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척수 손상 환자의 라이프 스타일 개선을 위한 재활 중재 효과: 무작위 대조군 연구의 체계적 고찰 및 메타분석

Effect of Rehabilitation Intervention for Lifestyle Improvement of Spinal Cord Injury: Systematic Review of Randomized Controlled Trials and Meta-Analysis

박혜연|하성규
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2020.11|재활치료과학 (Therapeutic Science for Rehabilitation)|제9권 제4호|pp. 107-120|DOI https://doi.org/10.22683/tsnr.2020.9.4.107

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참고문헌

키워드

메타분석LifestyleSystematic reviewMeta-analysis체계적 고찰라이프 스타일척수손상Spinal cord injury재활 중재Rehabilitation intervention

초록

목적 : 척수손상환자를 대상으로 한 무작위 대조군 연구의 체계적 고찰과 메타분석을 통해 척수손상환자의재활 중재의 효과성과 근거를 알아보고자 한다. 연구방법 : 국외 논문데이터베이스에서 검색어를 사용하여 학술지에 게재된 연구를 2명의 연구자가 독립적으로 검색하여 선정하였다. 선정기준에 부합한 연구는 총 21편이었고, PEDro Scale을 사용하여 연구의질적 평가를 실시하였다. 메타분석은 Comprehensive Meta-Analysis 3.0 프로그램을 사용하였다. 결과 : 분석된 연구에 참여한 연구대상자는 총 713명이었고, 메타분석을 실시한 결과 신체활동을 이용한중재는 0.406(95.0% 신뢰구간: 0.221~0.591), 전기 자극 치료중재는 0.505(95.0% 신뢰구간: 0.449~1.528) 로 중간크기(Medium)의 효과를 보이는 것으로 나타났고 교육적 방법 중재는 0.248(95.0% 신뢰구간: 0.033~0.464), 복합 중재는 0.280(95.0% 신뢰구간: 0.122~0.438)로 작은 크기(Small)의 효과를 보이는것으로 나타났다. 통계적 이질성 검정에서 유의미한 이질성이 있어 연구결과 통합 시 랜덤효과 모형을선택하여 분석하였고, 출판편견은 유의미하지 않아 신뢰할만한 연구결과였다. 결론 : 분석된 결과 척수손상환자를 대상으로한 재활 중재는 효과적임을 알 수 있었다. 척수손상환자를대상으로한 재활분야에서 임상가들이 대상자의 라이프 스타일을 개선하기 위한 프로그램을 구성할 때기여할 것으로 사료된다.

Abstract

Objective : The purpose of this study was to investigate the effectiveness and basis of rehabilitation intervention in patients with spinal cord injury by systematic review and meta-analysis of randomized controlled studies. Methods : Two researchers independently searched and selected a study published in an academic journal using a search term in an international thesis database. A total of 21 studies met the selection criteria, and qualitative evaluation of the study was conducted using the PEDro Scale. Meta-analysis was performed using Comprehensive Meta-Analysis 3.0 program. Results : A total of 713 subjects were included. The results of the meta-analysis showed a score of 0.406 (95.0% confidence interval: 0.221 ~ 0.591) for intervention using physical activity and 0.505 (95.0% confidence interval: 0.449 ~ 1.528) for electronic stimulation therapy, which showed medium effect; educational intervention had a 0.248 (95.0% confidence interval: 0.033 ~ 0.464), and mixed intervention 0.280 (95.0% confidence interval: 0.122 ~ 0.438). It was shown that the effect of small (small). There was a significant heterogeneity in the statistical heterogeneity test, and thus the random effects model was selected and analyzed. Conclusion : The results showed that rehabilitation interventions were effective for patients with spinal cord injury. During the rehabilitation of spinal cord injury patients, clinicians are expected to contribute to the development of programs to improve their lifestyles.

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