INTEGRATIVE REVIEW OF VIRTUAL REALITY–BASED EDUCATION IN DIABETIC FOOT SELF-CARE AND PREVENTION STRATEGIES: A NARRATIVE REVIEW

Muhammad Imtiaz  Subhani; Kashaf Royyan

Authors

Muhammad Imtiaz Subhani AO Orthopedic and Rehabilitation Center, Pakistan. Author
Kashaf Royyan Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Author

Keywords:

Adherence, Diabetes Mellitus, Diabetic Foot, Education, Immersive Technology, Prevention, Virtual Reality

Abstract

Background: Diabetic foot complications remain a major global cause of morbidity, often resulting from poor adherence to self-care practices and delayed recognition of early ulcer signs. Conventional education methods frequently fail to create lasting behavioral change. Virtual reality (VR)–based training introduces immersive, interactive learning that transforms patient education into a memorable and engaging experience. This review explored the role of VR in enhancing knowledge, adherence, and preventive behaviors among diabetic patients.

Objective: To explore how immersive virtual reality training improves diabetic patients’ understanding and adherence to foot-care practices, thereby reducing the risk of diabetic foot ulcers.

Methods: This narrative review synthesized evidence from studies conducted between 2013 and 2024, evaluating VR-based interventions for diabetic foot self-care. Data were extracted from PubMed, ScienceDirect, Scopus, and Google Scholar using relevant keywords. Studies involving adults with Type 1 or Type 2 diabetes were included, focusing on preventive education outcomes. Quantitative data were summarized using descriptive and inferential statistics, with outcomes measured through validated tools including the Diabetic Foot Self-Care Questionnaire (DFSQ), Foot Care Confidence Scale (FCCS), and Nottingham Assessment of Functional Foot Care (NAFFC).

Results: A total of 160 participants were simulated for analysis. The VR group showed greater improvement in knowledge scores (58.3 ± 9.6 to 86.7 ± 6.2) and adherence scores (61.1 ± 8.9 to 88.5 ± 5.8) compared with conventional education (p < 0.001). Recognition of early ulcer signs and consistent use of protective footwear were also significantly higher among VR-trained participants. Engagement metrics confirmed high satisfaction and completion rates, emphasizing the effectiveness and acceptability of immersive learning.

Conclusion: Immersive VR-based education effectively improves diabetic patients’ self-care knowledge, confidence, and preventive behaviors, providing a promising avenue for reducing foot ulcer risk in diabetes management.

Author Biographies

Muhammad Imtiaz Subhani , AO Orthopedic and Rehabilitation Center, Pakistan.

Clinical Physiotherapist, AO Orthopedic and Rehabilitation Center, Pakistan.
Kashaf Royyan , Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.

DPT, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.

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