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
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목적 : 본 연구는 뇌졸중 환자를 대상으로 한 이중과제 훈련(Dual-task training)의 효과를 알아본 연구들을분석하는 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 높은편에 속했다. 이중과제 훈련을 구성하고 있는 운동과제로는 7편의 문헌에서 보행 또는 균형 과제를선택했으며, 3편의 연구에서 상지운동 관련 과제를 선정하였다. 메타분석을 실시한 결과 일상생활활동수행능력이 0.65, 인지기능이 0.64로 보통(medium) 효과크기로, 하지운동 기능과 상지운동 기능은 각각0.34와 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 유용한중재기법이 될 수 있음을 확인하였다. 이는 국내 임상 환경에서 뇌졸중 환자에게 적절한 중재방법을선정할 때 도움이 될 만한 자료로 활용될 수 있을 것이다.
Abstract
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.
참고문헌 (32)
- Abernethy, B., "Dual-task methodology and motor skills research : Some applications and methodological constraints", Journal of Human Movement Studies, 14(3), pp.101~132 (1988)
- Arbesman, M., "Using AOTA’s Critically Appraised Topic(CAT)and Critically Appraised Paper(CAP)series to link evidence to practice", OT Practice, 13(5), pp.18~22 (2008)
- Bherer, L., "Training effects on dual-task performance: Are there age-related differences in plasticity of attentional control?", Psychology and Aging, 20(4), pp.695~709 (2005)[DOI]
- Borenstein, M., "A basic introduction to fixed-effect and random-effects models for meta-analysis", Research Synthesis Methods, 1(2), pp.97~111 (2010)[DOI]
- Brauer, S. G., "The influence of a concurrent cognitive task on the compensatory stepping response to a perturbation in balance-impaired and healthy elders", Gait & Posture, 15(1), pp.83~93 (2002)[DOI]
- Canning, C. G., "The effect of directing attention during walking under dual-task conditions in parkinson's disease", Parkinsonism and Related Disorders, 11(2), pp.95~99 (2005)[DOI]
- 최준환, "The Effect of Dual-Task Training on Balance and Cognition in Patients With Subacute Post-Stroke", Annals of Rehabilitation Medicine, 39(1), pp.81~90 (2015), 대한재활의학회
- 최원재, "청각적 되먹임을 이용한 인지 운동 이중 과제 훈련이 만성 뇌졸중 환자의 보행, 균형 및 집중력에 미치는 영향", 석사, 물리치료학, pp.2011
- 최원재, "청각적 되먹임을 이용한 인지 운동 이중 과제 훈련이 만성 뇌졸중 환자의 보행과 집중력에 미치는 영향", 특수교육재활과학연구, 50(3), pp.483~504 (2011), 특수교육재활과학연구소
- Cohen, J., "Statistical power analysis", Current Directions in Psychological Science, 1(3), pp.98~101 (1992)
- Dennis, A., "Fast walking under cognitive-motor interference conditions in chronic stroke", Brain Research, 1287, pp.104~110 (2009)[DOI]
- Haggard, P., "Interference between gait and cognitive tasks in a rehabilitating neurological population", Journal of Neurology, Neurosurgery & Psychiatry, 69(4), pp.479~486 (2000)
- 장철, "뇌졸중환자의 과제수행훈련이 상지기능과 인지처리속도에 미치는 영향", 정형스포츠물리치료학회지, 13(2), pp.117~126 (2017), 대한스포츠물리치료학회[DOI]
- 장연식, "이중과제수행이 뇌졸중 환자의 체간조절능력과 상지기능에 미치는 효과", 재활복지, 16(2), pp.311~331 (2012), 한국장애인재활협회 부설 재활연구소[DOI]
- Kim, G. Y., "Effect of dual-task rehabilitative training on cognitive and motor function of stroke patients", Journal of Physical Therapy Science, 26(1), pp.1~6 (2014)[DOI]
- Kim, J. Y., "Independency of ADL according to the ability of affected upper extremity of hemiplegic stroke patients : The correlation between the MAL and the MBI", The Journal of Occupational Therapy for the Aged and Dementia, 4(2), pp.11~18 (2010)
- 김여진, "이중과제 균형 훈련이 뇌졸중 환자의 균형과 일상생활동작에 미치는 효과", 대한물리의학회지, 6(1), pp.19~29 (2011), 대한물리의학회
- 이현민, "이중과제 동작관찰 신체훈련이 만성 뇌졸중 환자의 보행 능력과 일상생활 활동에 미치는 영향", 대한물리의학회지, 11(2), pp.83~91 (2016), 대한물리의학회
- Lee, Y. J., "The effects of task-specific dual-task training on upper extremity in adults with chronic stroke", Master, pp.2016
- 문미숙, "노인의 인지기능과 상지기능의 관련성에 관한 체계적 고찰", 재활치료과학, 5(2), pp.23~33 (2016), 대한신경계작업치료학회
- Liberati, A., "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : Explanation and elaboration", Annals of Internal Medicine, 151(4), pp.65~94 (2009)[DOI]
- Liepert, J., "Treatment-induced cortical reorganization after stroke in humans", Stroke, 31(6), pp.1210~1216 (2000)[DOI]
- McDowd, J. M., "The effects of age and extended practice on divided attention performance", Journal of Gerontology, 41(6), pp.764~769 (1986)[DOI]
- Park, K. D., "Effects of various dual task training on balance and abilities of daily living for the patients with stroke", Master, pp.2010
- Pellecchia, G. L., "Dual-task training reduces impact of cognitive task on postural sway", Journal of Motor Behavior, 37(3), pp.239~246 (2005)[DOI]
- Plummer-D’Amato, P., "Interactions between cognitive tasks and gait after stroke : A dual task study", Gait & Posture, 27(4), pp.683~688 (2008)[DOI]
- Silsupadol, P., "Effects of single-task versus dual-task training on balance performance in older adults : A double-blind, randomized controlled trial", Archives of Physical Medicine and Rehabilitation, 90(3), pp.381~387 (2009)[DOI]
- Simes, R. J., "Confronting publication bias : A cohort design for meta-analysis", Statistics in Medicine, 6(1), pp.11~29 (1987)
- Woo, H. M., "The effects of task-oriented dual task training on the cognitive function and daily living ability of stroke patients", Master, pp.2018
- Woollacott, M., "Attention and the control of posture and gait : A review of an emerging area of research", Gait & Posture, 16(1), pp.1~14 (2002)[DOI]
- Yang, Y. R., "Dual-task-related gait changes in individuals with stroke", Gait & Posture, 25(2), pp.185~190 (2007)[DOI]
- Yang, Y. R., "Dual-task exercise improves walking ability in chronic stroke : A randomized controlled trial", Archives of Physical Medicine and Rehabilitation, 88(10), pp.1236~1240 (2007)[DOI]