본문 바로가기
KERD
논문KCI 등재

거울치료가 뇌졸중 환자의 운동기능 회복에 미치는 영향: 메타분석

Effects of Mirror Therapy on Motor Recovery Following a Stroke: A Meta-Analysis

전혜선|이희원
한국전문물리치료학회 (Korean Research Society of Physical Therapy)|2012.05|한국전문물리치료학회지 (Physical Therapy Korea)|제19권 제2호|pp. 48-58|DOI http://dx.doi.org/

2

조회

0

다운로드

9

인용

0

참고문헌

키워드

Meta-analysisStrokeMirror therapyMotor function recovery
주제분류물리치료학

초록

The objective of this study was to evaluate the effects of mirror therapy on motor function recovery following a stroke through a systemic review and meta-analysis. In total, nine of the 48 studies were identified from search engines between 1997 and 2011, as well as from a review of the reference lists of each identified study. The quality of each study was assessed using Jadad scale, and the effect size was calculated as a Cohen's effect size using MetaAnalyst (Beta 3.13). The overall effect size of the mirror therapy was 2.005 (95% confidence interval=1.041~2.970) in a random-effects model. This finding suggests that mirror therapy is beneficial for improving motor function following a stroke. The results from the subgroup analysis according to categorical variables were as follows: First, the effect size was larger for an onset time of less than 1 year (1.166) than for a duration of 1 year or more (.668). Second, the effect size of unpublished dissertations (1.610) was larger than published articles (1.221). Third, motor recovery of upper extremities (1.609) had a greater effect than motor recovery of lower extremities (.903). The major limitation of this study is the relatively small study population. Therefore, further individual studies of mirror therapy should be conducted in order to generalize the effects. In addition, mirror therapy supervised by a physical therapist should be recognized as a potential approach to manage motor function following a stroke and recommended to patients to improve their motor function.

Abstract

The objective of this study was to evaluate the effects of mirror therapy on motor function recovery following a stroke through a systemic review and meta-analysis. In total, nine of the 48 studies were identified from search engines between 1997 and 2011, as well as from a review of the reference lists of each identified study. The quality of each study was assessed using Jadad scale, and the effect size was calculated as a Cohen's effect size using MetaAnalyst (Beta 3.13). The overall effect size of the mirror therapy was 2.005 (95% confidence interval=1.041~2.970) in a random-effects model. This finding suggests that mirror therapy is beneficial for improving motor function following a stroke. The results from the subgroup analysis according to categorical variables were as follows: First, the effect size was larger for an onset time of less than 1 year (1.166) than for a duration of 1 year or more (.668). Second, the effect size of unpublished dissertations (1.610) was larger than published articles (1.221). Third, motor recovery of upper extremities (1.609) had a greater effect than motor recovery of lower extremities (.903). The major limitation of this study is the relatively small study population. Therefore, further individual studies of mirror therapy should be conducted in order to generalize the effects. In addition, mirror therapy supervised by a physical therapist should be recognized as a potential approach to manage motor function following a stroke and recommended to patients to improve their motor function.

참고문헌 (52)

  1. 박상범, "뇌졸중 환자의 재활을 위한 인지적 중재전략으로서의 운동심상과 활동관찰", 한국특수체육학회지, 13(2), pp.109~120 (2005), 한국특수체육학회
  2. 박소연, "국내 노인을 대상으로 한 낙상예방 운동프로그램이 근력증가에 미치는 효과: 메타분석", 한국전문물리치료학회지, 18(3), pp.38~48 (2011), 한국전문물리치료학회
  3. 백남영, "거울치료가 편마비환자의 하지 기능에 미치는 영향", 석사, pp.2009
  4. 오성삼, "선행연구 결과의 통합과 재분석을 위한 메타분석의 이론과 실제", pp.14~15 (2002), 건국대학교출판부
  5. 우희순, "거울치료가 만성 뇌졸중 환자의 손 기능 회복에 미치는 영향", 대한작업치료학회지, 19(1), pp.93~103 (2011), 대한작업치료학회
  6. 유수전, "거울매개치료가 뇌졸중 후 편마비 환자의 상지기능과 일상생활활동에 미치는 영향", 대한작업치료학회지, 19(2), pp.25~37 (2011), 대한작업치료학회
  7. 이명모, "거울치료프로그램이 급성 뇌졸중 환자의 상지 운동회복과 운동기능에 미치는 영향", 석사, pp.2010
  8. 이준영, "메타분석", Endocrinology and Metabolism, 23(6), pp.361~378 (2008), 대한내분비학회
  9. 이충휘, "물리치료사와 작업치료사를 위한 연구방법론. 3판", pp.367~376 (2007), 계축문화사
  10. Altschuler EL, "Mirror therapy in a patient with a fractured wrist and no active wrist extension", J Plast Reconstr Surg Hand Surg, 42(2), pp.110~111 (2008)
  11. Altschuler EL, "Rehabilitation of hemiparesis after stroke with a mirror", Lancet, 353(9169), pp.2035~2036 (1999)
  12. Basmajian JV, "EMG feedback treatment of upper limb in hemiplegic stroke patients: A pilot study", Arch Phys Med Rehabil, 63(12), pp.613~616 (1982)
  13. Blanton S, "An application of upper-extremity constraint-induced movement therapy in a patient with subacute stroke", Phys Ther, 79(9), pp.847~853 (1999)
  14. Cacchio A, "Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients", Neurorehabil Neural Repair, 23(8), pp.792~799 (2009)
  15. Carson RG, "Neural pathways mediating bilateral interactions between the upper limbs", Brain Res Brain Res Rev, 49(3), pp.641~662 (2005)
  16. Cohen J, "Statistical Power Analysis for the Behavioral Science. 2nd ed", pp.24~40 (1988), Lawrence Erlbaum Associates
  17. Cook DJ, "Systematic reviews: Synthesis of best evidence for clinical decisions", Ann Intern Med, 126(5), pp.376~380 (1997)
  18. Cooper HM, "Scientific guidelines for conducting integrative research review", Rev Educ Res, 52(2), pp.291~302 (1982)
  19. Dijkerman HC, "Does motor imagery training improve hand function in chronic stroke patients", A pilot study. Clin Rehabil, 18(5), pp.538~549 (2004)
  20. Dohel C, "Mirror therapy promotes recovery from severe hemiparesis: A randomized controlled trial", Neurorehabil Neural Repair, 23(3), pp.209~217 (2009)
  21. Dunsky A, "Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis", Arch Phys Med Rehabil, 89(8), pp.1580~1588 (2008)
  22. Ezendam D, "Systematic review of the effectiveness of mirror therapy in upper extremity function", Disabil Rehabil, 31(26), pp.2135~2149 (2009)
  23. Feys H, "Predicting arm recovery following stroke: Value of site of lesion", Acta Neurol Scand, 102(6), pp.371~377 (2000)
  24. Garry ML, "Mirror, mirror on the wall: Viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability", Exp Brain Res, 163(1), pp.118~122 (2005)
  25. Grünert-Plüss N, "Mirror therapy in hand rehabilitation: A review of the literature, the St Gallen protocol for mirror therapy and evaluation of a case series of 52 patients", Hand Ther, 13(1), pp.4~11 (2008)
  26. Guillot A, "Contribution from neurophysiological and psychological methods to the study of motor imagery", Brain Res Brain Res Rev, 50(2), pp.387~397 (2005)
  27. Hartman-Maeir A, "Awareness of disabilities in stroke rehabilitation-a clinical trial", Disabil Rehabil, 25(1), pp.35~44 (2003)
  28. Hedges LV, "Statistical Methods for Meta-analysis", pp.78~80 (1985), Academic Press
  29. Hendricks HT, "Motor recovery after stroke: A systematic review of the literature", Arch Phys Med Rehabil, 83(11), pp.1629~1637 (2002)
  30. Hu XL, "A comparison between electromyography-driven robot and passive motion device on wrist rehabilitation for chronic stroke", Neurorehabil Neural Repair, 23(8), pp.837~846 (2009)
  31. Jackson PL, "Potential role of mental practice using motor imagery in neurologic rehabilitation", Arch Phys Med Rehabil, 82(8), pp.1133~1141 (2001)
  32. Jadad AR, "Assessing the quality of reports of randomized clinical trials: Is blinding necessary", Control Clin Trials, 17(1), pp.1~12 (1996)
  33. Karmarkar A, "Mirror box therapy for complex regional pain syndrome", Anaesthesia, 61(4), pp.412~413 (2006)
  34. Kerlikowske K, "Efficacy of screening mammography: A meta-analysis", JAMA, 273(2), pp.149~154 (1995)
  35. LeLorier J, "Discrepancies between meta-analyses and subsequent large randomized, controlled trials", N Engl J Med, 337(8), pp.536~542 (1997)
  36. McCobe CS, "A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1)", Rheumatology, 42(1), pp.97~101 (2003)
  37. Michielsen ME, "Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: A phaseⅡ randomized controlled trial.", Neurorehabil Neural Repair, 25(3), pp.223~233 (2011)
  38. Olney SJ, "Hemiparetic gait following stroke, partⅠ: characteristics", Gait Posture, 4, pp.136~148 (1996)
  39. Perry J, "Classification of walking handicap in stroke population", Stroke, 26(6), pp.982~989 (1995)
  40. Ramachandran VS, "Synaesthesia in phantom limbs induced with mirrors", Proc Bilo Sci, 263(1369), pp.377~386 (1996)
  41. Riccio I, "Mental practice is effective in upper limb recovery after stroke: A randomized single-blind cross-over study", Eur J Phys Rehabil Med, 46(1), pp.19~25 (2010)
  42. Rosen B, "Training with a mirror in rehabilitation of the hand", Scand J Plast Reconstr Surg Hand Surg, 39(2), pp.104~108 (2005)
  43. Rosenfeld RM, "Meta-analysis of antibiotics for the treatment of otitis media with effusion", Otolaryngol Head Neck Surg, 106(4), pp.378~386 (1992)
  44. Ryerson S, "Functional Movement Reeducation: A contemporary model for stroke rehabilitation", pp.1~13 (1997), Churchill Livingstone
  45. Sathian K, "Doing it with mirrors: A case study of a novel approach to neurorehabilitation", Neurorehabil Neural Repair, 14(1), pp.73~76 (2000)
  46. Shumway-Cook A, "Effectiveness of a community-based multifactorial intervention on falls and fall risk factors in community-living older adults: A randomized, controlled trial", J Gerontol A Biol Sci Med Sci, 62(12), pp.1420~1427 (2007)
  47. Smart CR, "Benefit of mammography screening in women ages 40 to 49 years: Current evidence from randomized controlled trials", Cancer, 75(7), pp.1619~1626 (1995)
  48. Stevens JA, "Using motor imagery in the rehabilitation of hemiparesis", Arch Phys Med Rehabil, 84(7), pp.1090~1092 (2003)
  49. Sütbeyaz S, "Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: A randomized controlled trial", Arch Phys Med Rehabil, 88(5), pp.555~559 (2007)
  50. Thirumala P, "Motor recovery after stroke: Lessons from functional brain imaging", Neurol Res, 24(5), pp.453~458 (2002)
  51. Williams RL, "Use of antibiotics in preventing recurrent acute otitis media and in treating otitis media with effusion: A meta-analytic attempt to resolve the brouhaha", JAMA, 270(11), pp.1344~1351 (1993)
  52. Yavuzer G, "Mirror therapy improves hand function in subacute stroke: A randomized controlled trial", Arch Phys Med Rehabil, 89(3), pp.393~398 (2008)

관련 논문AI추천

뇌졸중으로 인한 편마비 환자의 상지기능 향상을 위한 거울치료의임상적 효과에 대한 체계적 고찰김종배, 백선웅대한신경계작업치료학회 · 재활치료과학2016 · 제5권 제2호Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients유지현, Hong-Jae Lee, Hye-Jung Hwang, Hyun-Ju Yun, Kil-Byung Lim대한재활의학회 · Annals of Rehabilitation Medicine2016 · 제40권 제4호국내 뇌졸중 편마비 환자를 대상으로 한 건측억제-환측유도 치료효과의 메타분석박소연, 신인수한국전문물리치료학회 · 한국전문물리치료학회지2012 · 제19권 제2호Effect of Constraint-Induced Movement Therapy and Mirror Therapy for Patients With Subacute Stroke고현윤, 구본일, 신명준, 신용범, 신용일, 윤진아대한재활의학회 · Annals of Rehabilitation Medicine2014 · 제38권 제4호뇌졸중 후 상지 기능 개선을 위한 재활치료의 전략김상훈, 신명준, 신용일, 이창형대한뇌신경재활학회 · 뇌신경재활2014 · 제7권 제1호동작관찰훈련이 뇌졸중 환자의 상지 기능에 미치는 영향김종만, 이문규한국전문물리치료학회 · 한국전문물리치료학회지2011 · 제18권 제2호

이 간행물의 다른 논문 (8건)

골반압박벨트 착용이 한발서기 시 여성 천장관절통증 환자의 체간과 고관절 신전근 활성 양상에 미치는 영향정희석, 전혜선, 권오윤, 이충휘pp. 1-11수동적 어깨뼈 정렬이 작은가슴근 단축된 사람의 등세모근 근활성도에 미치는 영향최지영, 오재섭, 장준혁pp. 12-19다열근 심부 및 표면 근섬유 두께에 대한 세 가지 요추안정화 운동의 효과하성민, 김수정, 박규남, 신헌석, 권오윤, 김태진, 정도헌pp. 20-28일어서기 동작시 편마비 환자의 보행 속도에 따른 체간과 하지 근 활성 형태의 비대칭성에 관한 연구조혁신, 최성진, 장현정, 심선미, 오덕원, 박현주pp. 29-38승마시뮬레이터 훈련과 평류안뜰자극이 자세균형능력과 고유수용성감각에 미치는 영향조운수, 진희경, 박장성, 김용남pp. 39-47
원문 보기