Effects of eye movement training on balance and vision in community-dwelling Japanese children: A pilot study using a single-group intervention

Abstract Background: Balance training is widely recognized as beneficial for children. Recently, eye movement training (ET), which targets the vestibular system that is responsible for posture and balance, has been reported. Therefore, (SUKUBARA🄬), a video-based self-training program combining ET with online guidance for accurate practice, was developed. This study evaluated the medium- to long-term effectiveness of ET in improving balance and vision in children, as well as the feasibility of home implementation. Methods: This single-arm interventional study included community-dwelling children. The ET consisted of a combination of pursuit, saccade, and two VORx2 (Vestibulo-Ocular Reflex x2) exercises, with six sets of 20 repetitions each (5 min total). Training was recommended at least once daily for 24 weeks. Participants trained while watching a video, and the playback time was recorded as practice frequency (sessions/week). The evaluation items included four types of indices of postural stability and one-leg standing time (OLS) (with eyes open and closed, seconds) for balance ability, grip strength (kgf) for muscle strength, and eye-hand coordination (No. 1) and dynamic visual acuity (No. 4) for vision function (points). Results: Among the 30 participants, 28 completed the study (mean age 10±1 years, 12 women [43%]). The total video viewing time over the 24-week period was 9.2±3.6 hours (equivalent to 4.6±1.8 sessions /week). Pre-post comparisons revealed significant improvements in No. 1 (33±5 to 36±5; p<0.001), No. 4 (12±3 to 14±4; p=0.010), OLS with eyes closed (22 [11, 44] to 35 [19, 52]; p=0.004), and grip strength (16.5 [13.8, 18.1] to 18.0 [14.5, 20.5]; p=0.002). Furthermore, the correlation analysis between change and training frequency of the intervention showed a significant positive correlation (r=0.570, p=0.003) for No. 1. Conclusions: In this 24-week single-group trial of ET with SUKUBARA🄬 in community-dwelling children, the completion rate was high with high frequency. Although ET has a limited effect on balance ability, it may be effective in improving vision function. Trial registration: Japan Registry of Clinical Trials (jRCT1032250334; date of registration: September 3, 2025; retrospectively registered). No medical devices were used in this study.