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Several types of research examined if virtual reality can be an effective solution.\u00a0This paper aims to present the cyclic process of prototyping, testing, analysing, and refining the VR system in real-world clinical settings. Seven people with\u00a0moderate to severe dementia were recruited. The experiment required the patients to attend three virtual reality iterations of rapid prototyping with user testing. All three iterations involved training activities with upper body movements similar to their usual physical training. A mixed-methods design measured affect and emotional behaviour using the Observed Emotion Rating Scale and the Visual Analog Scale. Content analysis was conducted following observations and interviews. During each iteration of rapid prototyping with user testing, quantitative measurements of performance, independence and time were recorded. Eye tracking and movement information were captured by the system. Finally, a simplified version of the presence and usability scales evaluated\u00a0the system. The results of this study provide further evidence that virtual reality can play a significant role in the improvement of people\u2019s\u00a0with dementia physical training and emotional health when is appropriately designed. The results present the vital factors which should\u00a0be\u00a0incorporated in a virtual reality system which are: 1) a simple interactions modality; 2) visible visual targets and continuous feedback; 3) personalized virtual environments; 4) personalized range of movements.<\/jats:p>","DOI":"10.1007\/s10055-022-00639-1","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T13:03:41Z","timestamp":1649336621000},"page":"421-438","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Participatory design and evaluation of virtual reality physical rehabilitation for people living with dementia"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-5565","authenticated-orcid":false,"given":"Maria","family":"Matsangidou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2543-8194","authenticated-orcid":false,"given":"Fotos","family":"Frangoudes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3593-6605","authenticated-orcid":false,"given":"Eirini","family":"Schiza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8707-4667","authenticated-orcid":false,"given":"Kleanthis C.","family":"Neokleous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3608-9612","authenticated-orcid":false,"given":"Ersi","family":"Papayianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerian","family":"Xenari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0049-8553","authenticated-orcid":false,"given":"Marios","family":"Avraamides","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1271-8151","authenticated-orcid":false,"given":"Constantinos S.","family":"Pattichis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"issue":"3","key":"639_CR1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/gps.3823","volume":"28","author":"E Aguirre","year":"2013","unstructured":"Aguirre E, Hoare Z, Streater A, Spector A, Woods B, Hoe J, Orrell M (2013) Cognitive stimulation therapy (CST) for people with dementia\u2014who benefits most? 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