Age Differences in Flow Experience During Body Movement–Controlled Video Game Rehabilitation Tasks: Cross-Sectional Study
Bibliographic record
Abstract
Background: Body movement-controlled video games (BMCVGs) are increasingly adopted in rehabilitation because they combine physical training with interactive engagement. Flow experience, a critical factor for enhancing user engagement and training efficacy, exhibits age-related differences that are essential for designing age-appropriate rehabilitation tasks. However, current BMCVG rehabilitation tasks often overlook these age-related differences in subjective experience, leading to insufficient engagement among older adults. Objective: This study aimed to explore differences in flow experience between younger and older adults when performing the same BMCVG rehabilitation task and to provide empirical evidence for designing personalized and age-appropriate programs. Methods: A total of 40 participants were recruited, including 21 older adults (mean age 63.00, SD 6.64 y; n=10, 48% male participants) and 19 younger adults (mean age 24.68, SD 1.16 y; n=9, 47% male participants). Participants performed the "Space Pop" task in Kinect Adventures, simulating limb coordination training. Flow experience was assessed using the Chinese version of the Flow State Scale-2, which measures 9 dimensions of flow. Group differences were analyzed using the nonparametric Wilcoxon rank-sum tests, and effect sizes (Cohen d) were calculated via bootstrap estimation. Results: Older adults exhibited significantly lower overall flow experience than younger adults (W=339.5; P<.001; Cohen d=1.45; η2=0.37). Significant differences were also found in the dimensions of "challenge-skill balance" (W=339; P<.001); "clear goals" (W=271; P=.04); "sense of control" (W=389.5; P<.001); and "loss of self-consciousness" (W=268; P=.048). The largest effect was observed in the "sense of control" dimension (Cohen d=3.22; η2=0.74), indicating it was the most significantly impacted by age. Other dimensions (eg, concentration and time transformation) showed no significant differences. Conclusions: Age plays a significant role in shaping flow experiences during BMCVG rehabilitation tasks. Older adults' reduced flow may be attributed to declines in cognitive processing speed, motor control, and self-efficacy, which particularly impair their sense of control and goal clarity. Tailoring designs through strategies such as dynamic difficulty adjustment, clearer goal cues, and reduced motor demands is crucial. These adaptations can enhance older adults' sense of control and immersion, promoting active participation and ultimately improving rehabilitation outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".