The Journal of Korean society of community based occupational therapy (대한지역사회작업치료학회지)

Korean Society of Community Based Occupational Therapy Association (대한지역사회작업치료학회)
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Occupational Therapy for Community Mobility in Stroke Patients : Systematic review

뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰

  • Jo, Eun-Ju (Workers' Compensation and Welfare Service Changwon hospital) ;
  • Kam, Kyung-Yoon (Dept. of Occupational Therapy, College of Healthcare Medical Science and Engineering, Inje University) ;
  • Chang, Moon-Young (Dept. of Occupational Therapy, College of Healthcare Medical Science and Engineering, Inje University)
  • 조은주 (근로복지공단 창원병원과) ;
  • 감경윤 (인제대학교 작업치료학과) ;
  • 장문영 (인제대학교 작업치료학과)
  • Received : 2018.11.20
  • Accepted : 2018.12.24
  • Published : 2018.12.31
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Abstract

Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.

목적 : 본 연구는 뇌졸중 환자에게 적용한 지역사회이동을 위한 작업치료적 중재를 분석한 논문으로, 임상에서 지역사회이동에 대한 중재를 사용하는데 있어 근거를 제시하고자 한다. 연구방법 : PRISMA checklist와 diagram을 통해 체계적 고찰을 시행하였고, 데이터베이스는 PubMed, EMBASE, Cochrane library (CENTRAL), ProQuest Dissertations & thesis (PQDT), 한국교육학술정보원(RISS)과 코리아메드(KoreaMed)를 이용하였다. 검색기간은 2005년부터 2018년 9월까지로 하였다. 연구에 선택된 문헌의 질 평가는 RoBANS (Riks of Bias Assessment tool for Non-randomized Study)를 사용하였다. 연구에 포함된 문헌은 총 8개이었다. 문헌에서 사용된 중재들은 종류에 따라 분류하였다. 결과 : 문헌의 연구디자인은 무작위배정 실험연구, 유사실험연구, 전후비교연구, 환자-대조군연구, 횡단적 연구로 다양하게 나타났다. 포함된 문헌의 질적수준은 level I이 1편(12.5%), level II가 6편(75%), level III가 1편(12.5%)으로 나타났다. 문헌의 '편향 위험 낮음' 비율은 62.5%~87.5%로 각 문헌마다 다르게 나타났다. 문헌에 사용된 중재는 가상 현실 및 가상환경을 기반으로 한 중재가 4편(50%)으로 가장 많았고, 프로토콜을 이용한 중재가 3편(37.5%), 휠체어 사용훈련이 1편(12.5%)으로 나타났다. 각 중재의 효과는 전반적으로 유의미하게 나타났다. 결론 : 본 연구는 지역사회이동에 대한 작업치료의 중재효과를 체계적으로 보고하여 임상적 적용근거를 제공하였다. 추후 지역사회이동성에 대해 다양한 형태로 중재를 적용한 연구가 이루어져야 할 것이다.

Keywords

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