메타분석을 통한 고유수용성신경근촉진법의 영향 연구-뇌졸증 환자의 보행과 균형에 미치는 효과를 중심으로-
A Study on the Effect of Proprioceptive Neuromuscular Facilitation Training by Meta-analysis -Focused on Balance and Gait Ability in Patients with Storke
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초록
뇌졸중은 균형 장애와 보행능력에도 직접적인 영향을 미친다. 본 연구는 고유수용성신경근촉진법이뇌졸중 환자의 균형 및 보행에 미치는 영향 연구를 목적으로 한다. 따라서 뇌졸중 환자에게 고유수용성신경근촉진법을 적용하여 균형과 보행 능력을 평가하는 모든 무작위 배정 연구를 포함하였다. 본 연구는 메타분석에서 있어서 꼭 필요한 프리즈마 가이드 라인을 준수하였다. Cochrane library, CINAHL, Pubmed에서 2021년 11월까지 발행된 연구를 포함하였고, 그 연구들은 고유수용성신경근촉진법을 적용한 무작위 배정 연구들이다. 데이터베이스에서 검색된 1091개의 논문 중 18개의 연구를 메타분석을시행하였고, 메타분석은 R 프로젝트 4.0.2를 사용하여 시행하였다. 본 연구의 전체 효과 크기는 0.56으로 중간 정도로, 균형과 보행에 관한 척도에 대한 효과 크기도 중간정도 산출되었다. 무작위 배정 정도를 나타내는 페드로 점수는 18점 만점에서 6.63으로 비뚤림 위험이 낮은 것으로 나타났다. 이러한 결과는 PNF가 뇌졸중 환자의 균형 및 보행을 향상시키는 효과적인 중재 방법임을 알 수 있다.
Abstract
Stroke results in balance disorders, these directly affect autonomy and gait ability. The aim of this meta-analysis was to determine the efficacy of proprioceptive neuromuscular facilitation on balance and gait. We included all randomized controlled trials assessing the efficacy of proprioceptive neuromuscular facilitation on balance and gait control in patients after stroke. This study was conducted according to the PRISMA guideline. Cochrane library, CINAHL, and PubMed were searched for studies published up to November 2021, and all randomized controlled trails(RCT) assessing PNF therapy were included. This analysis included only RCT. A total of 18 studies were selected from 1091 records obtained from the databases. The meta-analysis was performed using the R project for statistical computing version 4.0.2. The overall intervention effect was middle (standardized mean difference (SMD): 0.56) Additionally, berg balance scale (SMD: 0.48), functional reach test (SMD: 0.51), timed up and go test (SMD: 0.78), 10m walking test (SMD: 0.52), and dynamic gait index (SMD: 0.33) had medium effect sizes. The average Pedro scale was 6.63 out of 18, with a low risk of bias. These findings indicate that PNF is an effective therapy for improving balance gait in stroke patients.
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