대한지역사회작업치료학회지 (The Journal of Korean society of community based occupational therapy)

대한지역사회작업치료학회 (Korean Society of Community Based Occupational Therapy Association)
권호 표지
DOI QR코드

DOI QR Code

뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰

Occupational Therapy for Community Mobility in Stroke Patients : Systematic review

  • 조은주 (근로복지공단 창원병원과) ;
  • 감경윤 (인제대학교 작업치료학과) ;
  • 장문영 (인제대학교 작업치료학과)
  • Jo, Eun-Ju (Workers' Compensation and Welfare Service Changwon hospital) ;
  • Kam, Kyung-Yoon (Dept. of Occupational Therapy, College of Healthcare Medical Science and Engineering, Inje University) ;
  • Chang, Moon-Young (Dept. of Occupational Therapy, College of Healthcare Medical Science and Engineering, Inje University)
  • 투고 : 2018.11.20
  • 심사 : 2018.12.24
  • 발행 : 2018.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적 : 본 연구는 뇌졸중 환자에게 적용한 지역사회이동을 위한 작업치료적 중재를 분석한 논문으로, 임상에서 지역사회이동에 대한 중재를 사용하는데 있어 근거를 제시하고자 한다. 연구방법 : PRISMA checklist와 diagram을 통해 체계적 고찰을 시행하였고, 데이터베이스는 PubMed, EMBASE, Cochrane library (CENTRAL), ProQuest Dissertations & thesis (PQDT), 한국교육학술정보원(RISS)과 코리아메드(KoreaMed)를 이용하였다. 검색기간은 2005년부터 2018년 9월까지로 하였다. 연구에 선택된 문헌의 질 평가는 RoBANS (Riks of Bias Assessment tool for Non-randomized Study)를 사용하였다. 연구에 포함된 문헌은 총 8개이었다. 문헌에서 사용된 중재들은 종류에 따라 분류하였다. 결과 : 문헌의 연구디자인은 무작위배정 실험연구, 유사실험연구, 전후비교연구, 환자-대조군연구, 횡단적 연구로 다양하게 나타났다. 포함된 문헌의 질적수준은 level I이 1편(12.5%), level II가 6편(75%), level III가 1편(12.5%)으로 나타났다. 문헌의 '편향 위험 낮음' 비율은 62.5%~87.5%로 각 문헌마다 다르게 나타났다. 문헌에 사용된 중재는 가상 현실 및 가상환경을 기반으로 한 중재가 4편(50%)으로 가장 많았고, 프로토콜을 이용한 중재가 3편(37.5%), 휠체어 사용훈련이 1편(12.5%)으로 나타났다. 각 중재의 효과는 전반적으로 유의미하게 나타났다. 결론 : 본 연구는 지역사회이동에 대한 작업치료의 중재효과를 체계적으로 보고하여 임상적 적용근거를 제공하였다. 추후 지역사회이동성에 대해 다양한 형태로 중재를 적용한 연구가 이루어져야 할 것이다.

Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.

키워드

참고문헌

  1. 법제처. (2017). 교통약자의 이동편의 증진법. Retrieved November, 14, 2018, from http://www.law.go.kr
  2. 김수영, 박지은, 서현주, 서혜선, 손희정, 신채민 등. (2011). NECA 체계적 문헌고찰 매뉴얼. NECA 연구방법시리즈, 8, 1-287.
  3. 한국보건의료연구원. (2012). 뇌졸중 환자의 의료이용현황 및 의료이용 관련 요인분석. Retrieved November, 14, 2018, from http://policy.nl.go.kr/cmmn/FileDown.do?atchFileId=213098&fileSn=54848.
  4. Ahn, S. N. (2016). Analysis of occupational goals according to participation and functional status in stroke patients. The Journal of Korean Society of Occupational Therapy, 24(3), 121-131.
  5. Amini, D. A., Kannenberg, K., Bodison, S., Chang, P., Colaianni, D., Goodrich, B. et al. (2014). Occupational therapy practice framework: Domain & process 3rd edition. American Journal of Occupational Therapy, 68, S1-S48. doi:10.5014/ajot.2014.682006
  6. Aravind, G., & Lamontagne, A. (2017). Dual tasking negatively impacts obstacle avoidance abilities in post-stroke individuals with visuospatial neglect: task complexity matters!. Restorative Neurology and Neuroscience, 35(4), 423-436. doi:10.3233/RNN-160709
  7. Arbesman, M., Scheer, J., & Lieberman, D. (2008). Using AOTA's critically appraised topic and critically appraised paper series to link evidence to practice. OT Practice Magazine, 13(5), 18-22.
  8. Barclay, R. E., Stevenson, T. J., Poluha, W., Ripat, J., Nett, C., & Srikesavan, C. S. (2015). Interventions for improving community ambulation in individuals with stroke. Cochrane Database of Systematic Reviews, 3. doi:10.1002/14651858.CD010200.pub2
  9. Cameirao, M. S., i Badia, S. B., Oller, E. D., & Verschure, P. F. (2010). Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. Journal of Neuroengineering Rehabilitation, 7(1), 48. https://doi.org/10.1186/1743-0003-7-48
  10. Chang, K. Y., Lee, H. S., Jung, M. Y., Jeon, B. J., Park, S. H., Woo, H. S., et al. (2015). Development of the Korean Occupational Therapist Essential Competency. The Journal of Korean Society of Occupational Therapy, 23(4), 1-16 https://doi.org/10.14519/jksot.2015.23.4.01
  11. Christiansen, C. H., & Hammecker, C. L. (2001). Self care. In B. R. Bonder & M. B. Wagner (Eds.), Functional performance in older adults (pp. 155-175). Philadelphia: F. A. Davis.
  12. Corbetta, D., Imeri, F., & Gatti, R. (2015). Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review. Journal of Physiotherapy, 61(3), 117-124. https://doi.org/10.1016/j.jphys.2015.05.017
  13. Darekar, A., Lamontagne, A., & Fung, J. (2017). Locomotor circumvention strategies are altered by stroke: I. Obstacle clearance. Journal of Neuroengineering and Rehabilitation, 14(1), 56. doi:10.1186/s12984-017-0264-8
  14. Dohle, C., Tholen, R., Wittenberg, H., Quintern, J., Saal, S., & Stephan, K. M. (2016). Evidence-based rehabilitation of mobility after stroke. Der Nervenarzt, 87(10), 1062-1067. https://doi.org/10.1007/s00115-016-0188-8
  15. George, S., Crotty, M., Gelinas, I., & Devos, H. (2014). Rehabilitation for improving automobile driving after stroke. Cochrane Database of Systematic Reviews, 2. doi:10.1002/14651858.CD008357.pub2
  16. Gillen, G. (2018). Cerebrovascular accident (Stroke) In H. M. H. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (pp. 809-840). St. Louis, MO: Mosby/Elsevier.
  17. Justiss, M. D. (2013). Occupational therapy interventions to promote driving and community mobility for older adults with low vision: A systematic review. American Journal of Occupational Therapy, 67(3), 296-302. https://doi.org/10.5014/ajot.2013.005660
  18. Kim, S. Y., Park, J. E., Lee, Y. J., Seo, H. J., Sheen, S. S., Hahn, S. et al. (2013). Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity. Journal of Clinical Epidemiology, 66(4), 408-414. https://doi.org/10.1016/j.jclinepi.2012.09.016
  19. Kirby, R. L., Adams, C. D., MacPhee, A. H., Coolen, A. L., Harrison, E. R., Eskes, G. A. et al. (2005). Wheelchair-skill performance: controlled comparison between people with hemiplegia and able-bodied people simulating hemiplegia. Archives of Physical Medicine and Rehabilitation, 86(3), 387-393. https://doi.org/10.1016/j.apmr.2004.05.020
  20. Kizony, R., Levin, M. F., Hughey, L., Perez, C., & Fung, J. (2010). Cognitive load and dual-task performance during locomotion poststroke: a feasibility study using a functional virtual environment. Physical Therapy, 90(2), 252-260. doi: 10.2522/ptj.20090061
  21. Lee, D., Fischer, H., Zera, S., Robertson, R., & Hammel, J. (2017). Examining a participation-focused stroke self-management intervention in a day rehabilitation setting: a quasi-experimental pilot study. Topics in Stroke Rehabilitation, 24(8), 601-607. doi: 10.1080/10749357.2017.1375222
  22. Logan, P. A., Gladman, J. R. F., Avery, A., Walker, M. F., Dyas, J., & Groom, L. (2004). Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke. Bmj, 329(7479), 1372. https://doi.org/10.1136/bmj.38264.679560.8F
  23. McCluskey, A., & Middleton, S. (2010). Increasing delivery of an outdoor journey intervention to people with stroke: A feasibility study involving five community rehabilitation teams. Implementation Science, 5(1), 59. doi: 10.1186/1748-5908-5-59
  24. McCluskey, A., Ada, L., Middleton, S., Kelly, P. J., Goodall, S., Grimshaw, J. M., et al. (2013). Improving quality of life by increasing outings after stroke: Study protocol for the Out-and-About trial. International Journal of Stroke, 8(1), 54-58. doi: 10.1111/j.1747-4949.2012.00966.x
  25. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  26. Ogourtsova, T., Archambault, P. S., & Lamontagne, A. (2018). Post-stroke unilateral spatial neglect: virtual reality-based navigation and detection tasks reveal lateralized and non-lateralized deficits in tasks of varying perceptual and cognitive demands. Journal of neuroengineering and rehabilitation, 15(1), 34. doi: 10.1186/s12984-018-0374-y
  27. Portney, L. G., & Watkins, M. P. (2009). Foundations of Clinical Research: Applications to Practice (3 ed.). Upper Saddle River, NJ: Pearson/Prentice Hall.
  28. Priest, A. W., Salamon, K. B., & Hollman, J. H. (2008). Age-related differences in dual task walking: a cross sectional study. Journal of neuroengineering and rehabilitation, 5(1), 29. https://doi.org/10.1186/1743-0003-5-29
  29. Sackett, D. L., Rosenberg, W. M., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence-based medicine: What it is and what it isn't. British Medical Journal, 312, 71-72. https://doi.org/10.1136/bmj.312.7023.71
  30. Sidney, S., Rosamond, W. D., Howard, V. J., & Luepker, R. V. (2013). The "heart disease and stroke statistics-2013 update" and the need for a national cardiovascular surveillance system. Circulation, 127(1), 21-23. https://doi.org/10.1161/CIRCULATIONAHA.112.155911
  31. So, N. Y. (2009). Research on the influence that rights of transfer can affect on the quality of people with the physical disabilities. unpublished master's thesis, Sungkyul University, Anyang.
  32. Vahlberg, B., Cederholm, T., Lindmark, B., Zetterberg, L., & Hellstrom, K. (2013). Factors related to performance-based mobility and self-reported physical activity in individuals 1-3 years after stroke: a cross sectional cohort study. Journal of Stroke Cerebrovascular Disease, 22, E426-34. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.04.028
  33. Yogev, G., Giladi, N., Peretz, C., Springer, S., Simon, E. S., & Hausdorff, J. M. (2005). Dual tasking, gait rhythmicity, and Parkinson's disease: which aspects of gait are attention demanding? European Journal of Neuroscience, 22(5), 1248-1256. https://doi.org/10.1111/j.1460-9568.2005.04298.x