강제 유도 운동치료(Constraint-Induced Movement Therapy)가 편마비를 가진 뇌성마비 아동의 상지 기능에 미치는 효과: 메타분석 = Effects of Constraint-Induced Movement Therapy for the Upper-extremity Function in Children With Cerebral Palsy Suffering From Hemiplegia : Meta-analysis

국문 초록 (Abstract)

목적 : 본 연구는 전통적인 치료와 비교했을 때, 강제 유도 운동치료가 편마비를 가진 뇌성마비 아동의 상지 기 능에 미치는 효과를 메타분석을 통해 알아보고자 한다. 연구방법 : 국내외 검색엔진을 이용하여 자료를 수집하였으며, 2006년∼2013년까지 게재된 14편의 연구를 선정 하였다. 선정기준에 적합한 논문을 대상으로 PEDro score를 사용하여 질적 평가를 실시하였으며, 상지기능의 사전-사후 평균과 표준편차, 표본수를 사용하여 메타분석을 실시하였다. 결과 : 선정된 14편의 연구는 PEDro score가 6점 이상이었으며, 연구 참여자는 527명이었다. 효과크기분석 결 과 환측 상지의 운동 능력, 사용빈도 및 질에서는 “큰 효과크기”를 나타내었고 통계적으로 유의한 수준이었다(p<.001). 또한 분리된 움직임, 잡기 능력, 시각 운동 통합 능력에서는 “보통 효과크기”를나타내었으 며 통계적으로 유의하였다(p<.05). 결론 : 강제 유도 운동치료는 전통적인 치료보다 편마비를 가진 뇌성마비 아동의 상지 기능 회복에 있어더 효과 적임을 알 수 있었다. 이것은 임상에서 편마비를 가진 뇌성마비 아동의 상지 기능을 회복하기 위한 치료 방법으 로 객관적인 근거가 될 수 있다.

목차 (Table of Contents)

• 국문초록
• I. 서론
• Ⅱ. 연구 방법
• 1. 연구 대상 및 자료 수집
• 2. 대상논문의 선정기준
• 3. 질적 평가
• 4. 메타분석 방법
• Ⅲ. 연구 결과
• 1. 분석 대상 연구의 일반적 특성
• 2. 계량적 메타분석 결과
• Ⅳ. 고찰
• Ⅴ. 결론
• References
• Abstract

참고문헌 (Reference)

1 Fedrizzi, E., "Unimanual and bimanual intensive training in children with hemiplegic cerebral palsy and persistence in time of hand function improvement : 6-month follow-up results of a multisite clinical trial" 28 : 161-175, 2013

2 Taub, E., "The learned nonuse phenomenon : Implications for rehabilitation" 42 : 241-255, 2006

3 Sakzewski, L., "Systematic review and meta-analysis of therapeutic management of upper limb dysfunction in children with congenital hemiplegia" 123 : 1111-1122, 2009

4 Page, S. J., "Stroke patients’ and therapists’ opinions of constraint-induced movement therapy" 16 (16): 55-60, 2002

5 Cohen, J., "Statistical power analysis for the social sciences" Erlbaum 1988

6 Hedges, L. V., "Statistical methods for meta-analysis" Academic Press 1985

7 Lau, J., "Quantitative synthesis in systematic reviews" 127 : 820-826, 1997

8 Rothstein, H. R., "Publication bias as a threat to the validity of meta-analytic results" 4 (4): 61-81, 2008

9 Glass, G., "Primary, secondary, and metaanalysis of research" 5 (5): 3-8, 1976

10 DeLuca, S. C., "Pediatric constraint-induced movement therapy for a young child with cerebral palsy : Two episodes of care" 83 : 1003-1013, 2003

11 OTseeker, "PEDro scale (partitioned): Rating sheet"

12 Steultjens, E. M. J., "Occupational therapy for children with cerebral palsy: A systematic review" 18 : 1-14, 2004

13 Sunderland, A., "Neuroplasticity, learning and recovery after stroke: A critical evaluation of constraint-induced therapy" 15 : 81-96, 2005

14 Geerdink, Y., "Motor learning curve and long-term effectiveness of modified constraint-induced movement therapy in children with unilateral cerebral palsy : A randomized controlled trial" 34 : 923-931, 2013

15 Wallen, M., "Modified constraint-induced therapy for children with hemiplegic cerebral palsy : A randomized trial" 53 : 1091-1099, 2011

16 Deppe, W., "Modified constraint-induced movement therapy versus intensive bimanual training for children with hemiplegia-a randomized controlled trial" 27 : 909-920, 2013

17 Page, S. J., "Modified constraint induced therapy : A randomized feasibility and efficacy study" 38 : 583-590, 2001

18 Gordon, A. M., "Methods of constraint-induced movement therapy for children with hemiplegic cerebral palsy : Development of a child-friendly intervention for improving upper-extremity function" 86 : 837-844, 2005

19 Boyd, R. N., "Management of upper limb dysfunction in children with cerebral palsy : A systematic review" 8 : 150-166, 2001

20 Hoare, B., "Intensive therapy following upper limb botulinum toxin a injection in young children with unilateral cerebral palsy: A randomized trial" 55 : 238-247, 2013

21 Wiklund, L. M., "Hemiplegic cerebral palsy. Correlation between CT morphology and clinical findings" 33 : 512-523, 1991

22 Fedrizzi, E., "Hand function in children with hemiplegic cerebral palsy : Prospective follow-up and functional outcome in adolescence" 45 (45): 85-91, 2003

23 Willis, J. K., "Forced use treatment of childhood hemiparesis" 110 (110): 94-96, 2002

24 Choudhary, A., "Efficacy of modified constraint induced movement therapy in improving upper limb function in children with hemiplegic cerebral palsy : A randomized controlled trial" 35 : 870-876, 2013

25 Hsin, Y. J., "Efficacy of constraint-induced therapy on functional performance and health-related quality of life for children with cerebral palsy : A randomized controlled trial" 27 : 992-999, 2012

26 Gordon, A. M., "Efficacy of constraint-induced movement therapy on involved upper-extremity use in children with hemiplegic cerebral palsy is not agedependent" 117 : 363-373, 2006

27 Xu, K., "Efficacy of constraint-induced movement therapy and electrical stimulation on hand function of children with hemiplegic cerebral palsy: A controlled clinical trial" 34 : 337-346, 2012

28 Charles, J. R., "Efficacy of a child-friendly form of constraint-induced movement therapy in hemiplegic cerebral palsy : A randomized control trial" 48 : 635-642, 2006

29 Gordon, A. M., "Efficacy of a Hand-Arm Bimanual Intensive Therapy (HABIT) in children with hemiplegic cerebral palsy: A randomized control trial" 49 : 830-838, 2007

30 Taub, E., "Efficacy of Constraint-induced movement therapy for cerebral palsy with asymmetric motor impairment" 113 : 305-312, 2004

31 Rostami, H. R., "Effects of modified constraint-induced movement therapy in virtual environment on upper-limb function in children with spastic hemiparetic cerebral palsy: A randomised controlled trial" 31 : 357-365, 2012

32 Lin, K. C., "Effects of home-based constraint-induced therapy versus dose-matched control intervention on functional outcomes and caregiver well-being in children with cerebral palsy" 32 : 1483-1491, 2011

33 Anttila, H., "Effectiveness of physical therapy interventions for children with cerebral palsy : A systematic review" 8 (8): 1-10, 2008

34 Yen, J. G., "Effectiveness of modified constraintinduced movement therapy on upper limb function in storke subjects" 14 (14): 16-20, 2005

35 Aarts, P. B., "Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy : A randomized controlled trial" 24 : 509-518, 2010

36 Chen, C. L., "Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy : A randomized controlled study" 27 : 236-245, 2013

37 Eliasson, A. C., "Development of hand function and precision grip control in individuals with cerebral palsy : A 13-year follow-up study" 118 : 1226-1236, 2006

38 Mackey, A. H., "Deficits in upper-limb task performance in children with hemiplegic cerebral palsy as defined by 3-dimensional kinematics" 87 : 207-215, 2006

39 Hoare, B., "Constraint-induced movement therapy in the treatment of the upper limb in children with hemiplgic cerebral palsy: A Cochrane systematic review" 21 : 675-685, 2007

40 Taub, E., "Constraint-induced movement therapy : A new family of techniques with broad application to physical rehabilitation : A clinical review" 36 : 237-251, 1999

41 Rosenthal, R., "Comparing effect sizes of independent studies" 92 (92): 500-, 1982

42 Stanley, F. J., "Cerebral palsies: Epidemiology and causal pathways" Cambridge University Press 2000

43 Gordon, A. M., "Bimanual training and constraintinduced movement therapy in children with hemiplegic cerebral palsy : A randomized trial" 25 : 692-702, 2011

44 Egger, M., "Bias in meta-analysis detected by a simple, graphical test" 315 : 629-634, 1997

45 Brandao, M., "Adapted version of constraint-induced movement therapy promotes functioning in children with cerebral palsy : A randomized controlled trial" 24 : 639-647, 2010

46 Sung, I. Y., "A pilot evaluation of cast immobilization of intact upper extremity : A new therapeutic approach for spastic hemiplegic cerebral palsy" 22 : 828-832, 1998