트레드밀 운동이 뇌졸중 환자의 폐기능과 보행능력에 미치는 효과: 메타분석 (Effects of Treadmill Exercise on Pulmonary Function and Gait Capacity in Stroke Patients : A Meta-analysis)

서지정보

· 발행기관 : 대한통합의학회
· 수록지 정보 : 대한통합의학회지 / 8권 / 2호 / 169 ~ 185페이지
· 저자명 : 조성현, 최기복

초록

본 연구는 메타분석 기법을 활용하여 뇌졸중 환자를 대상으로 한 트레드밀 운동의 효과성을 종합적으로 평가하고자 한다. 본 메타분석 연구는 2005년 1월부터 2020년 2월까지 뇌졸중환자에게 트레드밀 운동을 적용한 논문을 대상으로 하였다. 체계적으로 메타분석을 실시하기 위해 PICOS 기준에 의거하여 검색한 후 총 25개의 국내 ‘뇌졸중’, ‘트레드밀’ 관련 연구물을 선정하였다. CMA 프로그램을 이용하여 폐 기능과 보행능력(6분 보행검사, 10m 보행검사)의 효과크기를 산출하였다. 메타분석 결과, 국내 트레드밀 운동의 전체 효과크기는 0.535이였고, 중간크기의 효과로 통계학적으로 유의미하였다(p<.05). 트레드밀 운동이 뇌졸중 환자에게 미치는 종속변인에 대하여 폐 기능(0.372), 보행(0.584)으로 나누어 효과크기를 비교하였다. 추가적으로 보행은 하위항목들을 관찰하였으며, 6MWT(0.756), 10MWT(0.514)의 효과크기가 나타났다.
본 연구는 트레드밀 보행훈련프로그램의 효과에 대한 객관적인 증거를 제시하며, 뇌졸중 환자의 트레드밀 보행 프로그램의 개발 및 적용을 위한 자료로 사용하고자 한다.

영어초록

Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application.
Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen’s d has a tendency to overestimate the effect size, we used Hedge’s g to increase the accuracy in computing the effect size.
Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514).
Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

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