Medea\"--Scientific Hospital for Neurorehabilitation--Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), 72100 Brindis, Italy; [PERSON]L.M. ); [PERSON]] (G.B. ); [PERSON]SS] (G.P. ); [PERSON](C.B. ); [EMAIL_ADDRESS] (M.C.O. ); [EMAIL_ADDRESS] (I.F. ); [EMAIL_ADDRESS] (I.G. ); [EMAIL_ADDRESS] (I.G. ); [EMAIL_ADDRESS] (I.D.R);  
2  
Scientific Institute IRCCS \"E. Medea\", Scientific Direction, 23842 Bossio Parini, Italy; [EMAIL_ADDRESS] (G.A. ); valentina.nicolardielanostrafamiglia.it (V.N.) 4  
A Two-Step Neurorehabilitation Program Utilizing Extended Reality and Telex rehabilitation for Children with Cerebral Palsy: A Pilot Study on Effectiveness, Adherence, and Technical Feasibility. _J. Scri._ Scri._ Scri._ Scri._ Scri._ Scri._ Scri._ Scri._ Scri._ Scri._ Scri. Scri._ Scri. secondary complications, including musculoskeletal problems, epilepsy, cognitive impairments, and behavioral challenges, all of which can further impact their quality of life [1]. Neurorehabilitation treatments for children with cerebral palsy (CP) target all aspects of the International Classification of Functioning, Disability, and Health (ICF) framework, using a motor learning approach [4; 5]. The primary goal is to enhance motor function by prioritizing child-initiated movement. The approach incorporates strategies such as task specificity, goal-directed training, high-intensity training, parental engagement (aligned with family-centered care), and environmental modifications [6; 7]. These interventions are often supported by pharmacological treatments, such as oral balcofen and botulinum toxin injections, as well as surgical options. The combined approach seeks to optimize motor function during key periods of neuroplasticity, ultimately improving the quality of life for individuals with CP [6; 8; 9; 10]. In recent years, the digital age has introduced transformative technologies and e-health tools, paving the way for groundbreaking treatments across diverse healthcare domains. Among these, \"extended reality\" (XR) has emerged as a comprehensive term that encompasses a range of immersive technologies, including augmented reality (AR), mixed reality (MR), and virtual reality (VR). XR applications, combined with advancements in telerehabilitation (TR), have demonstrated substantial potential in the field of neurorehabilitation, showing promise particularly in addressing motor dysfunctions in individuals with cerebral palsy [11; 12; 13; 14]. Beyond CP, these technologies are increasingly applied to address both motor and cognitive impairments across a wide spectrum of neurological and neuropsychological conditions, including stroke, neurodegenerative diseases, and neurodevelopmental disorders [15; 16; 17]. Virtual reality (VR) is an advanced human-computer interface that allows users to engage with and immerse themselves in a simulated environment, often crafted to mirror elements of the real world [18]. VR enables individuals to feel as though they are in a different location from their physical surroundings, creating a \"sense of presence\"--the feeling of genuinely being within the virtual setting. This immersive experience responds naturally to stimuli, involving not only visual perception but also engaging the user's physiological and neural responses. This effect, known as \"embodiment\", describes the sensation of having a body within the virtual space that behaves as it would in reality. This embodied experience can serve as a rehabilitation tool, promoting and enhancing functional recovery [19; 20]. VR systems can be broadly categorized into immersive, semi-immersive, and non-immersive types [21]. The term \"immersion\" refers to the degree to which a VR system provides a convincing sensorimotor experience by simulating reality through sensory input [22]. Immersive virtual reality (VR) is designed to transport users into computer-generated three-dimensional environments, offering a sensation of total immersion.