A Multi-Component Physiotherapeutic Intervention among Schoolchildren with Myopia: 3D-Based Vision Training Program with Auditory Frequency Entrainment and Electrical Stimulation

Purpose. This study evaluated whether 3D-based vision training (VT) with visual cortex-activated auditory frequency entrainment and bilateral orbital electrical stimulation (ES) could prevent the progression of myopia among schoolchildren. Methods. In this two-stage, randomized, crossover, single-blind study, pre- and post-logMAR visual acuity and refractive error from 27 schoolchildren with myopia (<=-0.50 D) were evaluated among four groups: (1) sham control with no VT, frequency following response (FFR), or ES (control group); (2) 3D-based VT only (VT group); (3) VT with FFR generated through visual cortex-activated auditory entrainment (VT-FFR group); and (4) VT with FFR and bilateral orbital ES (VT-FFR-ES group). In stage 1, the intervention was administered for 30 min to all groups using a randomized crossover design. In stage 2, the intervention was administered for 30 min/day, 3 days a week, for 4 weeks to evaluate the effectiveness of intervention. Results. Compared with the pre-test, post-test logMAR visual acuity after a single intervention was not significantly different in control and VT groups, but significantly improved in the VT-FFR (-0.08 +/- 0.11) and VT-FFR-ES groups (-0.13 +/- 0.14). Compared with the pre-test, post-test refractive error by spherical equivalent in VT-FFR-ES group for the 4-week intervention was significantly (<0.001) improved (0.21 D) compared with the control group (-0.1 D). Conclusions. The multicomponent physiotherapeutic intervention of 3D-based VT with auditory FFR and bilateral orbital ES can inhibit the progression of myopia. This intervention can be used as a noninvasive physiotherapeutic approach to prevent or reduce the severity of myopia.