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The aim of this device is to empower children with motor impairment and enable them to access and enjoy gaming despite their disabilities. The videogame controller function was achieved through on-board gesture classification using a two-tiered Fine Tree machine learning algorithm integrated into the device\u2019s firmware. Based on features extracted from two inertial sensors present on the device, the classifier was trained to identify in real time 22 classes representing different postures and movements of forearm and wrist, showing an accuracy higher than 94%. A cohort of children (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200919, aged 9.01\u2009\u00b1\u20091.95\u00a0years old) with neuromotor impairment involving the upper limb were enrolled to test the device. The acceptability and effectiveness of the device were evaluated through a specific questionnaire: the resulting answers were heavily skewed towards appreciation (80.5%) rather than criticism. The methods of classification were found to be simple and effective in controlling the game. In conclusion, Playcuff was shown to be a versatile and well-received orthotic controller, which could be used in future also for videogame-based rehabilitation.\n                  <\/jats:p>","DOI":"10.1007\/s10439-026-04035-7","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T18:27:50Z","timestamp":1771871270000},"page":"2346-2363","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Design and Preliminary Evaluation of a Smart Orthotic Videogame Controller Dedicated to Children"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4072-6431","authenticated-orcid":false,"given":"Fabio","family":"Lazzari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0347-401X","authenticated-orcid":false,"given":"Jacopo","family":"Roman\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3055-2327","authenticated-orcid":false,"given":"Roberta","family":"Nossa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Meloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-5276","authenticated-orcid":false,"given":"Lorenzo","family":"Garavaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-9355","authenticated-orcid":false,"given":"Eleonora","family":"Diella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Valoriani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Fedeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9160-9986","authenticated-orcid":false,"given":"Matteo","family":"Porro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2568-9735","authenticated-orcid":false,"given":"Emilia","family":"Biffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-4602","authenticated-orcid":false,"given":"Simone","family":"Pittaccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"4035_CR1","unstructured":"WHO. 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