Csikszentmihalyi’s first studies involved interviews with people from different backgrounds such as athletes, chess masters, rock climbers, dancers, composers of music and many more. He began his research on flow experiences with the simple question of why people are often highly committed to activities without obvious external rewards. The flow state was first described by Csikszentmihalyi (1975) as the “optimal experience”. Attention is fully invested in the task at hand, and the person functions at his or her fullest capacity. During flow, subjective perception of time may change: Time can pass faster or slower and the environment is hardly or no longer perceived. Whether flow experiences can ultimately have positive effects on physical/cognitive parameters needs further study.įlow experience is a subjective psychological state that people report when they are completely involved in something to the point of forgetting time and their surrounding except the activity itself. For exergame developers working in the field of physical/cognitive rehabilitation in patients with neurological diseases, a valid flow questionnaire can help to further optimize the content of the games so that optimal engagement can occur during the gameplay. However, psychometric properties of used flow questionnaires are lacking. The present review indicates that flow experience is increasingly measured in the physical/cognitive rehabilitation setting in patients with neurological diseases. None of the studies presented psychometric data in their respective research population. Six different flow questionnaires were used, all of which were originally validated in healthy people. Three studies assessed flow in other activities than gaming (song-writing intervention and activities of daily living). Seven studies measured flow in the context of serious games in patients with stroke, traumatic brain injury, multiple sclerosis and Parkinson’s disease. Ten studies out of 911 records met the inclusion criteria. A qualitative data synthesis was performed to present the measurement properties of the used flow questionnaires. Inclusion criteria were (1) peer-reviewed studies that (2) focused on the investigation of flow experience in (3) patients with neurological diseases (i.e., stroke, traumatic brain injury, multiple sclerosis and/or Parkinson’s disease). MEDLINE Ovid, EMBASE Ovid, CINAHL EBSCO, SCOPUS were searched. Additionally, we critically appraised, compared and summarized the measurement properties of self-reported flow questionnaires used in neurorehabilitation setting.Ī systematic review using PRISMA and COSMIN guidelines. The purpose of this study was to identify and systematically review current literature on flow experience assessed in patients with stroke, traumatic brain injury, multiple sclerosis and Parkinson’s disease. When developing new therapy games, measuring flow experience can indicate whether the game motivates one to train. Being in flow during physical/cognitive rehabilitation may have a considerable impact on functional outcome, especially when patients with neurological diseases engage in exercises using robotics, virtual/augmented reality, or serious games on tablets/computer. Flow is a subjective psychological state that people report when they are fully involved in an activity to the point of forgetting time and their surrounding except the activity itself.
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