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Background <p>This study systematically evaluated the effects of exercise interventions on functional visual outcomes (dynamic and static visual acuity) and structural myopia indicators (refractive error and axial length) in children and adolescents, and compared the effectiveness of different intervention strategies to provide evidence for myopia prevention and control.</p> Methods <p>We systematically searched CNKI, Wanfang, PubMed, and Web of Science for randomized controlled trials investigating the effects of exercise on myopia in children and adolescents. Meta-analyses, subgroup analyses, sensitivity analyses, and publication bias assessments were conducted using Stata 18.0. Multivariate meta-regression analyses were performed in R (version 4.6.0) to identify potential sources of between-study heterogeneity.</p> Results <p>A total of 31 studies involving 9,892 children and adolescents were included. Meta-analysis demonstrated that exercise significantly improved both dynamic visual acuity (SMD = 0.58, 95% CI: 0.21–0.96, <i>P</i> &lt; 0.001) and static visual acuity (SMD = 0.69, 95% CI: 0.46–0.92, <i>P</i> &lt; 0.001), with both outcomes showing moderate effect sizes. Exercise also produced a small but significant improvement in refractive error (SMD = 0.29, 95% CI: 0.12–0.45, <i>P</i> &lt; 0.001) and significantly inhibited axial length growth (SMD = − 0.13, 95% CI: − 0.19 to − 0.07, <i>P</i> &lt; 0.001). Subgroup analyses indicated that students in grades 1–3, vision training interventions, programs conducted 4–6 times per week, and intervention durations of 120–300&#xa0;min per week were associated with greater improvements in dynamic visual acuity, while interventions implemented in combined indoor–outdoor settings yielded the largest effect sizes. For static visual acuity, physical and mental health exercises, ball sports, intervention frequencies of 1–3 times per week, and durations of 120–300&#xa0;min per week were associated with more favorable outcomes. Multivariate meta-regression identified intervention setting as a potential independent moderator of improvements in dynamic visual acuity, whereas differences among certain exercise types were attenuated after multivariable adjustment. These findings remained robust following CRVE correction. No stable or significant independent moderators were identified for static visual acuity. Axial length outcomes exhibited low heterogeneity, indicating a high degree of consistency across studies regarding the inhibitory effect of exercise on axial elongation.</p> Conclusion <p>Exercise interventions exert a consistently positive effect on the visual function of children and adolescents, significantly improving both dynamic and static visual acuity. They may also help slow the structural progression of myopia, with particularly consistent effects on inhibiting axial elongation. Exercise modality and intervention characteristics may act as moderating factors influencing intervention efficacy. Specifically, vision training exercises conducted in combined indoor–outdoor settings and delivered at moderate intervention doses appear to be more effective for enhancing dynamic visual, whereas mind–body exercises and ball sports may provide greater benefits for static visual acuity. Overall, exercise interventions represent a promising adjunctive strategy for the comprehensive prevention and management of myopia in children and adolescents.</p>

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Impact of exercise on myopia in children and adolescents and its modifying factors: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月9日

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  • Jiacheng Ren,
  • Xuan Liu,
  • Lu Peng,
  • Wei Sun,
  • Aona Chen,
  • Miaomiao Zhou,
  • Meizhu Chen,
  • Zixuan Peng,
  • Chenggen Guo

摘要

Background

This study systematically evaluated the effects of exercise interventions on functional visual outcomes (dynamic and static visual acuity) and structural myopia indicators (refractive error and axial length) in children and adolescents, and compared the effectiveness of different intervention strategies to provide evidence for myopia prevention and control.

Methods

We systematically searched CNKI, Wanfang, PubMed, and Web of Science for randomized controlled trials investigating the effects of exercise on myopia in children and adolescents. Meta-analyses, subgroup analyses, sensitivity analyses, and publication bias assessments were conducted using Stata 18.0. Multivariate meta-regression analyses were performed in R (version 4.6.0) to identify potential sources of between-study heterogeneity.

Results

A total of 31 studies involving 9,892 children and adolescents were included. Meta-analysis demonstrated that exercise significantly improved both dynamic visual acuity (SMD = 0.58, 95% CI: 0.21–0.96, P < 0.001) and static visual acuity (SMD = 0.69, 95% CI: 0.46–0.92, P < 0.001), with both outcomes showing moderate effect sizes. Exercise also produced a small but significant improvement in refractive error (SMD = 0.29, 95% CI: 0.12–0.45, P < 0.001) and significantly inhibited axial length growth (SMD = − 0.13, 95% CI: − 0.19 to − 0.07, P < 0.001). Subgroup analyses indicated that students in grades 1–3, vision training interventions, programs conducted 4–6 times per week, and intervention durations of 120–300 min per week were associated with greater improvements in dynamic visual acuity, while interventions implemented in combined indoor–outdoor settings yielded the largest effect sizes. For static visual acuity, physical and mental health exercises, ball sports, intervention frequencies of 1–3 times per week, and durations of 120–300 min per week were associated with more favorable outcomes. Multivariate meta-regression identified intervention setting as a potential independent moderator of improvements in dynamic visual acuity, whereas differences among certain exercise types were attenuated after multivariable adjustment. These findings remained robust following CRVE correction. No stable or significant independent moderators were identified for static visual acuity. Axial length outcomes exhibited low heterogeneity, indicating a high degree of consistency across studies regarding the inhibitory effect of exercise on axial elongation.

Conclusion

Exercise interventions exert a consistently positive effect on the visual function of children and adolescents, significantly improving both dynamic and static visual acuity. They may also help slow the structural progression of myopia, with particularly consistent effects on inhibiting axial elongation. Exercise modality and intervention characteristics may act as moderating factors influencing intervention efficacy. Specifically, vision training exercises conducted in combined indoor–outdoor settings and delivered at moderate intervention doses appear to be more effective for enhancing dynamic visual, whereas mind–body exercises and ball sports may provide greater benefits for static visual acuity. Overall, exercise interventions represent a promising adjunctive strategy for the comprehensive prevention and management of myopia in children and adolescents.