We present the architecture and usability evaluation of virtual reality system—“Positive Bike”—designed for improving cognitive and motor conditions in frail elderly patients. The system consists of a cycle-ergometer integrated in an immersive virtual reality system (CAVE) which allows combining motor and cognitive exercises according to a “dual-task” paradigm. We tested the usability and user’s experience of the prototype in a pilot evaluation study that involved five elderly patients. The prototype was tested in one-session training to understand the limitations and areas for improvement of our system. The evaluation consisted in (i) usability assessment using the system usability scale; (ii) evaluation of user’s engagement using the flow state scale; and (iii) expert evaluation involving interviews with domain experts. Results showed a good usability, both for system usability scale and the semi-structured interview. The level of flow (i.e., enjoyment with the task at hand) measured using the short flow state scale, was also high. Analysis of semi-structured interview carried out with domain experts provided further indications to improve the system. Overall, these findings show that, despite some limitations, the system is usable and provides an enjoyable user’s experience.

Background: Virtual reality (VR) has recently emerged as a promising means for the administration of cognitive training of seniors at risk of dementia. Immersive VR could result in increased engagement and performances; however, its acceptance in older adults with cognitive deficits still has to be assessed. Objective: To assess acceptance and usability of an immersive VR environment requiring real walking and active participants’ interaction. Methods: 58 seniors with mild cognitive impairment (MCI, n = 24) or subjective cognitive decline (SCD, n = 31) performed a shopping task in a virtual supermarket displayed through a head-mounted display. Subjective and objective outcomes were evaluated. Results: Immersive VR was well-accepted by all but one participant (TAM3 positive subscales >  5.33), irrespective of the extent of cognitive decline. Participants enjoyed the experience (spatial presence 3.51±0.50, engagement 3.85±0.68, naturalness 3.85±0.82) and reported negligible side-effects (SSQ: 3.74; q1-q3:0–16.83). The environment was considered extremely realistic, such as to induce potentially harmful behaviors: one participant fell while trying to lean on a virtual shelf. Older participants needed more time to conclude trials. Participants with MCI committed more errors in grocery items’ selection and experienced less “perceived control” over the environment. Conclusion: Immersive VR was acceptable and enjoyable for older adults in both groups. Cognitive deficits could induce risky behaviors, and cause issues in the interactions with virtual items. Further studies are needed to confirm acceptance of immersive VR in individuals at risk of dementia, and to extend the results to people with more severe symptoms.

The use of technology for educational purposes is a consolidated reality, and many new tools are constantly being devised and offered for use with both normally developing children and children with special needs. Nonetheless, a detailed analysis of the processes being stimulated and of the goals being pursued is often lacking or absent. In this work we describe the design, development and preliminary testing of an integrated system which combines the use of smart devices, a physical cube, augmented reality (AR) technology, a smart TV, and a software application especially designed to stimulate cognitive and social functions in pre-school children. The system was tested with three groups of children (25 children in total) during kindergarten activities. The results show that the system is easy to understand, elicits high levels of participation and social interaction, favors strategic behaviors, and can be used by the children with limited need of instruction and support by the adult. The implications for empowerment in typically developing children and the possibilities for use with children who have specific impairments in social communication are discussed.

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