@Article{info:doi/10.2196/64004,
author="Everard, Gauthier
and Declerck, Louise
and Lejeune, Thierry
and Edwards, Martin Gareth
and Bogacki, Justine
and Reiprich, Cl{\'e}o
and Delvigne, Kelly
and Legrain, Nicolas
and Batcho, Charles Sebiyo",
title="A Self-Adaptive Serious Game to Improve Motor Learning Among Older Adults in Immersive Virtual Reality: Short-Term Longitudinal Pre-Post Study on Retention and Transfer",
journal="JMIR Aging",
year="2025",
month="Mar",
day="3",
volume="8",
pages="e64004",
keywords="virtual reality; aged; learning; upper extremity; video games; kinematics",
abstract="Background: Despite their potential, the use of serious games within immersive virtual reality (iVR) for enhancing motor skills in older adults remains relatively unexplored. In this study, we developed a self-adaptive serious game in iVR called REAsmash-iVR. This game involves swiftly locating and striking a digital mole presented with various distractors. Objective: This short-term longitudinal pre-post study aims to evaluate REAsmash-iVR's efficacy in promoting motor learning in older adults. Specifically, we seek to determine the transfer and retention of motor learning achieved through REAsmash-iVR to other iVR tasks. Methods: A total of 20 older adults participated in the study, engaging with REAsmash-iVR over 7 consecutive days. The evaluation included iVR tests such as KinematicsVR and a VR adaptation of the Box and Block Test (BBT-VR). KinematicsVR tasks included drawing straight lines and circles as fast and as accurately as possible, while BBT-VR required participants to move digital cubes as quickly as possible within 60 seconds. Assessments were conducted before and after the intervention, with a follow-up at 1 week post intervention. The primary outcome focused on evaluating the impact of REAsmash-iVR on speed-accuracy trade-off during KinematicsVR tasks. Secondary outcomes included analyzing movement smoothness, measured by spectral arc length, and BBT-VR scores. Results: Results revealed significant improvements in speed-accuracy trade-off post intervention compared to that before the intervention, with notable retention of skills for straight lines (t19=5.46; P<.001; Cohen d=1.13) and circle drawing (t19=3.84; P=.001; Cohen d=0.787). Likewise, there was a significant enhancement in spectral arc length, particularly for circle drawing ($\chi${\texttwosuperior}2=11.2; P=.004; $\epsilon$2=0.23), but not for straight-line drawing ($\chi${\texttwosuperior}2=2.1; P=.35; $\epsilon$2=0.003). Additionally, participants demonstrated transfer with significant improvement (q=5.26; P<.001; Cohen r=0.678) and retention (q=6.82; P<.001; Cohen r=0.880) in BBT-VR skills. Conclusions: These findings provide perspectives for the use of iVR to improve motor learning in older adults through delivering self-adaptive serious games targeting motor and cognitive functions. Trial Registration: ClinicalTrials.gov NCT04694833; https://clinicaltrials.gov/study/NCT04694833 ",
issn="2561-7605",
doi="10.2196/64004",
url="https://aging.jmir.org/2025/1/e64004",
url="https://doi.org/10.2196/64004",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053708"
}