## 3 Results and Questions Analysis
### Delivery Question: Are We Getting Things Done Well? In the study by [PERSON] et al. [52] patients affirmed that they found VR rehabilitation activities \"enjoyable and challenging\". Although only 6 participants were involved and only 8 activities related to a submarine VR game were assessed, this study explains that getting the feedback of patients is important to identify motivation factors and stress factors: the feeling of \"stretching myself\", the existence of \"purpose and expectations\", and the expectation of \"future improvements\" are all motivation factors to consider when building or acquiring a VR rehabilitation game. Doing this as an additional task to the usual rehabilitation tasks was a negative factor for some patients. Nevertheless, besides measuring improvements in cognitive and physical skills, getting feedback from the patients will help researchers to improve the virtual rehabilitation approach as well. Regarding this feedback, other authors such as [PERSON] et al. [53] have recently published findings on the co-creation of these virtual rehabilitation games with the patients, particularly with younger patients, and, additionally, what is called a \"sense of community\" was identified as a powerful driver for motivation, according to [PERSON] et al. [54]. Considering computer monitor VR environments versus head-mounted display VR environments, the latter show better results on engagement, transportation, flow, and sense of presence, while negative effects such as nausea are also more probable than in the former, according to studies such as [PERSON] et al. [55]. Taking clinicians into account, on the one hand, their training needs to be increased, according to [PERSON] et al. [56], and, on the other, based on their feedback, there are also several factors to consider, including good organization of the activities, overcoming the technological gap, and the fact that individual circumstances of participants can impact positively or negatively on user experience and on the success of this experience [48]. According to other studies reviewed [57], three factors have been identified as key to assessing the outcomes on the usability of virtual rehabilitation systems: effectiveness, efficiency, and satisfaction. Patient performance on rehabilitation exercises with VR can be measured objectively, the level of difficulty can be established and reviewed objectively according to this performance ([58,59]), and treatment can be personalized to the patient's condition. Satisfaction has been measured using different systems not specifically oriented to virtual rehabilitation. However, specific questionnaires on virtual rehabilitation exist such as USEQ [60], which have proven their reliability to measure this factor. As mentioned by [PERSON] et al. [61], one of the main barriers to a more extended use of VR rehabilitation solutions is the physical space that these solutions require. Hospitals and clinics are places where space is scarce, and room for these solutions is generally in competition with room for the rest of the equipment that conventional physical and cognitive rehabilitation requires. When we try to set up these solutions in patients' homes, this is an issue that should be considered, especially if it is a long-term installation. Other aspects, such as power consumption in a context of energy prices escalating, and spare parts service, in case of malfunction, should be taken into account. Adherence to home-based treatment was studied by authors such as [PERSON] et al. [17] as well as [PERSON] et al. [62], who observed that it mainly depends on motivational enhancements. Regarding motivation, recent studies such as [PERSON] et al. [63] showed higher motivation and an acceleration of rehabilitation using VR technology. Comparing immersive and non-immersive VR environments for rehabilitation, some studies like [PERSON] et al. [64] explain that non-immersive ones are preferred by older patients as they are more comfortable and with less secondary effects such as nausea, for instance.