Abstract: Systems and methods are provided for identifying a therapeutic VR activity or exercise for a subject/patient based on the subject's impairments, dynamically adjusting a VR activity for a patient, and identifying potential impairments based on a patient's performance in a VR activity. Patients may each have various physical, neurological, cognitive, and/or sensory impairments to be treated. Not all therapeutic activities may be appropriate for some patients and their impairments. A VR therapeutic activity platform may increase patient engagement and challenge patients at more appropriate times by better matching activities corresponding to a patient's impairments and dynamically adjusting each VR activity based on performance to offer a challenging and rewarding therapeutic experience.