Associations of rope-skipping and endurance running performance with myopia and spherical equivalent refraction in children and adolescents: a cross-sectional study
- 1Hunan University of Technology
Abstract
Objective To examine nonlinear associations and reference thresholds between physical fitness performance and refractive outcomes in children and adolescents. Methods We surveyed 17235 students aged 6-18 years from 35 schools in seven counties or cities in Hainan Province in December 2023. Cycloplegic autorefraction was used, and spherical equivalent refraction averaged between the two eyes (SEmean) of [≤]-0.50 diopters was classified as myopia. Models adjusted for age, sex, ethnicity, urban-rural residence, near-work duration, outdoor activity time, parental myopia history, BMI, and a centered BMI-squared term, with school-clustered robust standard errors. Waist-to-height ratio was examined in sensitivity analyses. Results The overall myopia prevalence was 64.43%. Among students aged 6-12 years, rope skipping showed a nonlinear association with refractive outcomes, with a reference threshold of 66 skips/min. Below this threshold, each additional 10 skips/min was associated with lower odds of myopia (OR 0.949, 95% CI 0.919-0.980; P=0.001) and a 0.034-D shift toward more hyperopic SEmean (95% CI 0.016- 0.052; P<0.001). Among students aged 16-18 years, endurance performance showed no clear overall nonlinearity; however, beyond 307 s, each additional 10 s was associated with higher odds of myopia (OR 1.255, 95% CI 1.030-1.531; P=0.025) and a 0.098-D shift toward myopia in SEmean (95% CI -0.171 to -0.026; P=0.007). Sensitivity estimates were directionally consistent. Conclusions Fitness indicators showed range-specific associations with refractive outcomes. The two thresholds should be regarded as exploratory values for school-level risk stratification rather than causal or diagnostic cutoffs. Missing direct body-composition measures and the cross-sectional design limit interpretation of independent effects.
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BibTeX
@misc{li2026associations,
title = {{Associations of rope-skipping and endurance running performance with myopia and spherical equivalent refraction in children and adolescents: a cross-sectional study}},
author = {A. Li and L. Xin and J. Zhou},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.20.26365985},
url = {https://www.medrxiv.org/content/10.64898/2026.10.20.26365985v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Associations of rope-skipping and endurance running performance with myopia and spherical equivalent refraction in children and adolescents: a cross-sectional study
AU - A. Li
AU - L. Xin
AU - J. Zhou
PY - 2026
DA - 2026/10/20
PB - medRxiv
DO - 10.64898/2026.10.20.26365985
UR - https://www.medrxiv.org/content/10.64898/2026.10.20.26365985v1
AB - Objective To examine nonlinear associations and reference thresholds between physical fitness performance and refractive outcomes in children and adolescents. Methods We surveyed 17235 students aged 6-18 years from 35 schools in seven counties or cities in Hainan Province in December 2023. Cycloplegic autorefraction was used, and spherical equivalent refraction averaged between the two eyes (SEmean) of [≤]-0.50 diopters was classified as myopia. Models adjusted for age, sex, ethnicity, urban-rural residence, near-work duration, outdoor activity time, parental myopia history, BMI, and a centered BMI-squared term, with school-clustered robust standard errors. Waist-to-height ratio was examined in sensitivity analyses. Results The overall myopia prevalence was 64.43%. Among students aged 6-12 years, rope skipping showed a nonlinear association with refractive outcomes, with a reference threshold of 66 skips/min. Below this threshold, each additional 10 skips/min was associated with lower odds of myopia (OR 0.949, 95% CI 0.919-0.980; P=0.001) and a 0.034-D shift toward more hyperopic SEmean (95% CI 0.016- 0.052; P<0.001). Among students aged 16-18 years, endurance performance showed no clear overall nonlinearity; however, beyond 307 s, each additional 10 s was associated with higher odds of myopia (OR 1.255, 95% CI 1.030-1.531; P=0.025) and a 0.098-D shift toward myopia in SEmean (95% CI -0.171 to -0.026; P=0.007). Sensitivity estimates were directionally consistent. Conclusions Fitness indicators showed range-specific associations with refractive outcomes. The two thresholds should be regarded as exploratory values for school-level risk stratification rather than causal or diagnostic cutoffs. Missing direct body-composition measures and the cross-sectional design limit interpretation of independent effects.
ER -