Falls among older adults are a major public health concern and often occur during daily activities that rely on visual information, such as walking and negotiating obstacles. Accurate visual input supports adaptive movement strategies needed for safe obstacle avoidance. Despite common use of lower-limb strength and balance training in fall-prevention programs, interventions that directly target visual and oculomotor function are limited. Vision training (VT), developed to improve visual skills and oculomotor control in athletes, involves repeated eye movements, visual attention, and visuospatial tasks and may engage neural systems relevant to visual processing. The effects of VT on core visual-function components in older adults, including eye–hand coordination, visual memory, peripheral perception, and eye movement, remain unclear. This trial explored whether adding an oculomotor-focused VT component to a straight leg raising program would be associated with changes in multiple visual-function outcomes in community-dwelling older adults.
This study was an exploratory pilot randomized trial designed to generate hypotheses and inform future definitive trials. The protocol was approved by the Ethics Committee of International University of Health and Welfare (Approval No. 23-Ig-12) and registered in the UMIN Clinical Trials Registry (UMIN000050796). Participants provided written informed consent prior to enrollment.
Thirty community-dwelling older adults were enrolled based on pragmatic recruitment capacity. Inclusion criteria were the ability to walk independently, sufficient visual function for daily activities, and absence of physical or cognitive impairments. Participants were recruited between January and March 2024. Baseline assessments and interventions took place from April to August 2024. The sample comprised 30 individuals with a mean age of 73.7 ± 4.8 years. The sample size was set at 15 participants per group as a pilot, exploratory allocation rather than a prespecified powered calculation.
Participants were randomly assigned in a 1:1 ratio using a random number table generated by the investigator. Randomization was simple, without blocking or stratification. No allocation concealment mechanism (for example, sealed envelopes or central randomization) was used, and the investigator who generated the sequence also enrolled and assigned participants. Participant blinding was not feasible because of the nature of the interventions. Outcome assessors and data analysts were also not blinded, and the authors acknowledge the potential for performance and detection bias.
All participants completed an 8-week intervention. One group performed straight leg raising (SLR) exercises alone (SLR group). The other group performed the same SLR exercises with an additional oculomotor-focused VT component (SLR + VT group). The VT program used the commercial V-training system and emphasized repeated eye movements and visual tasks designed to challenge oculomotor control and visual attention. Specific session frequency, intensity, and progression details beyond the 8-week duration were not reported in the article excerpt.
Visual function was assessed with the V-training system (Advance Vision Partners LLC, Tokyo, Japan), which includes six task domains:
Physical function was assessed using the Timed Up and Go (TUG) test, in which participants stand from a chair, walk 3 m to a cone, turn, return, and sit down.
Given the exploratory nature of the trial, eye–hand coordination was prioritized as a key exploratory visual-function outcome because it plausibly reflects visual search efficiency and visuomotor response to repeated oculomotor practice. For each outcome, analysis of covariance (ANCOVA) was conducted with the post-intervention value as the dependent variable, group allocation as the fixed factor, and the corresponding baseline value as a covariate. This baseline-adjusted approach aimed to control for initial differences between groups. The study explicitly framed analyses as exploratory and hypothesis-generating.
All 30 participants completed the 8-week intervention and post-intervention assessments. Baseline-adjusted analyses did not demonstrate clear between-group differences in post-intervention visual-function outcomes measured by the V-training system or in the physical-function outcome measured by the TUG test. Several point estimates favored the SLR + VT group on outcomes aligned with repeated eye-movement practice (for example, measures reflecting oculomotor-related tasks), but confidence intervals were wide, and no definitive effect was confirmed. Given the small sample size and pilot design, the authors emphasize that these observations are not conclusive but may inform the selection of outcomes and sample-size calculations for future trials.
The trial had several limitations that constrain interpretation. The sample size was small and chosen pragmatically for a pilot study rather than to provide adequate statistical power for definitive comparisons. Randomization was simple and performed without allocation concealment; outcome assessors and data analysts were not blinded. These design aspects introduce potential selection, performance, and detection biases. Detailed parameters of the VT dose and session characteristics were not presented in the provided excerpt. The authors therefore characterize findings as hypothesis-generating and stress the need for adequately powered trials with time- and attention-matched control conditions and clinically meaningful endpoints to determine whether VT can produce reliable improvements in visual function relevant to mobility and fall risk.
In this pilot randomized trial of 30 community-dwelling older adults, adding an oculomotor-focused vision training component to a lower-limb SLR program did not produce clear baseline-adjusted differences in measured visual-function or physical-function outcomes. Some outcomes related to eye-movement practice showed numerical advantages for the VT group, but uncertainty was high. The results should be interpreted as exploratory; they highlight feasibility and outcome domains to consider when designing larger, rigorously controlled trials with appropriate blinding where possible, allocation concealment, and clinically meaningful functional endpoints linked to fall risk.