Frontiers in public health · 2026
Comparative effectiveness of outdoor and exercise interventions for myopia control in children and adolescents: a systematic review and network meta-analysis of randomized clinical trials.
СтатьяСистематический обзорNetwork Meta-AnalysisСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Weng Xiaoquan, Yang Yang, Zhou Shuo, Yuan Lingyan
Аннотация
OBJECTIVE: To compare and rank the effects of different sports and outdoor activities on myopia control in children and adolescents using network meta-analysis.
METHODS: We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and major Chinese databases from database inception to Dec 31, 2025, for randomized controlled trials involving school-aged children and adolescents with myopia or at risk of myopia progression. Data were analysed using network meta-analysis in Stata 18.0. Treatment effects were expressed as mean differences (MDs) with 95% CIs, and interventions were ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: Sixteen randomized controlled trials involving 9,084 participants were included. Racket sports ranked highest for slowing axial elongation (MD -0.30 mm, 95% CI -0.58 to -0.01; SUCRA 94.9%), followed by increased outdoor time (MD -0.08 mm, 95% CI -0.13 to -0.02; SUCRA 55.7%). For refractive outcomes, visual tracking exercise ranked highest for improving spherical equivalent (MD 0.38 D, 95% CI -0.04 to 0.80; SUCRA 83.7%), followed by racket sports (MD 0.29 D, 95% CI 0.00 to 0.59; SUCRA 77.0%). Subgroup analyses showed that increased outdoor time remained effective in children aged 8.5 years or younger and in interventions lasting more than 24 weeks. Sensitivity analyses supported the robustness of the findings.
CONCLUSION: Sports and outdoor activities may affect myopia control differently across outcomes. Racket sports showed the most consistent signal for slowing axial elongation, while visual tracking exercise and racket sports ranked higher for spherical equivalent.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261339612, identifier (CRD420261339612).
METHODS: We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and major Chinese databases from database inception to Dec 31, 2025, for randomized controlled trials involving school-aged children and adolescents with myopia or at risk of myopia progression. Data were analysed using network meta-analysis in Stata 18.0. Treatment effects were expressed as mean differences (MDs) with 95% CIs, and interventions were ranked using the surface under the cumulative ranking curve (SUCRA).
RESULTS: Sixteen randomized controlled trials involving 9,084 participants were included. Racket sports ranked highest for slowing axial elongation (MD -0.30 mm, 95% CI -0.58 to -0.01; SUCRA 94.9%), followed by increased outdoor time (MD -0.08 mm, 95% CI -0.13 to -0.02; SUCRA 55.7%). For refractive outcomes, visual tracking exercise ranked highest for improving spherical equivalent (MD 0.38 D, 95% CI -0.04 to 0.80; SUCRA 83.7%), followed by racket sports (MD 0.29 D, 95% CI 0.00 to 0.59; SUCRA 77.0%). Subgroup analyses showed that increased outdoor time remained effective in children aged 8.5 years or younger and in interventions lasting more than 24 weeks. Sensitivity analyses supported the robustness of the findings.
CONCLUSION: Sports and outdoor activities may affect myopia control differently across outcomes. Racket sports showed the most consistent signal for slowing axial elongation, while visual tracking exercise and racket sports ranked higher for spherical equivalent.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261339612, identifier (CRD420261339612).