Exergames are increasingly established for training purpose; however, newly assessment strategies based on the internal data flow are hardly developed and validated. Such assessment strategies provide high-class data with strict focus on applied training goals and programs. In this study we analyzed construct validity, test-retest reliability, sensitivity to change, and feasibility of the Physiomat® training device, which combines challenging postural motor tasks with cognitive tasks based on established neuro-psychological assessments such as trail making test (TMT) in patients with dementia. Assessments of 105 multi-morbid patients with mild to moderate dementia (mean age 82.7 ± 5.9) were tested in conditions with increasing complexity level (simple, moderate, complex) for construct validity, test-retest reliability, sensitivity to change of trained Physiomat® tasks, and for feasibility. Analyses showed moderate to high correlations between established motor as well as cognitive tests and simple (rs=-.22-.68, P ≤.001-.03), moderate (rs=-.33-.71, p ≤.001-.004), and complex motor-cognitive Physiomat tasks (rs=-.22-.83, P ≤.001-.30) indicating a good construct validity. Moderate to high correlations between test and retest assessments were found for simple, moderate, and complex motor-cognitive tasks (ICC=.47-.83, p ≤.001) indicating good test-retest reliability. Sensitivity to change was good to excellent for Physiomat assessment reproducing significant improvements during an intervention trail (RCT) (p ≤.001) with moderate to large effect sizes (SRM=0.5–2.0). Completion time averaged 25.8 minutes, with high completion rate (96%) for initial Physiomat measures. No adverse events occurred during assessment. The Physiomat® assessment proved a reliable, valid, responsive, and feasible game-based assessment strategy in multi-morbid persons with mild to moderate dementia.
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