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Immersive Virtual Reality (iVR) is a promising medium to motivate users through engaging virtual environments. Currently, modern iVR lacks a comparative analysis between research and consumer-grade systems for exercise and health. This article examines two such iVR mediums: the Cave Automated Virtual Environment (CAVE) and the head-mounted display (HMD). Specifically, we compare the room-scale Mechdyne CAVE and HTC Vive Pro HMD with a custom in-house exercise game that was designed such that user experiences were as consistent as possible between both systems. To ensure that our findings are generalizable for users of varying abilities, we recruited 40 participants with and without cognitive disabilities with regard to the fact that iVR environments and games can differ in their cognitive challenge between users. Our results show that across all abilities, the HMD excelled in in-game performance, biofeedback response, and player engagement. 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