Validation of a Motor-Cognitive Assessment for a Stepping Exergame in Older Adults: Use of Game-Specific, Internal Data Stream

To comprehensively validate an assessment tailored to an exergaming training program with motor-cognitive challenges. Fifty-eight cognitively intact, multimorbid, independently living older adults (mean age [standard deviation]: 78.3 [6.5] years) with moderate functional limitations participated in the study. For construct validity, Spearman's rank correlations ( ) between game parameters and established cognitive (Number-Connection-Test [Zahlen-Verbindungs-Test], Simple Response Time Task, Simon Task) and motor (Short Physical Performance Battery, Physiomat balance tests) measures were calculated. Test-retest reliability was documented by intraclass correlation coefficients (ICCs), sensitivity to change by effect sizes using partial eta squared ( ), and feasibility by mean completion time and completion rates. Good construct validity of the assessment was observed, with on average moderate-to-high correlations between game parameters and cognitive tests, measures of lower extremity function and dynamic balance (range of including extreme outliers = 0.00-0.70,