운동프로그램이 한국 중년 및 노인 여성의 요통 지표와 골반 정렬에 미치는 효과: 체계적 문헌고찰 및 메타분석
A Systematic Review and Meta-Analysis of the Effects of Exercise Therapy on Pain and Pelvic Alignment in Middle-Aged and Older Women with Chronic Low Back Pain
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초록
본연구는만성요통을겪고있는중년및노인여성을대상으로, 운동중재프로그램이통증지표와골반정렬지표에미치는효과를검증하기위하여체계적문헌고찰및메타분석을수행하였다. PRISMA 가이드라인에따라PICO 기반의연구질문을설정하고, 국내외학술데이터베이스를통해문헌을수집·선별하였다. 최종적으로총14편의문헌이분석에포함되었으며, 모든문헌이양적합성이가능하여메타분석에활용되었다. 체계적문헌고찰결과, 다양한운동중재프로그램이중년및노인여성의통증과골반정렬개선에긍정적인효과를미치는것으로나타났다. 그러나일부문헌에서비뚤림위험이‘높음’ 또는‘불분명’으로평가되었다. 메타분석결과, 통증지표는높은수준의이질성(I² = 84.5%)을보였고, 무선효과모형분석결과높은효과크기(SMD = -1.48, 95% CI = -1.94; -1.01)로통계적으로유의하였다. 골반정렬지표에대한메타분석에서는높은효과크기(SMD = -1.21, 95% CI = -2.38; -0.04), I² = 86.6%로나타났으며통계적으로유의하였다. 이러한결과는운동중재가만성요통을겪는중년및노인여성의통증완화와기능향상에효과적이라는근거를제공하며, 향후임상적적용및맞춤형운동프로그램개발의기초자료로활용될수있을것으로기대된다.
Abstract
This study conducted a systematic literature review and meta-analysis to determine the effects of an exercise intervention program on pain indices and pelvic alignment indices in middle-aged and older women with chronic low back pain(CLBP). PICO-based research questions were set according to PRISMA guidelines, and literature was collected and selected from domestic and international academic databases. In the end, a total of 14 articles were included in the analysis, all of which were quantitatively synthesized and utilized in the meta-analysis. A systematic review of the literature found that various exercise intervention programs had positive effects on improving pain and pelvic alignment in middle-aged and older women. However, the risk of skewness was rated as ‘high risk’ or ‘unclear’ in some of the literature. In the meta-analysis, the pain metric showed a high degree of heterogeneity (I² = 84.5%) and was statistically significant with a high effect size (SMD = -1.48, 95% CI = -1.94; -1.01) in a random-effects model analysis. The meta-analysis of pelvic alignment indicators showed a high effect size (SMD = -1.21, 95% CI = -2.38; -0.04), I² = 86.6%, and was statistically significant. These results provide evidence that exercise interventions are effective in reducing pain and improving function in middle-aged and older women with chronic low back pain, and may serve as a basis for future clinical applications and the development of customized exercise programs.