We present the architecture and usability evaluation of virtual reality system\u2014\u201cPositive Bike\u201d\u2014designed 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 \u201cdual-task\u201d paradigm. We tested the usability and user\u2019s 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 ...