뇌졸중 환자의 운동기능에 원격재활이 미치는 효과: 체계적 문헌고찰
Effects of Telerehabilitation on Motor Function of Stroke Patients: A Systematic Review
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목적: 뇌졸중 환자에게 원격재활을 적용하고 운동기능의 변화를 알아본 연구들을 체계적으로 고찰하여 원격재활에서 사용한 원격감독 방법과 원격으로 제공된 중재의 효과를 알아보아 국내에서의 적용을 위한 기초자료를 제공하려 한다. 연구방법: 2000년부터 2018년 4월까지의 국외 문헌들을 PubMed, Embase 그리고 Cochrane을 통해 수집하 고 RISS를 통해 국내 문헌을 검색, 수집하다. 국외 논문 검색어로는 Telerehabilitation, Telemedicine, Stroke을 사용하고 국내 문헌은 원격재활, 뇌졸중, stroke, CVA, 뇌혈관질환 검색어를 사용하다. 총 406개의 국외 문헌과 15개의 국내 문헌이 검색되었으며 결과적으로 총 7개의 문헌이 분석대상 문헌으 로 선정되었다. 결과: 7편의 문헌 모두 원격재활을 적용받는 그룹에게 중재를 원격에서만 제공하으며 전, 후 비교를 통해 운동기능에서 유의미한 효과를 확인하다. 또한 원격재활 중재의 유의미한 효과를 전, 후 비교(n=7) 및 그룹간의 비교(n=4)를 통해 분석하여 운동기능에서의 긍정적인 효과를 확인하다. 사용된 원격감독 은 목적에 따라 중재로써의 감독(n=4)과 확인을 위한 감독(n=3)으로 분류할 수 있었다 . 결론: 본 연구를 통해 전통적인 재활 서비스를 제공받는 것에 제한이 있는 뇌졸중 환자들에게 원격재활의 적용이 잠재적인 대체 방법이 될 수 있음을 제한적으로 확인하다. 원격재활의 실질적인 국내적용을 위해서는 국내 실정에 맞는 비용효과에 대한 연구가 필요하며, 원격재활을 통해 제공되는 가장 효율적인 중재별 원격감독 방법을 확인해 볼 수 있는 연구가 이루어져야 할 것이다
Abstract
Objective: The purpose of this study was to investigate the effects of telerehabilitation on stroke patients through remotely operated intervention and monitoring. Methods: Literature from 2000 to April 2018 was collected through PubMed, Embase, Cochrane, and RISS. We used telerehabilitation, telemedicine, and stroke as the search terms in regard to foreign literature, and the terms telerehabilitation, stroke, and CVA in regard to Korean literature. A total of 406 foreign and 15 Korean published studies were found. As a result, a total of seven documents was selected for the analysis. Results: As a result of the analysis, all the interventions applied through telerehabilitation were provided remotely, and significant effects were reported between pre-post assessments. In addition, the significant effects of telerehabilitation were reported through analyzing pre-post(n=7) and between groups(n=4) assessments. The monitoring used could be categorized according to purpose, that is, for checking (n=3) and as an intervention (n=4). Conclusions: This study confirmed, within limits, that the application of telerehabilitation could be a potential alternative for stroke patients with limited rehabilitation services. In order to apply telerehabilitation in Korea, it is necessary to study the cost effectiveness, according to the current domestic situation, and confirm the most effective monitoring method based on the intervention.
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