만성 뇌졸중 환자의 트레드밀 훈련이 족저압, 하지 근 기능, 균형에 미치는 융복합적 효과 : 메타분석
Convergence Effects of Treadmill Training on Plantar Pressure, Lower Limb Muscle Function, and Balance in Chronic Stroke : A Meta-Analysis
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만성 뇌졸중 환자를 대상으로 메타분석 기법을 활용하여 트레드밀 훈련의 융복합적 효과성을 평가하고자 한다. PICOS 기준에 의거하여 문헌을 검색한 후 총 22편의 국내 ‘뇌졸중’, ‘트레드밀’ 관련 연구물을 선정하였다. 메타분석을 위해 CMA 프로그램을 이용하여 효과크기를 산출하였으며, 국내 트레드밀 훈련의 전체 효과크기는 0.661(95%CI: 0.456∼0.865)로 중간크기로 유의한 차이가 있었다(p<.05). 트레드밀 훈련의 효과를 족저압(1.147), 하지 근 기능(0.875), 균형(0.664)으로 나누어 효과크기를 비교한 결과, 족저압의 효과크기가 가장 크게 나타났다. 추가로 균형은 하위항목들을 나누어 분석하였고, 균형은 TUG(0.553), BBS(0.760), 정적균형지수(0.654)의 효과크기가 나타났다. 따라서 트레드밀 훈련이 만성 뇌졸중 환자의 삶의 질 향상에 긍정적인 영향을 제공한다. 트레드밀 훈련에 대한 메타분석 연구는 정보, 통신 및 의료기술의 헬스케어 융합을 향한 업계 패러다임의 전환으로 이어질 수 있을 것이다.
Abstract
The purpose of this study is to evaluate the convergence effectiveness of treadmill training in patients with chronic stroke through a meta-analysis. After searching the literature based on the patients, intervention, comparison, outcome criteria, and study desigan, a total of 22 studies related to "stroke" and "treadmill" were eligible for inclusion. Effect size was calculated using the comprehensive meta-analysis program for the meta-analysis. Based on the forest plot results, the overall effect size of treadmill training was 0.661 (95% confidence interval: 0.456-0.865), which was statistically significant with a medium effect size (p < 0.05). The effects of treadmill training on patients with stroke were separated by dependent variables of interest-plantar pressure (1.147), lower limb muscle function (0.875), and balance (0.664). The effect sizes were evaluated for the subdomains of timed up and go test (0.553), Berg Balance Scale (0.760), and static balance index (0.654) for balance. Therefore, treadmill training can be expected to have a positive impact on improving the quality of life of patients with chronic stroke. This meta-analysis of treadmill training may the lead to an industry paradigm shift toward healthcare convergence of information, communication, and medical technology.
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