## 4 Discussion  
This study aimed to investigate the effects of a 12-week semi-immersive VR-based intervention program on the QOL of young-old and middle-old adults. In general, the effects of the intervention on the older adults' QOL revealed that the EG exhibited significant improvements in the QOL dimensions of sensory abilities, autonomy, social participation/isolation, death and dying, and overall QOL compared with the CG. The semi \begin{table}
\begin{tabular}{c c c c c c c c c c c c} \hline  & & \multicolumn{3}{c}{**Young-Old Adults**} & \multicolumn{3}{c}{**Middle-Old Adults**} & \multicolumn{3}{c}{**A Mix (4 \(\times\) 2) Repeated-Measure ANOVA**} \\ \multicolumn{2}{c}{**Outcome**} & \multicolumn{3}{c}{**(65–73 Years)**} & \multicolumn{3}{c}{**(74-85 Years)**} & \multicolumn{3}{c}{**A Mix (4 \(\times\) 2) Repeated-Measure ANOVA**} \\ \multicolumn{2}{c}{**Measure**} & & \multicolumn{3}{c}{**EG (\(\mu\) = 26)**} & \multicolumn{3}{c}{**CG (\(\mu\) = 20)**} & \multicolumn{3}{c}{**EG (\(\mu\) = 19)**} & \multicolumn{3}{c}{**CG (\(\mu\) = 21)**} & \multicolumn{3}{c}{**F-Value, \(p\), (\(\mathbf{n^{\prime}}\)p)**} \\  & & \multicolumn{3}{c}{**Mean \(\pm\) SD**} & \multicolumn{3}{c}{**Mean \(\pm\) SD**} & \multicolumn{3}{c}{**Group**} & \multicolumn{3}{c}{**Time \(\pm\)**} & \multicolumn{3}{c}{**Interaction**} \\ \hline Sensory abilities (score) & Pre & 10.31 \(\pm\) 2.41 & 10.83 \(\pm\) 2.90 & 10.05 \(\pm\) 3.05 & 9.81 \(\pm\) 2.77 & \multirow{2}{*}{1.14} & \multirow{2}{*}{0.290 (0.01)} & \multirow{2}{*}{0.05} & \multirow{2}{*}{0.944 (0.00)} & \multirow{2}{*}{0.25} & \multirow{2}{*}{0.617 (0.00)} \\  & Post & 12.65 \(\pm\) 1.85 & 10.67 \(\pm\) 2.63 & 12.68 \(\pm\) 2.32 & 9.33 \(\pm\) 2.80 & & & & & & \\ Autonomy & Pre & 14.88 \(\pm\) 1.68 & 15.01 \(\pm\) 2.24 & 14.18 \(\pm\) 2.67 & 14.86 \(\pm\) 1.88 & \multirow{2}{*}{1.42} & \multirow{2}{*}{0.266 (0.02)} & \multirow{2}{*}{0.900 (0.00)} & \multirow{2}{*}{0.25} & \multirow{2}{*}{0.616 (0.01)} \\ (score) & Post & 16.08 \(\pm\) 2.51 & 14.29 \(\pm\) 2.33 & 15.00 \(\pm\) 2.30 & 14.43 \(\pm\) 1.86 & & & & & & \\ Past, present, and future & Pre & 14.54 \(\pm\) 1.45 & 15.25 \(\pm\) 2.67 & 14.32 \(\pm\) 1.91 & 13.76 \(\pm\) 2.05 & \multirow{2}{*}{0.55} & \multirow{2}{*}{0.461 (0.01)} & \multirow{2}{*}{0.02} & \multirow{2}{*}{0.893 (0.00)} & \multirow{2}{*}{0.48} & \multirow{2}{*}{0.037 (0.05)} \\ activity (score) & Post & 15.23 \(\pm\) 2.08 & 14.83 \(\pm\) 2.41 & 14.32 \(\pm\) 1.97 & 14.05 \(\pm\) 2.31 & & & & & & \\ Social participation/ & Pre & 14.50 \(\pm\) 1.92 & 15.33 \(\pm\) 2.47 & 14.21 \(\pm\) 2.12 & 13.95 \(\pm\) 2.20 & & & & & & & \\ isolation (score) & Post & 14.25 \(\pm\) 1.65 & 14.88 \(\pm\) 2.29 & 14.99 \(\pm\) 1.62 & 14.14 \(\pm\) 2.24 & & & & & & & \\ Death and dying (score) & Post & 16.19 \(\pm\) 2.88 & 15.21 \(\pm\) 4.16 & 15.58 \(\pm\) 2.99 & 13.06 \(\pm\) 3.93 & & & & & & & & \\ Intimacy & Pre & 15.54 \(\pm\) 2.12 & 15.32 \(\pm\) 2.65 & 14.32 \(\pm\) 3.17 & 13.71 \(\pm\) 2.33 & & & & & & & & \\ (score) & Post & 16.00 \(\pm\) 2.24 & 15.29 \(\pm\) 2.37 & 15.08 \(\pm\) 3.12 & 13.95 \(\pm\) 2.64 & & & & & & & & \\ Total quality of life (score) & Pre & 84.19 \(\pm\) 7.98 & 86.83 \(\pm\) 9.99 & 83.00 \(\pm\) 9.58 & & & & & & & & & \\ Post & Post & 91.58 \(\pm\) 9.23 & 85.17 \(\pm\) 9.95 & 87.64 \(\pm\) 10.50 & & & & & & & & & \\ \hline \end{tabular}
\end{table} 
Table 4: Effects of the intervention on older adults’ quality of life according to age. Figure 4: Comparison of pre- to post-test quality of life change between the experimental and control groups of different age groups. immersive nature of VR exercise in creating specific atmospheres is an important factor in improving the older adults' QOL. We believe this intervention stimulated sensory functions in the older adults, and our friendly training environment elicited improvements in autonomy and freedom. In addition, our group activities in the local community helped expand their social interactions [36].