뇌졸중 환자 대상의 가상현실 운동프로그램이 기능회복에 미치는 효과: 체계적 문헌고찰 및 메타분석
Effects of Virtual Reality Program on Recovery of Functional in individuals Stroke: A Systematic Review and Meta Analysis
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초록
본 연구는 뇌졸중 환자의 기능회복에 대한 가상현실 운동프로그램의 효과를 검증하기 위해 수행된 체계적 문헌고찰 및 메타분석 연구이다. 데이터베이스는 학술연구정보서비스(RISS), 한국학술정보(Korean studies Information Service System, KISS), 한국 의학논문데이터베이스(KMbase)를 활용하여 ‘뇌졸중’, ‘뇌경색’, ‘상지기능’, ‘균형’, ‘일상생활능력’, ‘운동훈련’, ‘운동중재’ ‘재활’ ‘가상현실’, ‘가상현실 교육’, ‘가상현실 프로그램’ 을 검색어로 최근 10년(2009년∼2018년)간 문헌을 검토하였다. 분석은 R을 이용한 임의효과모형을 적용하여 상지기능, 균형과 일상생활 능력의 효과크기를 각각 산출하였다. 최종적으로는 RCT 9편을 분석하였다. 개별문헌은 Cochrane Collaboration의 RoB (Risk of Bias) 도구를 통해 비뚤림 위험을 평가하였으며, 전반적인 비뚤림 위험은 낮았다. 본 연구결과 균형에 대한 효과크기(g=.77), 일상생활 활동에 대한 효과크기(g=.80)로 “큰 효과크기”를 나타내었다. 따라서, 뇌졸중 환자의 균형과 일상생활 능력 향상을 위한 가상현실 운동프로그램이 효과적임을 확인하게 되었다. 향후 가상현실 운동프로그램 이용한 보다 효과적인 프로그램 개발과 적용에 대한 연구가 필요하다고 생각된다.
Abstract
This study was carried out to evaluate the efficacy of Virtual Reality(VR) program on recovery of functional in Stroke through systematic literature review and meta-analysis. The following databases were used to search the literature: RISS, KISS, KMbase. Keywords included ‘stroke’, ‘CVA’ ‘virtual reality’, ‘rehabilitation’, ‘virtual reality program’ and the evaluated articles were published from 2009 to November 2018. The statistical was used R program, the effect size of upper limb, balance and ADL were calculated by random-effects model. As a result, 9 RCT studies were meta-analyzed and were evaluated for the risk of bias by the RoB of Cochrane Collaboration; the overall risk of bias was low. The effect sizes of VR program was balance(g=.77), ADL(g=.80) as indicated by a “large effect size”. Therefore, VR program is large effective in reducing balance and ADL in strokes. It is necessary to develop and apply a virtual reality-based program using more efficient program development.
참고문헌 (36)
- Shelley A. Sharp, "Isokinetic strength training of the hemiparetic knee: Effects on function and spasticity", Archives of Physical Medicine and Rehabilitation, 78(11), pp.1231~1236 (1997), Elsevier BV[DOI]
- Pamela W. Duncan, "Adherence to Postacute Rehabilitation Guidelines Is Associated With Functional Recovery in Stroke", Stroke, 33(1), pp.167~178 (2002), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Jacqueline Hochstenbach, "Patients’ and Relatives’ Reports of Disturbances 9 Months After Stroke: Subjective Changes in Physical Functioning, Cognition, Emotion, and Behavior", Archives of Physical Medicine and Rehabilitation, 86(8), pp.1587~1593 (2005), Elsevier BV[DOI]
- Steven L. Wolf, "Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke", Stroke, 32(7), pp.1635~1639 (2001), Ovid Technologies (Wolters Kluwer Health)[DOI]
- H C Dijkerman, "Does motor imagery training improve hand function in chronic stroke patients? A pilot study", Clinical Rehabilitation, 18(5), pp.538~549 (2016), SAGE Publications[DOI]
- H. M. Kim, "A study on the development of a force sensor and finger rehabilitation robot for stroke patients", Doctoral, pp.2015
- 신화경, "손가락 폄근에 실시한 근전도 유발 전기자극 치료가 편마비 환자의 손기능 회복에 미치는 영향", 대한작업치료학회지, 16(3), pp.61~69 (2008), 대한작업치료학회
- 변필숙, "비디오 게임을 이용한 재활운동이 뇌졸중 편마비 환자의 상지 관절가동 범위와 통증, 스트레스에 미치는 효과", 근관절건강학회지, 19(1), pp.46~56 (2012), 대한근관절건강학회[DOI]
- 이병희, "가상현실기반 근전도 유발 기능적 전기자극치료가 뇌졸중 환자의 근 긴장도 및 보행 능력에 미치는 효과", 재활복지, 16(3), pp.361~378 (2012), 한국장애인재활협회 부설 재활연구소
- Pin-Cheng Kung, "Neuro-rehabilitation robot-assisted assessments of synergy patterns of forearm, elbow and shoulder joints in chronic stroke patients", Clinical Biomechanics, 25(7), pp.647~654 (2010), Elsevier BV[DOI]
- Claudia R. Senesac, "Generalization of a modified form of repetitive rhythmic bilateral training in stroke", Human Movement Science, 29(1), pp.137~148 (2010), Elsevier BV[DOI]
- V. Sirtori, "Constraint-induced movement therapy for upper extremities in stroke patients", Cochrane Database Syst Rev, 4(4) (2009)[DOI]
- G. Yavuzer, "''Playstation eyetoy games''improve upper extremity-related motor functioning in subacute stroke : a randomized controlled clinical trial", European journal of physical and rehabilitation medicine, 44(3), pp.237~244 (2008)
- 김은경, "가상현실 기반 게임이 만성기 뇌졸중 환자의 균형과 상지 기능에 미치는 효과", 특수교육재활과학연구, 49(3), pp.131~149 (2010), 특수교육재활과학연구소
- 김환희, "뇌졸중 환자의 상지기능 회복을 위한 중재에 대한 체계적 고찰", 대한작업치료학회지, 20(1), pp.129~145 (2012), 대한작업치료학회
- Y. R. Yang, "Virtual reality-based training improves community ambulation in individuals with stroke : a randomized controlled trial", Gait & posture, 28(2), pp.201~206 (2008)
- Albert A. Rizzo, "Virtual Reality and Cognitive Rehabilitation: A Brief Review of the Future", Journal of Head Trauma Rehabilitation, 12(6), pp.1~15 (1997), Ovid Technologies (Wolters Kluwer Health)[DOI]
- C. Walker, "Use of visual feedback in retraining balance following acute stroke", Physical therapy, 80(9), pp.886~895 (2000)[DOI]
- 유영열, "체감형 게임이 뇌졸중 환자의 시지각 능력과 균형능력에 미치는 영향", 재활복지, 15(1), pp.1~17 (2011), 한국장애인재활협회 부설 재활연구소
- J. H. Kim, "Use of virtual reality to enhance balance and ambulation in chronic stroke : a double-blind, randomized controlled study", American Journal of physical medicine & rehabilitation, 88(9), pp.693~701 (2009)
- 김주홍, "가상현실 게임을 이용한 훈련이 뇌졸중환자의 기능회복에 미치는 영향", 대한작업치료학회지, 19(3), pp.101~114 (2011), 대한작업치료학회
- 김현기, "가상현실 기반 재활프로그램의 일상적 효과 : 체계적 고찰", 고령자･치매작업치료학회지, 12(1), pp.1~11 (2018), 고령자･치매작업치료학회[DOI]
- Alessandro Liberati, "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration", PLoS Medicine, 6(7), pp.e1000100~ (2009), Public Library of Science (PLoS)[DOI]
- 김성호, "가상현실 기반 운동프로그램이 뇌졸중 환자의 상지기능과 일상생활동작에 미치는 영향", 재활복지, 17(2), pp.373~391 (2013), 한국장애인재활협회 부설 재활연구소
- E.D. de Bruin, "Einsatz der virtuellen Realität für das Training der motorischen Kontrolle bei Älteren", Zeitschrift für Gerontologie und Geriatrie, 43(4), pp.229~234 (2010), Springer Science and Business Media LLC[DOI]
- Gwyn N. Lewis, "Virtual reality games for rehabilitation of people with stroke: perspectives from the users", Disability and Rehabilitation: Assistive Technology, 6(5), pp.453~463 (2010), Informa UK Limited[DOI]
- S. Y. Kim, "NECA s guidance’ for undertaking systematic reviews and meta-analyses for intervention", National Evidence-based Healthcare Collaborating Agency, ~ (2011)
- B. J. Becker, "Synthesizing standardized meanchange measures", British Journal of Mathematical and Statistical Psychology, 41(2), pp.257~278 (1988)[DOI]
- Scott B. Morris, "Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs.", Psychological Methods, 7(1), pp.105~125 (2002), American Psychological Association (APA)[DOI]
- Yael Netz, "Physical Activity and Psychological Well-Being in Advanced Age: A Meta-Analysis of Intervention Studies.", Psychology and Aging, 20(2), pp.272~284 (2005), American Psychological Association (APA)[DOI]
- J. Cohen, "Statistical power analysis for the behavioral sciences", pp.2~ (1988), Lawrence Earlbaum Associates
- Annick A.A. Timmermans, "Effect of Mental Practice on the Improvement of Function and Daily Activity Performance of the Upper Extremity in Patients With Subacute Stroke: A Randomized Clinical Trial", Journal of the American Medical Directors Association, 14(3), pp.204~212 (2013), Elsevier BV[DOI]
- 김용남, "가상현실에서 댄스 운동이 뇌졸중 환자의 균형, 우울 및 일상생활 동작에 미치는 효과", 대한물리치료학회지, 25(5), pp.360~365 (2013), 대한물리치료학회
- Andrea Turolla, "Virtual reality for the rehabilitation of the upper limb motor function after stroke: a prospective controlled trial", Journal of NeuroEngineering and Rehabilitation, 10(1), pp.85~93 (2013), Springer Science and Business Media LLC[DOI]
- 박태성, "정상성인에서의 완전 몰입형 가상현실 동작과 실제 동작에서의 근수축 개시시간의 분석", 융합정보논문지, 8(1), pp.173~177 (2018), 중소기업융합학회[DOI]