Che, RuitongRuitongCheLi, JiaanJiaanLiDeng, ChiChiDengDr. MAO QianHo, Jeffrey C. F.Jeffrey C. F.HoNah, FionaFionaNahOr, Calvin K. L.Calvin K. L.OrWang, HailiangHailiangWang2026-09-012026-09-012026International Journal of Human-Computer Studies, 2026, vol. 212, article no. 103826.1071-58191095-9300http://hdl.handle.net/20.500.11861/28630Open accessThe global trend toward longer life spans presents an opportunity to promote active and healthy aging. Physical exercises like Qigong support holistic well-being by integrating physical, cognitive, and emotional health. However, traditional programs lack adaptability to accommodate age-related changes in physical and cognitive abilities, which can limit accessibility and engagement for older adults. Virtual Reality (VR) offers a novel solution by creating immersive, customizable environments. In our study, we designed a VR-based physical exercise tutorial (VRPET) system and assessed the efficacy of using an adaptive self-avatar (i.e., a virtual representation of the user) to enhance user exercise performance and attitudes, while examining its impact on perceived workload. We conducted a two-phase mixed-methods investigation: (1) A formative phase involving focus group interviews (n=14), a consultation with a Qigong master on movement standardization, and a heuristic evaluation (n=5) to establish design requirements; (2) A user study (n = 30) that compared the self-avatar versus non-self-avatar conditions to assess their effects on perceived workload, exercise performance, and attitude metrics. Despite a significant dip in exercise performance (p=0.03) and a non-significant increase in perceived workload (p=0.58), participants expressed a preference for the self-avatar’s real-time feedback when scaffolded appropriately. Multi-modal analysis revealed auditory cues as most effective, followed by tactile and visual feedback. Based on these findings, we propose the ACT Framework (Adaptive, Cultural, Targeted) for developing age-appropriate VR exercise systems. Furthermore, we distill our iterative process into a tripartite validation workflow, advocating for a methodology that harmonizes user desirability, expert safety, and HCI usability. These evidence-based insights advance the design of therapeutic VR interventions that can support healthy aging populations.enVirtual RealitySelf-AvatarPhysical Exercise TutorialOlder AdultsHealthcarePerceptionPeer Reviewed Journal Article10.1016/j.ijhcs.2026.103826