An Action Research on the Effects of Exercise on the Vision of
Elementary School Students- with Yunlin County’s Dongshih
Elementary School Students as our Subject of Study
Li-Kung Tu
School Nurses Association of R.O.C
The Status Quo of Dongshih Elementary School
The school is situated in the rural area of Yunlin, with close proximity to the beach: It
is surrounded by a large, open space. Single parents, foreign spouses, grandparents
raising grandchildren, and low-income, underprivileged families make up 1/5 to 1/4
of the local population. The promotion of vision care has been taking place for many
years, but statistics show vision health is declining (table 1). From the school’s past
efforts in health promotion projects, the students’ knowledge and techniques have
taken a positive turn, but their actions have not shown significant change. A change is
called for: through nursing evaluation, the cause of the problem can be analyzed and
an action plan can be developed and implemented. The objective is to find a feasible
way of protecting students’ vision, hoping that this method can encourage children
and families to make an effort to protect their vision in a competitive generation
where electronic devices are all but too accessible. It is also a gateway to attracting
like-minded schools to join us in creating new ways of taking care of our vision.
Table 1: Dongshih Elementary School Academic Year 2010-2013 Poor Vision
Statistics Chart
Admission Year
Academic
Year
Admission Admission
Admission
Admission
Admission
Year 2010 Year 20009
Year 2008
Year 2007
Year 2006
Academic Year 2009
19.05% 37.25% 36.00% 59.40%
Academic Year 2010
31.00% 27.35% 40.20% 42.75% 63.45%
Academic Year 2011
27.65% 41.50% 50.00% 56.25% 67.20%
Academic Year 2012
39.40% 44.45% 53.60% 66.10%
Academic Year 2013
41.50% 44.95% 63.05%
Picture 1: Dongshih Elementary School Academic Year 2010-2013 Poor Vision
Statistics Graph
Admission
year
2010
2009
2008
2007
2006
Academic year
2010
2010
2011
2013
Picture 1 shows an annual increase in poor vision rate in each grade
Table 2: Incidence of myopia in Taiwan between the ages of 6 and 18 (1986-2010)
Year
Grade
Elementary
Grade 1
Elementary
Grade 6
Middle School
3rd Year
High School
3rd Year
1986
1990
1995
2000
2006
2010
3.00%
6.5%
12.80% 20.40% 19.60% 21.50%
27.5%
35.2%
55.80% 60.60% 61.80% 65.80%
61.6%
74.0%
76.4%
80.7%
77.1%
—
76.3%
75.2%
84.1%
84.2%
85.1%
—
3rd year in high school
3rd year in middle school
6th grader
1st grader
Picture 2 shows that since 1986 Taiwanese students’ poor vision rate has
increased
Motivation and Objective of Study
True health focuses on prevention rather than cure, so in order to carry out Entry
Level Prevention, we shouldn’t rely solely on medicine by prescribing mydriatic
drops to the “disease” of poor vision, as this would be contradictory to our emphasis
on prevention.
In the human body’s anatomical cycles, autonomic nerves mostly have an antagonistic
effect on each other, and an improvement in vision depends on the sympathetic
nervous system’s ability to activate the parasympathetic nervous system’s inhibitive
effects to regulate the ciliary muscles. In today’s high-pressure lifestyle, the method
must be simple, and one that is unaffected by environmental factors such as the
weather, in order for people to accept it into their daily lives.
Subject of Study
37 students are selected randomly, and after obtaining their verbal consent between
October and November (Year 2013), they are tested at the health center.
Method of Study
This study uses pre-experimental design. First, the blood pressure, pulse rate and
visual acuity of the student will be measured before exercise. Then, the subject will be
asked to jump up and down 200 times, after which they will be immediately measured
for blood pressure, pulse rate and visual acuity. The main apparatus used for this
experiment are: a wrist sphygmomanometer and an SP-6000 electronic liquid crystal
vision tester.
Data Analysis
This study used the SPSS17.0 software to analyze the vision data before and after
exercise, including blood pressure and pulse rate. A paired t-test was then conducted.
Results of Study
Right-eye vision results before and after exercise (t=-2.105, p<0.05) showed
significant difference; left-eye vision results (t=-4.505, p<0.001) showed an extremely
significant difference. The systolic blood pressure before and after exercise (t=-4.355,
p<0.001) showed an extremely significant difference, diastolic blood pressure before
and after exercise (t=-2.103, p<0.05) showed significant difference. Pulse rate before
and after exercise (t37=-2.966, p<0.05) showed significant difference. Results are
shown in table 2.
Table 3: Analysis of subjects’ vision, blood pressures and pulse rates before and after
exercise.
Variables
N
Right eye
37
before exercise
After exercise
Average(SD)
Average(SD)
4.618(0.25)
value of t
value of p
4.669(0.24)
-2.105*
.042
4.65(0.247)
4.730(0.22)
-4.505***
.000
106.676(13.03)
118.486(14.17)
-4.355***
.000
65.216(10.89)
70.649(18.38)
-2.103*
.042
85.351(14.98)
96.541(18.63)
-2.966**
.005
vision
Left eye
37
vision
Systolic
37
pressure
Diastolic
37
pressure
Pulse rate
37
Note: *p < 0.05，** means p < 0.01，*** means p < .001
Conclusions
The activation of the sympathetic nerve is the foundation of the theory of this study.
With an activated sympathetic nervous system, the ciliary muscles relax, creating a
long distance vision effect. With an activated parasympathetic nervous system, the
ciliary muscles contract, creating a short distance vision effect. The indoor jumping
exercise proves that if students used break times to perform this exercise, it would aid
in activating the autonomic nervous system, which would in turn take immediate
effect in improving students’ vision. The results of this study hope to provide a new
strategic direction for schools that are promoting vision care, as outdoor-exercise is
not the only option.
Suggestions
Although the results of this study show significant change, vision does not have direct
correlation with pulse rate and blood pressure. There is very little information on the
subject, so one limitation of this study is that it did not have good references and
accurate action steps, and the other limitation is the precision and stability of the
sphygmomanometer.
The following factors can also be considered in subsequent studies:

The intensity and frequency of the jumping exercise should be controlled in
order to analyze the differences between high and low intensity jumping.

Cases of possible habitual use of one eye.

Breathing frequency could be used as an element of analysis.

Measuring apparatus should be chosen according to their accuracy and stability,
or use electrocardiograms to measure heart rate variability (HRV) so that the
sympathetic nervous system can be supervised.
The experiment suggests that students should become physically active during break
times as this activates the autonomic nervous system, and therefore, even in an indoor
setting, students can still take action in improving vision.
Author: Li-Kung Tu, Health Center, Dongshih Primary School, Taiwan
E-mail：[email protected]
School Nurses Association of R.O.C (Email: [email protected])