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Here we describe a Virtual Reality (VR) based system, the Rehabilitation Gaming System (RGS) that is based on a number of hypotheses on the neuronal mechanisms underlying recovery, the structure of training and the role of individualization. We investigate the psychometrics of the RGS in stroke patients and healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We describe the key components of the RGS and the psychometrics of one rehabilitation scenario called Spheroids. We performed trials with 21 acute\/subacute stroke patients and 20 healthy controls to study the effect of the training parameters on task performance. This allowed us to develop a Personalized Training Module (PTM) for online adjustment of task difficulty. In addition, we studied task transfer between physical and virtual environments. Finally, we assessed the usability and acceptance of the RGS as a rehabilitation tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We show that the PTM implemented in RGS allows us to effectively adjust the difficulty and the parameters of the task to the user by capturing specific features of the movements of the arms. The results reported here also show a consistent transfer of movement kinematics between physical and virtual tasks. Moreover, our usability assessment shows that the RGS is highly accepted by stroke patients as a rehabilitation tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We introduce a novel VR based paradigm for neurorehabilitation, RGS, which combines specific rehabilitative principles with a psychometric evaluation to provide a personalized and automated training. Our results show that the RGS effectively adjusts to the individual features of the user, allowing for an unsupervised deployment of individualized rehabilitation protocols.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1743-0003-7-48","type":"journal-article","created":{"date-parts":[[2010,9,22]],"date-time":"2010-09-22T18:14:52Z","timestamp":1285179292000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":271,"title":["Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation"],"prefix":"10.1186","volume":"7","author":[{"given":"M\u00f3nica S","family":"Cameir\u00e3o","sequence":"first","affiliation":[]},{"given":"Sergi Berm\u00fadez i","family":"Badia","sequence":"additional","affiliation":[]},{"given":"Esther Duarte","family":"Oller","sequence":"additional","affiliation":[]},{"given":"Paul FMJ","family":"Verschure","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2010,9,22]]},"reference":[{"key":"255_CR1","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1053\/apmr.2002.35473","volume":"83","author":"HT Hendricks","year":"2002","unstructured":"Hendricks HT, van Limbeek J, Geurts AC, Zwarts MJ: Motor recovery after stroke: a systematic review of the literature. 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