Visual Complexity, Player Experience, Performance and Physical Exertion in Motion-Based Games for Older Adults
Jan Smeddinck, Kathrin M. Gerling, Saranat Tiemkeo · 2013 · Proceedings of the 15th International ACM SIGACCESS Conference on Computers and Accessibility (Assets '13) · doi:10.1145/2513383.2517029
Summary
This paper investigates how visual complexity (graphical fidelity) affects player experience, in-game performance, and physical exertion in motion-based games designed for older adults. The study is motivated by the growing use of kinesiatric serious games (KSGs) in physical therapy and rehabilitation for conditions like Parkinson's disease, stroke, and age-related decline, combined with the fact that vision impairments (glaucoma, cataracts, presbyopia) are common among older adults. The researchers adapted "Fish Harvester," a motion-based game originally designed for Parkinson's therapy, into four versions with systematically varied visual complexity levels: abstract (geometric shapes, flat-shaded, single-colored), simple 2D (identifiable objects, simplified forms), stylized 2D (shaded curved surfaces, texture mapping), and 3D pre-render (photo-realistic modeling, shadow casting, light scattering). These four levels were derived from an existing taxonomy of computer graphics fidelity covering modeling (form), animation (motion), and rendering (surface/lighting). Fifteen older adults (2 male, 13 female, average age 73.6, range 61-85) played all four versions in a within-subjects design using a 4x4 Latin square to counterbalance order. Measures included the Self-Assessment Manikin (SAM) for affective state, Borg Rating of Perceived Exertion (RPE), game log metrics, video-coded observations, and explicit preference rankings.
Key findings
The central finding is a dissociation between explicit preferences and measured player experience. When asked to rank the four versions, participants consistently preferred high-fidelity graphics: 3D pre-render ranked first, followed by stylized 2D, simple 2D, and abstract last (all ranking comparisons showed significant differences between abstract and non-abstract versions, p<0.001). However, the three post-trial player experience measures (ease of identifying visual elements, immersion, fun) showed no significant differences across conditions in ANOVA analyses — participants enjoyed all four versions comparably during actual gameplay. In-game performance (fish stopped, collected, and time metrics) also showed no significant differences across conditions. The most important finding concerned perceived exertion: participants reported significantly higher perceived exertion after playing the abstract version (M=10.80) compared to before gameplay (M=9.40, p=0.043) and compared to the stylized 2D version (M=9.60, p=0.034), despite objective exertion measures (movement distance, footsteps) showing no significant differences across conditions. This suggests that engaging visual experiences moderate the perception of physical effort — richer graphics make the same physical activity feel less tiring.
Relevance
This paper has important implications for both game accessibility and therapeutic game design. For accessibility practitioners, the finding that visual complexity does not significantly affect actual gameplay experience or performance suggests that simplified graphics can be used to improve accessibility for users with vision impairments without meaningfully degrading the experience — though explicit preferences still favor higher fidelity. The perceived exertion finding is particularly valuable for rehabilitation: therapists could strategically manipulate visual complexity to either encourage patients to push through uncomfortable exercises (using rich graphics to reduce perceived effort) or increase body awareness during proprioception training (using abstract graphics). The systematic visual complexity taxonomy (abstract through 3D pre-render) provides a reusable framework for game designers targeting older adults. For the broader accessibility field, the study highlights that age-related sensory changes must be considered alongside motor and cognitive factors when designing interactive systems for older adults, and that the relationship between visual design and physical experience is more complex than simple preference would suggest.
Tags: game accessibility · older adults · aging · visual complexity · serious games · rehabilitation · physical therapy · motion-based games · Parkinson's disease · exertion games · visual impairment