Effects of Virtual Reality Program on Glycated Hemoglobin, Static and Dynamic Balancing Ability, and Falls Efficacy for Diabetic Patients: A Systematic Review and Meta-Analysis

Purpose: We aimed to confirm the effects of virtual reality programs used for patients with diabetes on reducing blood glucose levels and improving physical function.Methods: In this systematic literature review and meta-analysis, literature was collected from various databases for randomized controlled trials published in Korean, Chinese, and English by May 2021. The search yielded 1,243 studies. Eight studies were selected for the systematic literature review, and six studies were included in the meta-analysis.Results: In the eight selected studies, a non-immersive virtual reality programs were employed as the intervention method. The effect size of the virtual reality programs on glycated hemoglobin (HbA1c) was -0.40, with no significant difference between experimental and control groups. The effect size on static balancing ability was 1.04, and the effect size on dynamic balancing ability was 2.39. The effect size on falls efficacy was 0.69, and all functional outcomes differed significantly between the experimental and control groups (p<.05). A subgroup analysis of static balancing ability was performed according to the duration of the interventional virtual reality program. When the virtual reality programs lasting for more than six weeks, shows an effect size of 1.27 for static balance ability, which was statistically significant (Z=3.32, p<.001).Conclusion: Virtual reality programs for participants with diabetes did not reduce HbA1c, but improved balance ability and falls prevention efficacy. The virtual reality program is an effective method for diabetics to be interested and consistently self-care.