Usability and Acceptability of a Virtual Reality-Based System for Endurance Training in Elderly with Chronic Respiratory Diseases Vera Colombo 1,2(&) , Marta Mondellini 1 , Alessandra Gandolfo 3 , Alessia Fumagalli 3 , and Marco Sacco 1 1 Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, 23900 Lecco, Italy vera.colombo@stiima.cnr.it 2 Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy 3 Pulmonary Rehabilitation Unit, National Institute on Health and Science on Ageing, 23880 Casatenovo, LC, Italy Abstract. Physical exercise is one of the main components of rehabilitation programs designed for patients with chronic respiratory diseases. Endurance exercise training, in the form of cycling or walking, allows to improve leg muscles strength and cardiorespiratory fitness. Positive effects have been demonstrated even if there is still need for improving patients’ motivation and empowerment with the aim of fostering the continuity of care. In this scenario, Virtual Reality (VR) represents a valuable solution thanks to the possibility to provide real-time feedback and to create engaging training environments. The literature shows some promising results mainly regarding the use of virtual games for strength and aerobic exercise in patients with respiratory diseases. However, more research is needed to understand whether coupling VR with physical training is effective in improving respiratory rehabilitation. Within this context, the current paper presents a VR-based system for patients with respi- ratory diseases performing endurance exercise training on a cycle-ergometer. The Virtual Park allows the therapists to create a personalized training and enables patients to exercise while riding in a virtual park. Preliminary results on a group of 8 patients showed excellent usability and high acceptability after a single session of exercise. Future works foresee the comparison, in terms of both clinical outcomes and motivational aspects, between a training program based on the Virtual Park and a traditional one. Keywords: Virtual Reality Á Physical training Á Usability Á Acceptability Á Chronic respiratory diseases Á Elderly 1 Introduction Physical exercise training is a cornerstone of rehabilitation for people affected by chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease, etc. In particular, endurance exercise training (cycling © Springer Nature Switzerland AG 2019 P. Bourdot et al. (Eds.): EuroVR 2019, LNCS 11883, pp. 87–96, 2019. https://doi.org/10.1007/978-3-030-31908-3_6