{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:14:36Z","timestamp":1778130876358,"version":"3.51.4"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myopia in children is occurring earlier and progressing faster, while existing interventions such as outdoor activity and device-based visual training are often difficult to implement consistently in school settings. Motor imagery (MI), as a low-burden cognitive approach, may offer a complementary pathway for visual-function support. However, ciliary muscle\u2013oriented MI scripts specifically designed for children remain underdeveloped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This study aimed to develop a ciliary muscle\u2013oriented MI script based on the PETTLEP model for primary school children and to compare two training arrangements: G1 (staged imagery group: 8\u202fweeks of general imagery followed by 8\u202fweeks of specific imagery;\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f76) versus G2 (specific-only group: 16\u202fweeks of specific imagery;\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f80).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A school-based cluster randomized design was used. A total of 156 children aged 10\u201311\u202fyears from one primary school in Suzhou were assigned by intact class to either G1 or G2. Visual outcomes, including uncorrected distance visual acuity (UDVA), kinetic visual acuity (KVA), accommodative amplitude (AMP), and binocular accommodative facility (BAF), were assessed at baseline (T1) and post-intervention (T3). Imagery ability was assessed using the Sport Imagery Questionnaire (SIQ; cognitive-general imagery [CG] and cognitive-specific imagery [CS] dimensions) at T1, T2, and T3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both groups improved over time on several outcomes. No between-group difference was found for UDVA at T3. After Benjamini\u2013Hochberg correction, KVA was the only visual outcome showing a significant adjusted between-group difference at T3; BAF was not significant at T3, and AMP showed only a borderline trend. Significant Time\u202f\u00d7\u202fGroup interactions were found for KVA, BAF, and CG. G1 scored higher than G2 on CG at both T2 and T3. In CS, both groups improved over time; G2 scored higher at T2, but no between-group difference was found at T3. However, because the study included only four classes in total (two per condition) and the class-level ICC for post-intervention KVA was 0.366, the KVA finding should be interpreted as a hypothesis-generating class-level observation rather than a reliable training effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study developed and preliminarily evaluated a ciliary muscle\u2013oriented MI script under structured school-based conditions. The clearest between-group evidence was observed for CG. Different imagery arrangements may be associated with different developmental patterns, but visual-function findings, particularly KVA, require cautious interpretation and replication in studies with more clusters and stronger control conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1809541","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:57:24Z","timestamp":1778129844000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and preliminary evaluation of a ciliary muscle\u2013oriented motor imagery script for primary school children: a school-based cluster randomized controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Meng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Basic Courses, Suzhou City University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Basic Courses, Suzhou City University","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Sport Department, Suzhou University of Technology","place":["Suzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1038\/s41572-020-00231-4","article-title":"Myopia","volume":"6","author":"Baird","year":"2020","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref9001","doi-asserted-by":"crossref","first-page":"202196","DOI":"10.1016\/j.jeph.2024.202196","article-title":"How should a cluster randomized trial be analyzed?","volume":"72","author":"Billot","year":"2024","journal-title":"Journal of epidemiology and population health"},{"key":"ref9002","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.optom.2019.05.002","article-title":"Sources of error in clinical measurement of the amplitude of accommodation","volume":"13","author":"Burns","year":"2020","journal-title":"Journal of Optometry"},{"key":"ref2","first-page":"188","article-title":"The accommodation response of the human eye","volume":"16","author":"Campbell","year":"1959","journal-title":"Br. J. Physiol. Opt."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"280","DOI":"10.5301\/ejo.5000571","article-title":"How can we prevent myopia progression?","volume":"25","author":"Chassine","year":"2015","journal-title":"Eur. J. Ophthalmol."},{"key":"ref4","first-page":"543","volume-title":"Routledge Handbook of Applied sport Psychology: A Comprehensive guide for Students and Practitioners","author":"Cumming","year":"2023"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.ajsep.2022.07.003","article-title":"Improving the reporting of sport imagery interventions with TIDieR","volume":"2","author":"Cumming","year":"2022","journal-title":"Asian J. Sport Exerc. Psychol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/j.1468-0017.1995.tb00004.x","article-title":"Visual imagery as the simulation of vision","volume":"10","author":"Currie","year":"1995","journal-title":"Mind Lang."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/j.apmr.2020.09.397","article-title":"Overview of reviews using the template for intervention description and replication (TIDieR) as a measure of trial intervention reporting quality","volume":"102","author":"Dijkers","year":"2021","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/0014-4835(90)90234-L","article-title":"Histochemical differences within the ciliary muscle and its function in accommodation","volume":"50","author":"Fl\u00fcgel","year":"1990","journal-title":"Exp. Eye Res."},{"key":"ref9","first-page":"223","article-title":"Cardioventilatory responses during real or imagined walking at low speed","volume":"143","author":"Fusi","year":"2005","journal-title":"Arch. Ital. Biol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"3446","DOI":"10.4103\/ijo.IJO_3602_20","article-title":"Outdoor activity and myopia progression in children: a follow-up study using mixed-effects model","volume":"69","author":"Gupta","year":"2021","journal-title":"Indian J. Ophthalmol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1080\/10413200109339004","article-title":"The PETTLEP approach to motor imagery: a functional equivalence model for sport psychologists","volume":"13","author":"Holmes","year":"2001","journal-title":"J. Appl. Sport Psychol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1167\/iovs.63.2.9","article-title":"Study of the immediate effects of autostereoscopic 3D visual training on the accommodative functions of myopes","volume":"63","author":"Huang","year":"2022","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/S0364-0213(77)80020-7","article-title":"A simulation of visual imagery","volume":"1","author":"Kosslyn","year":"1977","journal-title":"Cogn. Sci."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"101673","DOI":"10.1016\/j.psychsport.2020.101673","article-title":"Generate, maintain, manipulate? Exploring the multidimensional nature of motor imagery","volume":"48","author":"Kraeutner","year":"2020","journal-title":"Psychol. Sport Exerc."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1177\/0956797613503556","article-title":"The eye pupil adjusts to imaginary light","volume":"25","author":"Laeng","year":"2014","journal-title":"Psychol. Sci."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1207\/s15516709cog2602_3","article-title":"Eye scanpaths during visual imagery reenact those of perception of the same visual scene","volume":"26","author":"Laeng","year":"2002","journal-title":"Cogn. Sci."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"132-134+252","DOI":"10.16719\/j.cnki.1671-6981.2001.02.002","article-title":"Discussion on the new procedure of mental imagery training","volume":"2","author":"Liu","year":"2001","journal-title":"Psychol. Sci."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"566","DOI":"10.13444\/j.cnki.zgzyykzz.2021.08.007","article-title":"Effect of visual training combined with anti-peripheral hyperopia optical defocus lens on myopia control in adolescents","volume":"31","author":"Lu","year":"2021","journal-title":"Chin. J. Ophthalmol. Tradit. Chinese Med."},{"key":"ref9003","doi-asserted-by":"crossref","first-page":"683","DOI":"10.4103\/0301-4738.126990","article-title":"Comparing measurement techniques of accommodative amplitudes","volume":"62","author":"Momeni-Moghaddam","year":"2014","journal-title":"Indian Journal of Ophthalmology"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.brainresrev.2008.12.024","article-title":"Cognitive motor processes: the role of motor imagery in the study of motor representations","volume":"60","author":"Munzert","year":"2009","journal-title":"Brain Res. Rev."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1111\/cxo.12365","article-title":"Visual demands in modern Australian primary school classrooms","volume":"99","author":"Narayanasamy","year":"2016","journal-title":"Clin. Exp. Optom."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1177\/2167702613497932","article-title":"Reenvisioning clinical science: unifying the discipline to improve the public health","volume":"2","author":"Onken","year":"2014","journal-title":"Clin. Psychol. Sci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"a28","DOI":"10.4102\/aveh.v74i1.28","article-title":"Mechanism of accommodation: a review of theoretical propositions","volume":"74","author":"Ovenseri-Ogbomo","year":"2015","journal-title":"African Vis. Eye Heal."},{"key":"ref23","volume-title":"Mental Representations: A Dual Coding Approach","author":"Paivio","year":"2008"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/j.tics.2015.03.004","article-title":"Phantom perception: voluntary and involuntary nonretinal vision","volume":"19","author":"Pearson","year":"2015","journal-title":"Trends Cogn. Sci."},{"key":"ref25","first-page":"116","article-title":"Childhood myopia: epidemiology, risk factors, and prevention","volume":"112","author":"Recko","year":"2015","journal-title":"Mo. Med."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1080\/07370024.2017.1293540","article-title":"Detecting intention through motor-imagery-triggered pupil dilations","volume":"34","author":"Rozado","year":"2019","journal-title":"Hum. Comput. Interact."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"287","DOI":"10.2466\/pms.1992.75.1.287","article-title":"The eyes in imagery and perceptual processes: first remarks","volume":"75","author":"Ruggieri","year":"1992","journal-title":"Percept. Mot. Skills"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/00004397-200604630-00006","article-title":"The mechanism of accommodation and presbyopia","volume":"46","author":"Schachar","year":"2006","journal-title":"Int. Ophthalmol. Clin."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1080\/00221309.1937.9917986","article-title":"A case of voluntary control of accommodation","volume":"17","author":"Sisson","year":"1937","journal-title":"J. Gen. Psychol."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance","volume":"374","author":"Skivington","year":"2021","journal-title":"BMJ"},{"key":"ref31","volume-title":"Cognitive Psychology: Mind and Brain","author":"Smith","year":"2007"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.16835\/j.cnki.1000-9817.2023.10.002","article-title":"Special interpretation of\u201ctechnical guidelines for comprehensive public health intervention in prevention and control of myopia in children and adolescents\u201d","volume":"44","author":"Tao","year":"2023","journal-title":"Sch. Heal. China"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"201","DOI":"10.3390\/app12010201","article-title":"A multi-component physiotherapeutic intervention among schoolchildren with myopia: 3d-based vision training program with auditory frequency entrainment and electrical stimulation","volume":"12","author":"Teng","year":"2022","journal-title":"Appl. Sci."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1007\/BF00998739","article-title":"Biofeedback of accommodation to reduce functional myopia","volume":"6","author":"Trachtman","year":"1981","journal-title":"Biofeedback Self Regul."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.visres.2019.08.002","article-title":"Emmetropes and myopes differ little in their accommodation dynamics but strongly in their ciliary muscle morphology","volume":"163","author":"Wagner","year":"2019","journal-title":"Vis. Res."},{"key":"ref9004","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1214\/24-STS944","article-title":"On the mixed-model analysis of covariance in cluster-randomized trials","volume":"41","author":"Wang","year":"2026","journal-title":"Statistical science: a review journal of the Institute of Mathematical Statistics"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.2202\/1932-0191.1025","article-title":"Does imagery work? Effects on performance and mental skills","volume":"3","author":"Weinberg","year":"2008","journal-title":"J. Imag. Res. Sport Phys. Act."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1515\/jirspa-2012-0005","article-title":"Methodological variations in guided imagery interventions using movement imagery scripts in sport: a systematic review","volume":"8","author":"Williams","year":"","journal-title":"J. Imag. Res. Sport Phys. Act."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/21520704.2013.781560","article-title":"Seeing the difference: developing effective imagery scripts for athletes","volume":"4","author":"Williams","year":"","journal-title":"J. Sport Psychol. Action"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1270947","DOI":"10.3389\/fpubh.2023.1270947","article-title":"The impact of additional visual tasks in physical exercise on balance ability among 9-10-year-old children: the mediating effect of visual acuity","volume":"11","author":"Yin","year":"2023","journal-title":"Front. Public Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"3831","DOI":"10.3760\/cma.j.cn112137-20200825-02468","article-title":"Vision 2020: Progress in prevention and treatment of blindness and eye health in China","volume":"100","author":"Yusuf","year":"2020","journal-title":"Chinese J. Med."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1587481","DOI":"10.3389\/fpsyg.2025.1587481","article-title":"Improving children\u2019s visual health by integrating motor imagery training into physical education classes","volume":"16","author":"Zhou","year":"2025","journal-title":"Front. Psychol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"191","DOI":"10.14166\/j.issn.1671-2420.2023.03.001","article-title":"Guidance of experts on eye health management of electronic screen for school-age children and adolescents","volume":"23","author":"Zhou","year":"2023","journal-title":"Chin. J. Ophthalmol. Otolaryngol."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1809541\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:57:29Z","timestamp":1778129849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1809541\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":46,"alternative-id":["10.3389\/fpsyg.2026.1809541"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1809541","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,7]]},"article-number":"1809541"}}