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뇌졸중 환자 대상의 가상현실 운동프로그램이 기능회복에 미치는 효과: 체계적 문헌고찰 및 메타분석

Effects of Virtual Reality Program on Recovery of Functional in individuals Stroke: A Systematic Review and Meta Analysis

  • 박서아 (경북보건대학교 간호학과) ;
  • 김혜영 (계명대학교 간호학과)
  • 투고 : 2019.02.14
  • 심사 : 2019.05.20
  • 발행 : 2019.05.28

초록

본 연구는 뇌졸중 환자의 기능회복에 대한 가상현실 운동프로그램의 효과를 검증하기 위해 수행된 체계적 문헌고찰 및 메타분석 연구이다. 데이터베이스는 학술연구정보서비스(RISS), 한국학술정보(Korean studies Information Service System, KISS), 한국 의학논문데이터베이스(KMbase)를 활용하여 '뇌졸중', '뇌경색', '상지기능', '균형', '일상생활능력', '운동훈련', '운동중재' '재활' '가상현실', '가상현실 교육', '가상현실 프로그램'을 검색어로 최근 10년(2009년~2018년)간 문헌을 검토하였다. 분석은 R을 이용한 임의효과모형을 적용하여 상지기능, 균형과 일상생활능력의 효과 크기를 각각 산출하였다. 최종적으로는 RCT 9편을 분석하였다. 개별문헌은 Cochrane Collaboration의 RoB (Risk of Bias) 도구를 통해 비뚤림 위험을 평가하였으며, 전반적인 비뚤림 위험은 낮았다. 본 연구결과 균형에 대한 효과크기(g=.77), 일상생활 활동에 대한 효과크기(g=.80)로 "큰 효과크기"를 나타내었다. 따라서, 뇌졸중 환자의 균형과 일상생활능력 향상을 위한 가상현실 운동프로그램이 효과적임을 확인하게 되었다. 향후 가상현실 운동프로그램 이용한 보다 효과적인 프로그램 개발과 적용에 대한 연구가 필요하다고 생각된다.

This study was carried out to evaluate the efficacy of Virtual Reality(VR) program on recovery of functional in Stroke through systematic literature review and meta-analysis. The following databases were used to search the literature: RISS, KISS, KMbase. Keywords included 'stroke', 'CVA' 'virtual reality', 'rehabilitation', 'virtual reality program' and the evaluated articles were published from 2009 to November 2018. The statistical was used R program, the effect size of upper limb, balance and ADL were calculated by random-effects model. As a result, 9 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of VR program was balance(g=.77), ADL(g=.80) as indicated by a "large effect size". Therefore, VR program is large effective in reducing balance and ADL in strokes. It is necessary to develop and apply a virtual reality-based program using more efficient program development.

키워드

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Fig. 1. Flow diagram of study screening

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Fig. 2. Summary of Bias in Overall Trials

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Fig. 3. Forest plots of the effects of Virtual Reality program

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Fig. 4. Forest plots of the effects of Virtual Reality program by program type

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Fig. 5. Forest plots of the effects of Virtual Reality program by intervention time

Table 1. General characteristics of included studies

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