Immersive Physical Activity Program for Overweight Schoolchildren (PEESO)

Immersive Recreational Physical Exercise Program for Schoolchildren With Overweight or Obesity (PEESO)

Childhood overweight and obesity are major public health concerns associated with increased cardiometabolic risk and reduced quality of life. In Galicia (Spain), approximately one-third of schoolchildren aged 7-15 years are affected. Physical inactivity and sedentary behaviors contribute significantly to this condition.

The PEESO Project is a clinical trial designed to evaluate the effects of an immersive virtual reality-based physical exercise program delivered during school recess in children with overweight or obesity. The intervention uses head-mounted displays to promote moderate-to-vigorous intensity physical activity in an engaging environment.

Study Overview

• Status: Enrolling by invitation
• Conditions: Childhood Overweight and Obesity Immersive Physical Activity
• Intervention / Treatment: Behavioral: RVI_Experimental_Immersive Virtual Reality Exergame Program; Behavioral: RVI_ControGroup_Immersive Virtual Reality Exergame Program

Detailed Description

Childhood overweight and obesity are major public health concerns worldwide and are associated with increased risk of cardiometabolic disease, musculoskeletal disorders, and reduced quality of life. In Galicia (Spain), approximately one-third of schoolchildren aged 7-15 years present overweight or obesity. Physical inactivity and excessive sedentary behaviors, particularly screen time, contribute significantly to this condition.

The PEESO Project is a clinical trial designed to evaluate the effects of an immersive recreational physical exercise program delivered during school recess in children diagnosed with overweight or obesity. The intervention uses immersive virtual reality (IVR) technology through head-mounted displays to create an interactive and engaging environment that promotes moderate-to-vigorous intensity physical activity.

Immersive virtual reality may enhance exercise adherence and enjoyment by increasing motivation and reducing perceived exertion through distraction. Although active video games (exergames) have demonstrated potential to increase daily physical activity and reduce body mass index (BMI), most previous studies have focused on non-immersive systems and adult populations.

The primary objective of this study is to determine the effect of a moderate-to-vigorous intensity immersive virtual exercise program on body composition in schoolchildren with overweight or obesity. Secondary objectives include assessing its impact on quality of life and other health-related outcomes. The intervention is implemented during academic recess periods to ensure feasibility and integration within the school setting.

• Study Type: Interventional
• Enrollment (Estimated): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Pontevedra
    • Vigo, Pontevedra, Spain, 36210
      • Ies Santa Irene

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion criteria:

• Age: >12 to 16 years (n>15).
• BMI: >25.5 kg/m² (overweight) and >30 kg/m² (obesity classes I-IV).
• Agreement to participate in the study.
• Signed informed consent from parents or guardians.

Exclusion criteria:

• Presence of cardiovascular, pulmonary, or musculoskeletal conditions that would prevent participation in the virtual session.
• Inability to comply with the assessment protocol.
• Presence of severe visual or hearing impairment, vertigo, epilepsy, or uncontrolled psychosis.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: RVI_Experimental_Immersive Virtual Reality Exergame Program; The PEESO intervention is an immersive recreational physical exercise program designed for schoolchildren with overweight or obesity. The intervention is delivered during school recess periods using Head-Mounted Display (HMD)-based immersive virtual reality exergames. The program aims to provide moderate-to-vigorous intensity physical activity through personalized exercise sessions in a motivating and interactive environment.	Behavioral: RVI_Experimental_Immersive Virtual Reality Exergame Program; Participants assigned to the experimental group will perform immersive virtual reality exercise sessions THREE (3) TIMES A WEEK during school breaks. The intervention lasts 24 weeks, following a one-week adaptation period to the head-mounted devices (HMDs) and exercise video games. Exercise routines will be personalized to each participant's characteristics using a "Weight Loss" mode and will include three training categories: Full Body (6 weeks), Strength (9 weeks), and Boxing (9 weeks). The exercise load will be programmed individually through the exercise video game platform based on each participant's progress and performance. The sessions are designed to achieve a moderate to vigorous level of physical activity.
Placebo Comparator: RVI_ControGroup_Immersive Virtual Reality Exergame Program; The PEESO intervention in the control group will be the same as in the experimental group: a recreational and immersive physical exercise program designed for overweight or obese schoolchildren. It is conducted during school recess using immersive virtual reality exercise video games with virtual reality headsets (HMDs). The program aims to provide moderate-to-vigorous physical activity through personalized exercise sessions in a motivating and interactive environment.	Behavioral: RVI_ControGroup_Immersive Virtual Reality Exergame Program; Participants assigned to the control group will perform immersive virtual reality exercise sessions ONE TIMES (1) A WEEK during school breaks. The intervention lasts 24 weeks, following a one-week adaptation period to the head-mounted devices (HMDs) and exercise video games. Exercise routines will be personalized to each participant's characteristics using a "Weight Loss" mode and will include three training categories: Full Body ( 6 weeks), Strength (9 weeks), and Boxing (9 weeks). The exercise load will be programmed individually through the exercise video game platform based on each participant's progress and performance. The sessions are designed to achieve a moderate to vigorous level of physical activity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment body composition	Description: Body composition was assessed using the Tanita MC-780 bioelectrical impedance analyzer. Measured variables included fat mass (FM), fat-free mass (FFM), muscle mass (MM), total body water (TBW), and segmental body composition of the trunk and limbs. Unit of Measurement: Fat Mass (FM): kg Fat-Free Mass (FFM): kg Muscle Mass (MM): kg Total Body Water (TBW): kg Segmental Body Composition: kg Interpretation: Higher FFM, MM, and TBW indicate better physical fitness. Lower FM indicates better body composition.	24 weeks
Assessment user experience and engagement	User experience and engagement will be assessed using the Game Experience Questionnaire (GEQ - Post-Game Module). Items are rated from 0 to Unit of Measure: GEQ subscale scores (0-4) Interpretation: Higher scores indicate better experience for positive dimensions and poorer experience for negative dimensions.	24 weeks
Assessment Safety and cybersickness symptoms	Safety and cybersickness symptoms will be assessed using the Simulator Sickness Questionnaire (SSQ). Higher scores indicate greater severity of cybersickness symptoms. Unit of Measure: SSQ total score Interpretation: Lower scores indicate better tolerability and safety; a score of 0 indicates no symptoms. Safety and cybersickness symptoms will be assessed using the Simulator Sickness Questionnaire (SSQ). Higher scores indicate greater severity of cybersickness symptoms. Unit of Measure: SSQ total score Interpretation: Lower scores indicate better tolerability and safety; a score of 0 indicates no symptoms.	24 weeks
Assessment usability	System usability will be assessed using the System Usability Scale (SUS), a validated 10-item questionnaire. Scores range from 0 to 100, with higher scores indicating better usability. Unit of Measure: SUS score (0-100) Interpretation: Scores ≥68 indicate acceptable usability; scores >80 indicate excellent usability.	24 weeks
Health-Related Quality of Life (KINDL)	Description: Health-related quality of life will be assessed using the KINDL Questionnaire, a validated instrument that evaluates children's and adolescents' well-being across multiple domains, including physical well-being, emotional well-being, self-esteem, social relationships, and school functioning. Scores are calculated according to the instrument scoring manual and transformed to a scale from 0 to 100. Unit of Measure: KINDL total score (0-100) Emotional well-being (0-100) Physical well-being (0-100) Self-esteem (0-100) Social relationships (0-100) School functioning (0-100) Interpretation: Higher scores indicate better health-related quality of life and well-being in the corresponding domain. Lower scores indicate poorer perceived quality of life and greater difficulties in physical, emotional, social, or school-related functioning.	24 weeks
Physical Activity Level	Description: Physical activity and sedentary behavior will be assessed using the International Physical Activity Questionnaire - Short Form (IPAQ-SF), child/adapted version. The questionnaire evaluates moderate-to-vigorous physical activity (MVPA), sedentary time, and total physical activity. Unit of Measure: Moderate-to-vigorous physical activity (MVPA): minutes/week Sedentary time: minutes/day or hours/day Total physical activity: MET-minutes/week Interpretation: Higher MVPA and total physical activity scores indicate greater participation in physical activity and better activity levels. Higher sedentary time indicates more time spent inactive and poorer movement behavior. Lower sedentary time and higher physical activity levels reflect a healthier lifestyle.	24 weeks
Assessment Muscular Strength	Outcome Measure: Muscular Strength Description: Muscular strength will be assessed using the ALPHA-Fitness battery, including handgrip strength testing. Unit of Measure: kg Interpretation: Higher values indicate greater muscular strength and better physical fitness.	24 weeks
Assessment Agility	Outcome Measure: Agility Description: Agility will be assessed using the ALPHA-Fitness battery, through a standardized agility and speed test. Unit of Measure: seconds Interpretation: Lower completion times indicate better agility, speed, and motor performance.	24 weeks
Assessment Cardiorespiratory Fitness	Outcome Measure: Cardiorespiratory Fitness Description: Cardiorespiratory fitness will be assessed using the ALPHA-Fitness battery and expressed as estimated maximal oxygen consumption (VO₂max). Unit of Measure: mL/kg/min (VO₂max) Interpretation: Higher VO₂max values indicate better cardiorespiratory fitness and aerobic capacity. Lower values indicate poorer aerobic fitness.	24 weeks

Collaborators and Investigators

• Sponsor: University of Vigo
• Collaborators: Ministry of Work and Welfare - Xunta de Galicia

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): July 15, 2026

Study Registration Dates

• First Submitted: May 27, 2026
• First Submitted That Met QC Criteria: June 26, 2026
• First Posted (Actual): July 2, 2026

Study Record Updates

• Last Update Posted (Actual): July 2, 2026
• Last Update Submitted That Met QC Criteria: June 26, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Virtual Reality; Physical exercise; Training program; Overweight children
• Additional Relevant MeSH Terms: Nutrition Disorders; Overnutrition; Body Weight; Overweight; Obesity; Pathological Conditions, Signs and Symptoms; Behavior; Nutritional and Metabolic Diseases; Signs and Symptoms; Pediatric Obesity; Motor Activity
• Other Study ID Numbers: CP-220126-37

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No