뇌졸중 재활에 관한 최근 메타분석에 대한 고찰 = A Review of Recent Meta-Analyses in Stroke Rehabilitation

다국어 초록 (Multilingual Abstract)

Background: Meta-analysis is an integrative statistical analysis of individual analyses, and has the compensatory role to ran-domized controlled trial in the medical decision. The results of meta-analyses can help to establish the guidelines of rehabilita-tive treatment and critical pathway in stroke rehabilitation. Methods: We reviewed the currently reported results of meta-analyses, using search term of “stroke” and “rehabilitation” within limit of “meta-analysis” on PubMed. Articles published on or after January, 2004 were selected, and we excluded articles which were not directly related to stroke rehabilitation or which were not meta-analyses methodologically. Results: Total 31 articles were selected. There are proven evidences for electromechanical walking training, functional electric stimulation (FES) for gait, strengthening training, aerobic exercise, occupational therapy (OTx) focused on activities of daily living (ADL), augmented exercise therapy, constraint-induced movement therapy (CIMT), bilateral movement training, community OTx for ADL and leisure, stroke unit, early supported discharge, early home-supported discharge, and information provision. However subjects regarding treadmill training, transcutaneous electric nerve stimulation (TENS) for gait, force platform feedback for clinical balance, physical fitness training, electrostimulation for motor function, robot-assisted therapy for ADL, motor apraxia training for ADL, cognitive rehabilitation for spatial neglect, rehabilitation one year or more after stroke, acupuncture had not enough evidences yet. There was an evidence against electromyographic (EMG)-biofeedback. Conclusion: According to recent published meta-analyses results, there are still many clinical therapies of which the effects are not proved yet. Further research is needed for the development of evidence-based medicine in stroke rehabilita-tion. (Korean J Stroke 2009;11:10-18)

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