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Effects of Therapeutic Interventions on Upper Extremity Function Among Children With Cerebral Palsy in Domestic: A Systematic Review

국내 뇌성마비 아동의 상지기능 향상을 위한 중재효과에 대한 고찰

  • 박영주 (세한대학교 작업치료학과)
  • Received : 2018.07.31
  • Accepted : 2018.09.13
  • Published : 2018.09.30

Abstract

Objective : The purpose of this study is to examine the effects of therapeutic interventions on upper extremity function of children with cerebral palsy using systematic review methods and to suggest intervention trends in Korea. Methods : The subjects of the study were the researches published in the Korean Journal since 2008. Total 12 studies were selected through Korean research database engine such as DBpia, Scholar, KSDC, KISS and RISS for the systematic review. Key words were 'cerebral palsy', 'upper extremity function' and 'hand function'. The results of this study were analyzed by qualitative level and methodological quality level of evidence, and the results of each study were analyzed according to the PICO approach, that is Patient, Intervention, Comparison and Outcome. Results : For the level of evidence, Grade IV and V were most frequent. In terms of methodological quality, majority of the studies showed 'Fair' level. The subjects were the children with hemiplegia, and Single-subjects designs and case studies were frequent experimental design. Constraint-induced movement therapy (CIMT) was most frequently conducted among the intervention studies, and Jebsen-Taylor Hand Function Test was most frequently used evaluation tool. Eleven studies showed that the upper limb functions were significantly improved or were positively effective. Conclusion : Various intervention methods have been implemented to improve the upper limb functions of children with cerebral palsy. In the future, studies on intervention methods based on the type of paralysis and studies with high quality of evidence should be conducted in Korea.

목적 : 뇌성마비 아동의 상지기능을 향상시키기 위해 국내에서 사용되고 있는 중재방법의 종류와 그 효과를 체계적 고찰방법을 사용하여 국내에서 사용되는 치료경향을 제시하고자 한다. 연구방법 : 연구 대상은 2008년 이후로 국내학회지에 게재된 연구를 대상으로 하였다. 누리미디어(DBpia), 스콜라(Scholar), 한국사회과학데이터(KSDC), 학술연구정보서비스(RISS), 그리고 한국학술정보(KISS)의 데이터베이스를 사용하여 '뇌성마비', '상지 기능', '손 기능'의 검색어를 사용하였다. 총 12개의 연구로 근거의 질적 수준, 방법론적 질적 수준으로 분석한 후 대상자(Patient), 중재(Intervention), 대조(Comparison), 결과(Outcome)의 PICO로 제시하였다. 결과 : 분석에 포함된 연구에서 근거기반 실행의 질적 수준은 수준 IV와 수준 V가 가장 많았고, 방법론적 질적 수준은 '우수'의 연구가 가장 많았다. 대상자는 편마비 아동을 대상으로 한 연구가 가장 많았고, 실험설계는 단일대상연구 및 사례연구가 높았다. 중재의 종류는 강제유도운동치료가 가장 많았고, 평가는 젭슨테일러 손기능 검사 빈도가 높았다. 총 11개의 연구에서 뇌성마비 아동의 상지기능에서 유의한 향상 또는 긍정적인 효과가 나타났다. 결론 : 국내에서 뇌성마비 아동의 상지기능을 향상시키기위해 다양한 중재방법이 시행되어 왔다. 앞으로 마비 유형별에 따른 중재방법에 대한 연구와 근거의 질적수준이 높은 연구가 지속적으로 이루어져야 할 것이다.

Keywords

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