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이중과제 훈련이 뇌졸중 환자에게 미치는 영향 : 체계적 고찰 및 메타분석

Effects of the Dual-Task Training on Stroke Patients : A Systematic Review and Meta-analysis

  • 원경아 (연세대학교 일반대학원 작업치료학과) ;
  • 임승주 (연세대학교 일반대학원 작업치료학과) ;
  • 박혜연 (연세대학교 보건과학대학 작업치료학과) ;
  • 박지혁 (연세대학교 보건과학대학 작업치료학과)
  • Won, Kyung-A (Dept. of Occupational Therapy, Graduate School of Yonsei University) ;
  • Lim, Seung-Ju (Dept. of Occupational Therapy, Graduate School of Yonsei University) ;
  • Park, Hae Yean (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Park, Ji-Hyuk (Dept. of Occupational Therapy, College of Health Science, Yonsei University)
  • 투고 : 2019.11.05
  • 심사 : 2019.11.07
  • 발행 : 2020.05.31

초록

목적 : 본 연구는 뇌졸중 환자를 대상으로 한 이중과제 훈련(Dual-task training)의 효과를 알아본 연구들을 분석하는 것을 목적으로 한다. 연구방법 : NDSL, RISS, PubMed, CoChrane, EMBASE를 통해 지난 10년 간 국내외 학술지에 게재된 논문들을 검색하였고, 최종적으로 10개의 논문을 선정하였다. 이를 전통적 단일계층 근거 모형에 따른 질적평가를 시행하고, Comprehensive Meta Analysis 3.0 프로그램을 통해 메타분석을 시행하였다. 결과 : 선정된 10편의 논문의 질적 수준은 모두 전통적 단일계층 근거 모형의 I과 II에 해당되어 높은 편에 속했다. 이중과제 훈련을 구성하고 있는 운동과제로는 7편의 문헌에서 보행 또는 균형 과제를 선택했으며, 3편의 연구에서 상지운동 관련 과제를 선정하였다. 메타분석을 실시한 결과 일상생활활동 수행능력이 0.65, 인지기능이 0.64로 보통(medium) 효과크기로, 하지운동 기능과 상지운동 기능은 각각 0.34와 0.22로 작은(small) 효과크기를 보였다. 일상생활활동 수행능력과 인지기능의 효과크기만 통계학적으로 유의미하였다(p<0.05). 결론 : 본 연구를 통해 이중과제 훈련이 뇌졸중 환자의 일상생활활동 수행능력 및 인지기능 회복에 유용한 중재기법이 될 수 있음을 확인하였다. 이는 국내 임상 환경에서 뇌졸중 환자에게 적절한 중재방법을 선정할 때 도움이 될 만한 자료로 활용될 수 있을 것이다.

Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

키워드

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