# The impact of physical exercise with additional visual tasks on self-esteem in children: the mediating role of visual acuity

## TL;DR

Adding visual tasks to physical exercise in children improves self-esteem and vision, with vision partially explaining the effect on self-esteem.

## Contribution

Demonstrates that physical exercise with visual tasks enhances self-esteem and visual acuity in children, with visual acuity partially mediating the effect.

## Key findings

- Physical exercise with visual tasks significantly improves self-esteem and visual acuity in children.
- Uncorrected distance visual acuity (UDVA) partially mediates the relationship between exercise and self-esteem.
- Self-esteem in children is positively correlated with UDVA in both eyes.

## Abstract

This study aimed to investigate the effects of physical exercise incorporating additional visual tasks on self-esteem and visual acuity in children aged 11–12. Specifically, it explored the relationship between self-esteem and visual acuity and examines whether visual acuity mediates the impact of such exercise on self-esteem.

The study randomly selected four sixth-grade classes from a primary school in Suzhou as participants. The children were divided into two groups: one group engaged in physical exercise with additional visual tasks (n = 84), while the other group followed a regular physical exercise regimen (n = 83). The experiment lasted 16 weeks, and self-esteem levels, uncorrected distance visual acuity (UDVA), and kinetic visual acuity (KVA) were measured before and after the experiment.

Significant improvements in self-esteem were observed in both the experimental and control groups (p < 0.01). In the experimental group, notable enhancements were recorded in both UDVA and KVA for both eyes (p < 0.001). In contrast, the control group showed no significant change in left eye UDVA (p > 0.05), while right eye UDVA and KVA declined. A low positive correlation was identified between self-esteem and UDVA in both eyes within the experimental group, although no correlation was found between self-esteem and KVA. Additionally, left eye UDVA was moderately positively correlated with right eye UDVA. KVA was positively correlated with UDVA in both the left and right eyes. Physical exercise incorporating visual tasks was a significant positive predictor of self-esteem in 11-12-year-olds (β = 0.759, p < 0.01). UDVA in both eyes partially mediated the relationship between exercise and self-esteem (left eye 95% CI: [0.079, 0.400]; right eye 95% CI: [0.216, 0.666]).

Physical exercise incorporating additional visual tasks can enhance self-esteem and improve both UDVA and KVA in children aged 11–12. Furthermore, the level of self-esteem in children was related to the level of UDVA in the right and left eyes. The UDVA of both eyes partially mediated the impact of physical exercise with additional visual tasks on self-esteem.