-152024-05-31Disability and Rehabilitation, ISSN: 0963-8288 (Print); 1464-5165 (Online), Taylor and Francis Group, 47(3), 560-570. doi: 10.1080/09638288.2024.23560100963-82881464-5165http://hdl.handle.net/10292/19077Purpose: Rehabilitation plays a critical role in minimising disability after stroke, with the concept of “challenge” proposed to be essential to rehabilitation efficacy and outcomes. This review unpacks how challenge is conceptualised in stroke rehabilitation literature from the perspectives of physiotherapy, occupational therapy, speech-language therapy and people with stroke. A secondary purpose was to provide a definition of challenge that is applicable to stroke rehabilitation. Methods: Principle-based concept analysis was utilised to examine challenge within the stroke rehabilitation literature. Forty-two papers were included. Data analysis involved immersion, analytical questioning, coding and synthesis to elicit the conceptual components of challenge. Results: Challenge was understood as a multidimensional and dynamic concept with three facets: nominal, functional and perceived challenge. Functional and perceived challenge were integral to optimal challenge. Optimal challenge was central to enhancing the outcomes and experiences of people with stroke, in rehabilitation and everyday life. Conclusions: Challenge is a key concept which, when carefully optimised to the person’s ability and experience, may positively influence their learning, recovery and engagement after stroke. This review lays a conceptual foundation for better understanding, operationalisation and advancement of challenge, offering important implications for addressing the growing burden of stroke disability, through rehabilitation.© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.http://creativecommons.org/licenses/by-nc-nd/4.0/Strokechallengeconcept analysisdoseengagementintensityrehabilitationreview4201 Allied Health and Rehabilitation Science42 Health SciencesRehabilitationNeurosciencesCerebrovascularClinical ResearchStrokeAgingPhysical RehabilitationBehavioral and Social ScienceBrain DisordersStroke11 Medical and Health SciencesRehabilitation32 Biomedical and clinical sciences42 Health sciences44 Human societyHumansStroke RehabilitationOccupational TherapyPhysical Therapy ModalitiesRecovery of FunctionPersons with DisabilitiesStrokeHumansOccupational TherapyRecovery of FunctionPhysical Therapy ModalitiesStrokeStroke RehabilitationPersons with DisabilitiesHumansStroke RehabilitationOccupational TherapyPhysical Therapy ModalitiesRecovery of FunctionPersons with DisabilitiesStrokeJournal ArticleOpenAccess10.1080/09638288.2024.2356010