{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T06:38:03Z","timestamp":1772087883224,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011096","name":"Philippine Council for Health Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011096","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of the Philippines Manila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Information"],"abstract":"<jats:p>Virtual reality (VR) is increasingly integrated into the rehabilitation of children with cerebral palsy (CP). However, evidence to substantiate its potential as part of standard care remains limited. This Phase 1 study aimed to evaluate a VR-based immersive gamification technology system (ImGTS) for use in CP rehabilitation based on its safety, acceptability, and usability in healthy children. The system included software and hardware designs informed by discussions with CP rehabilitation and VR development experts (e.g., developmental pediatricians, physical therapists) and tailored to the local context, tested with two setups: the head-mounted display (HMD) and the semi-cave automatic virtual environment (semi-CAVE). We describe the experience of 30 healthy children aged 6\u201312 years using the ImGTS (Mission to Planet Axel version 1.0) using either the HMD (n = 15) or semi-CAVE (n = 15) setup. Descriptive and thematic analyses of data from semi-structured interviews based on questionnaires for safety and acceptability, as well as observations of behaviors for the usability dimensions of effectiveness, efficiency, and satisfaction, indicated that participants were engaged and motivated with the ImGTS, with low incidence and severity of VR-related symptoms for both setups and high acceptance of the ImGTS, based on perceptions of the environment and feelings of presence. Usability was also high. These findings suggest that the ImGTS is safe, acceptable, and usable for healthy children. This trial provides initial evidence to guide the methods of subsequent trials testing the safety, acceptability, usability, and clinical effectiveness of the ImGTS in children with cerebral palsy, and, eventually, to guide its deployment.<\/jats:p>","DOI":"10.3390\/info17020206","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T11:11:28Z","timestamp":1771240288000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety, Acceptability, and Usability of Immersive Gamification System for Use in Rehabilitation Management of Pediatric Patients with Cerebral Palsy and with Mobility Limitations (Phase 1 Trial)"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-4655","authenticated-orcid":false,"given":"Maria Eliza R.","family":"Aguila","sequence":"first","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-0189","authenticated-orcid":false,"given":"Cherica A.","family":"Tee","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josiah Cyrus R.","family":"Boque","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Computer Science, College of Engineering, University of the Philippines Diliman, Quezon City 1101, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4471-8415","authenticated-orcid":false,"given":"Juan Raphael M.","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-0891","authenticated-orcid":false,"given":"Isabel Teresa O.","family":"Salido","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4943-3504","authenticated-orcid":false,"given":"Bryan Andrei C.","family":"Galecio","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Game Design and Development, School of Management and Information Technology-Analytics, Computing and Infotech Cluster, De La Salle-College of St. Benilde, Manila 1004, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-7585","authenticated-orcid":false,"given":"Ben Anthony A.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Neurosciences, College of Medicine\u2013Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2849-8683","authenticated-orcid":false,"given":"Christian Alfredo K.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0113-8290","authenticated-orcid":false,"given":"Michael L.","family":"Tee","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Physiology, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-8805","authenticated-orcid":false,"given":"Veeda Michelle M.","family":"Anlacan","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Neurosciences, College of Medicine\u2013Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5317-7369","authenticated-orcid":false,"given":"Roland Dominic G.","family":"Jamora","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Neurosciences, College of Medicine\u2013Philippine General Hospital, University of the Philippines Manila, Manila 1000, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-594X","authenticated-orcid":false,"given":"Jaime D. L.","family":"Caro","sequence":"additional","affiliation":[{"name":"Augmented Experience eHealth Laboratory, UP CAMP Immersive Laboratory, University of the Philippines Manila, Manila 1000, Philippines"},{"name":"Department of Computer Science, College of Engineering, University of the Philippines Diliman, Quezon City 1101, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.47895\/amp.v51i4.496","article-title":"Profile of pediatric patients with cerebral palsy at the department of rehabilitation medicine, Philippine General Hospital","volume":"51","author":"Hebreo","year":"2017","journal-title":"Acta Medica Philipp."},{"key":"ref_2","first-page":"8","article-title":"A report: The definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum","year":"2007","journal-title":"Dev. Med. 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