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Accepted for/Published in: JMIR Serious Games

Date Submitted: Apr 20, 2025
Open Peer Review Period: Apr 22, 2025 - Jun 17, 2025
Date Accepted: Oct 9, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Age Differences in Flow Experience During Body Movement–Controlled Video Game Rehabilitation Tasks: Cross-Sectional Study

Tong S, Li L, Zhang Y, Pu F, Ren W

Age Differences in Flow Experience During Body Movement–Controlled Video Game Rehabilitation Tasks: Cross-Sectional Study

JMIR Serious Games 2025;13:e76278

DOI: 10.2196/76278

PMID: 41160722

PMCID: 12571201

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Age Differences in Flow Experience During Virtual Reality Rehabilitation Tasks: A Cross-Sectional Study

  • Shiyi Tong; 
  • Lixuan Li; 
  • Yuankun Zhang; 
  • Fang Pu; 
  • Weiyan Ren

ABSTRACT

Background:

Virtual reality (VR) is increasingly applied in rehabilitation training. Flow experience, a critical factor for enhancing user engagement and training efficacy, exhibits age-related differences that are essential for designing elderly-friendly rehabilitation tasks. However, current VR rehabilitation systems often overlook age-related subjective experience disparities, leading to insufficient engagement among older adults.

Objective:

This study aims to explore differences in flow experience between younger and older adults during identical VR rehabilitation tasks and provide empirical evidence for designing personalized elderly rehabilitation programs.

Methods:

We recruited 21 older adults (mean age: 63.00 ± 6.64 years, 10 males) and 19 younger adults (mean age: 24.68 ± 1.16 years, 9 males). Participants performed the "Space Pop" task in Kinect Adventures (simulating limb coordination training) using VR. Flow experience was measured using the Chinese version of the Flow State Scale-2 (CFSS-2). Group differences were analyzed via Wilcoxon rank-sum tests.

Results:

Older adults exhibited significantly lower overall flow experience than younger adults (p < 0.001, d = 1.45), with significant differences in the dimensions of "challenge-skill balance" (p < 0.001), "clear goals" (p = 0.044), "sense of control" (p < 0.001), and "loss of self-consciousness" (p = 0.048). Other dimensions (e.g., concentration, time transformation) showed no statistical differences.

Conclusions:

Age significantly impacts flow experience in VR rehabilitation tasks. Tailoring designs through dynamic difficulty adjustment, intuitive goal cues, and reduced motor demands can enhance older adults’ control, immersion, and active participation, thereby improving health outcomes.


 Citation

Please cite as:

Tong S, Li L, Zhang Y, Pu F, Ren W

Age Differences in Flow Experience During Body Movement–Controlled Video Game Rehabilitation Tasks: Cross-Sectional Study

JMIR Serious Games 2025;13:e76278

DOI: 10.2196/76278

PMID: 41160722

PMCID: 12571201

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