국내 성인 여성을 대상으로 한 체계적 문헌 고찰과 메타분석: 두개천골요법의 스트레스 관련 지표 개선 효과
Systematic Review and Meta-Analysis in Korean Adult Women: Effects of Craniosacral Therapy on Stress-Related Outcomes
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본연구는두개천골요법이국내성인여성의스트레스관련지표에미치는효과를검증하고자 체계적문헌고찰및메타분석을수행하였다. PICO 기준에따라관련문헌을체계적으로수집하고, 선별과정을통해최종적으로체계적문헌고찰과메타분석에6편의문헌을포함하였다. 체계적문헌 고찰결과, 대부분의연구에서두개천골요법적용후주관적스트레스가감소하고, 생리적스트레스 지표인코티솔농도가감소하는경향이나타났다. 이는두개천골요법이스트레스완화에긍정적인 영향을미칠수있음을시사한다. 다만, 포함된문헌들중상당수가무작위배정및눈가림과정에 대한보고가불충분하거나불명확하고, 불완전한결과가보고된경우가존재하여연구결과해석시 일반화오류의위험에유의할필요가있다. 메타분석에서는스트레스관련지표에대해중간수준의 전체이질성(I² = 72.2%)을보였고, 유의미한효과크기(SMD = -2.93, 95% CI = -4.02; -1.83)가 도출되었다. 하위요인분석에서는주관적스트레스지표에서중간수준의이질성(I² = 50.9%)이 발견되었으며효과크기(SMD = -3.63, 95% CI = -4.78; -2.48)가통계적으로유의하였다. 생리적 스트레스지표에서는낮은수준의이질성(I² = 0%)이발견되었으며효과크기(SMD = -1.52, 95% CI = -2.28; -0.76)가통계적으로유의하였다. 출판편향분석결과, 출판편향의위험이일부존재하였다. 이러한 결과는 두개천골요법이 성인 여성의 스트레스를 완화할 수 있는 비약물적, 비침습적 중재로서임상적활용가능성이있음을뒷받침한다. 특히자율신경계조절과심리적, 생리적안정에 기여할수있는점에따라다양한임상환경에서보완적치료법으로적용될수있으며, 향후표준화된 연구설계를바탕으로중재방법과효과의지속성에대한후속연구가필요하다.
Abstract
This study aimed to evaluate the effects of craniosacral therapy (CST) on stress-related outcomes in Korean adult women through a systematic review and meta-analysis. Following the PICO framework, relevant studies were systematically identified, and six studies were included in the final analysis. The systematic review revealed that most studies reported reductions in subjective stress and decreases in physiological stress indicators, such as cortisol levels, after CST intervention. These findings suggest that CST may have a positive effect on stress reduction. However, several included studies lacked sufficient reporting on randomization and blinding procedures, and some reported incomplete results, which may limit the generalizability of the findings. The meta-analysis demonstrated a moderate level of overall heterogeneity (I² = 72.2%) with a significant pooled effect size (SMD = –2.93, 95% CI: –4.02 to –1.83). Subgroup analysis showed that subjective stress indicators exhibited moderate heterogeneity (I² = 50.9%) with a significant effect size (SMD = –3.63, 95% CI: –4.78 to –2.48). Physiological stress indicators demonstrated low heterogeneity (I² = 0%) and a significant effect size (SMD = –1.52, 95% CI: –2.28 to –0.76). Publication bias analysis indicated some risk of bias. These results support CST as a non-pharmacological and non-invasive intervention that may alleviate stress in adult women, contributing to autonomic nervous system regulation and both psychological and physiological stability. CST thus holds potential as a complementary therapeutic approach in diverse clinical settings. Future research with standardized study designs is required to examine intervention protocols and the sustainability of effects.