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뇌졸중 환자의 상지기능에 대한 경두개 직류자극술 효과 : 체계적 고찰 및 메타분석

Effectiveness of Transcranial Direct Current Stimulation(tDCS) on Upper Extremity Function in Stroke Patients : A Systematic Review and Meta-Analysis

박혜연|박지혁|양민아|원경아
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2020.02|재활치료과학 (Therapeutic Science for Rehabilitation)|제9권 제1호|pp. 7-23|DOI https://doi.org/10.22683/tsnr.2020.9.1.007

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키워드

뇌졸중Stroke경두개직류자극상지기능Upper extremity function비 침습적 뇌 자극Non-invasive brain stimulation(NIBS)Transcranial Direct Current Stimulation(tDCS)

초록

목적 : 본 연구는 뇌졸중 환자의 상지기능 회복에 대한 경두개 직류자극(transcranial Direct Current Stimulation; tDCS)의 효과를 살펴본 연구를 분석하는 데 목적이 있다. 연구 방법 : 2009년부터 2018년 현재까지 국내외 학술지에 게재된 논문들을 NDSL과 RISS를 통해 검색하였 다. 선정기준과 배제기준을 통해 총 14개의 실험연구 논문이 선정되었다. 이를 PEDro 척도를 사용하여 질적 평가를 시행하고, 이 중 12개 논문에 대해서 Comprehensive Meta Analysis 3.0 프로그램을 사용하여 메타분석을 실시하였다. 결과 : 본 연구에서 고찰한 문헌 14편은 모두 국외 학술지에 게재된 문헌들이었다. 메타분석을 실시한 결과 효과 크기는 상지 근력 0.19로 ‘작은 효과크기’, 상지 움직임 0.49로 ‘보통 효과크기’를 보였다. 상지 움직임의 효과크기는 통계적으로 유의한 변화가 있던 것으로 분석되었다(  ). 또한 양극 (anode) 모드는 ‘큰 효과크기’를. 음극(cathode) 모드는 ‘보통 효과크기’를 보였으며, 양극 모드의 효과크기만 통계적으로 유의하였다(  ). 결론 : 본 연구 결과를 통하여 상지기능이 제한된 뇌졸중 환자에게 tDCS는 유용한 재활 기법이 될 수있다는 것을 확인하였다. 이는 국내 임상가들에게 뇌졸중 환자를 위한 새로운 재활 기법의 기초자료를 제시하고, 효과적인 중재를 계획하는 데 도움이 될 것이다.

Abstract

Objective : The purpose of this article was to analyze the effects of tDCS on the recovery of upper limb function in stroke patients. Methods : We searched for papers published in journals between 2009 to 2018, using NDSL and RISS. A total 14 experimental research papers were selected for analysis. The quality of the 14 articles was evaluated using the PEDro scale and 12 articles were analyzed through the Comprehensive Meta Analysis 3.0 program. Results : All of the 14 articles that were systematically reviewed in this study were published in foreign journals. The effect sizes for upper extremity(U/Ex) strength and U/Ex motion were 0.19(small size effect) and 0.49(medium size effect) respectively. Furthermore, the effect sizes of anode mode and cathode mode were 0.71(large size effect) and 0.41(medium size effect), respectively .The effect size of U/Ex motion and the anode mode were statistically significant(p<0.05). Conclusion : We identified that tDCS can be a useful rehabilitation technique for stroke patients with limited upper body function. These findings are expected to help with suggestions for basic data on new rehabilitation techniques for stroke patients and the planning of effective interventions.

참고문헌 (36)

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