JMIR Publications

ABSTRACT

Immersive virtual reality (VR) is increasingly used for embodied training, yet its ergonomic value for older adults depends on human factors trade-offs between experiential benefits and VR-related discomfort. We conducted a randomized, two-arm pre-test/post-test trial comparing head-mounted immersive VR (Meta Quest 3/3S) with standardized, content-matched 2D video instruction for Tai Chi learning among community-dwelling older adults (106 randomized; 92 included in the primary ANCOVA). Task performance was assessed using a five-item movement-encoding (knowledge) test (0–20) administered before and after training, and the post-test effect was evaluated using ANCOVA controlling for pre-test score and age. Adjusted post-test performance did not differ between groups (p = .80). In contrast, human factors outcomes diverged: FDR-adjusted analyses of the Game Experience Questionnaire indicated higher perceived competence and flow and lower tension in the VR group (q < .05). Safety and tolerability were characterized using the Virtual Reality Sickness Questionnaire (VRSQ), with a small number of withdrawals due to VR-related discomfort, highlighting feasible use for many participants but non-trivial individual boundaries. VR system telemetry (recognition accuracy, pose accuracy, and movement distance) provided descriptive process-level indicators during task execution. Overall, under a strong active control, immersive VR did not improve short-term movement-encoding outcomes but produced a more favorable affective experience, with clearly defined tolerability limits that should inform the ergonomic design and deployment of immersive training for older adults.