Balance and Gait Reading Research Literature Assignment

Reading Research Literature – Week 5: Balance and Gait Problems
For Use September 2018

Type your answers to the following questions using complete sentences and correct grammar, spelling, and syntax. Click Save as and save the file with your last name and assignment, e.g., NR439_Reading_Research_Literature_Smith. Submit by 11:59 pm MT Sunday at the end of Week 5. The guidelines and grading rubric for this assignment may be found on the assignment page.

Title: RRL

Name: [replace this text with your name]

The following questions pertain to:

Velayutham, S. G., Chandra, S. R., Bharath, S., & Shankar, R. G. (2017). Quantitative balance and gait measurement in patients with frontotemporal dementia and Alzheimer diseases: A pilot study. Indian Journal of Psychological Medicine, 39(2), 176-182. doi:10.4103/0253-7176.203132

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1)    What is the purpose of this research?

The purpose of this study was to investigate balance and gait problems in normal elderly as well as patients with AD and FTD during dual tasking, indicating the role of divided attention (Velayutham et al., 2017).

2)    What is the research question (or questions)? This may be implicit or explicit.

The research question is on whether the abnormalities of gait and balance are related with FTD and AD (Velayutham et al., 2017).

3)    Give a complete description of the research design of this study.

The research design is a quasi-experimental design because it seeks to establish the relationship two variables which in this case are the AD and FTD to the control which in this case are the healthy volunteers (Creswell, 2014). The results of the two variables are compared to the results of the groups which are not exposed to the variable, which in this study is the comparison of the effects of AD and FTD to the results of the healthy volunteers (Creswell, 2014).

4)    What is the population (sample) for this study?

The sample population consisted of 24 males between the age of 50 to 70 years, eight in each group of potential FTD diagnosed by revised consensus criteria, probable AD diagnosed by ADs association technique and healthy health volunteers who were serving as controls. The AD and FTD patients were sampled from Geriatric Clinic and the Outpatient Department of Neurology, and the controls were recruited from the community.

5)    Was the sampling approach adequate for the research design that was selected and explain why?

The sampling approach was adequate for the research selected design because it made the comparison of AD and FTD with the controls possible. It also enabled research to tell the difference between AD and FTD by analyzing the signs and symptoms of patients with these disorders.

6)    Describe the data collection procedure.

The balance was measured using Biodex Balance Master Incorp., USA, using dynamic posturography, in single and in dual tasks while gait was measured with Biodex Gait Trainer (Velayutham et al., 2017). In the single task, three trials with twenty durations each were done. The amount of deviation from original BOS and direction of difference were recorded without using handrail support. The test results contain OBI and API, that is the amount of front to back sway, and MLI, the is the amount of side to side sway. The higher the score indicates the poor the patient’s balance (Velayutham et al., 2017).

In the dual task, the subject performed dynamic balance, LOS task alongside cognitive task and repeated after a rest period of two minutes from a single task. The cognitive task includes digital subtraction of three to two from one hundred in dynamic balance LOS task respectively. 

7)    How were the data analyzed after collection?

The normalcy of the parameters was tested using Shapiro-Wilkins test. Descriptive analysis was conducted for education years, body mass index, and age. Paired t-test was used to analyze within-group analysis for dual and single tasks (Shaikh, & Rufa, 2018). Additionally, One-way ANOVA was done to show the difference between groups than by post hoc test with Bonferroni correction.

8)    Discuss the limitations found in the study.

The AD, FTD, and the control groups showed tremendous differences in the overall LOS score between dual-task versus single task, but the sub-component of LOS reveled that FTD patients found it difficult to balance on forward lateral direction while the control sample had problems left and forward guidance (Shaikh, & Rufa, 2018). On the other hand, the AD sample population had a significant challenge to balance in the backward direction. 

9)    Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

The authors concluded that postural stability training early patients with AD and gait training in patients with FTD could help to delay the further progress of the complications to falls in these patients. They further assert that patients with FTD and patients AD have problems in overall AI, but patients with FTD particularly suffer from stride length and step cycle which is absent among patients with the AD.  I feel like the conclusion is based on the data collected because it summarizes the purpose of the study (Buetow, 2016).

10)    How does this advance knowledge in the field?

The research helps to advance knowledge in this field because it distinguishes the AD from FTD based on the signs and symptoms of patients with each disorder (Buetow, 2016). In effect, it helps to reduce future confusions between the two diseases by making their distinguishing characteristics available to health care providers.

The following questions pertain to:

Pals, R. S., Hansen, U. M., Johansen, C. B., Hansen, C. S., Jørgensen, M. E., Fleischer, J., & Willaing, I. (2015). Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives. BMC Health Services Research, 15(1), 1-10. doi:10.1186/s12913-015-1071-1

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1)    What is the purpose of this research?

The purpose of this research was to explore patient and physician perspectives on the usefulness of new technology to detect Cardiovascular Autonomic Neuropathy (CAN) in a specialist diabetes clinic (Pals et al., 2015).

2)    What is the research question (or questions)? This may be implicit or explicit.

Does early detection of CAN important to motivate patients and physicians to minimise risk factors and reduce further development of complications?

3)    Give a complete description of the research design of this study.

The study is a descriptive research design which seeks to describe the current status of patient and physician’s perspective on the usefulness of new technology (Creswell, 2014). The review does not begin with a hypothesis, but it develops them after collecting data. Additionally, it majorly uses an observational technique to collect data (Creswell, 2014).

4)    What is the population (sample) for this study?

The population used in the sample consisted of diabetic patients and physicians from a specialist diabetes clinic in the great Copenhagen area. The sample consisted of nine physicians; six female and three males (Pals et al., 2015). Of the nine physicians, three were chief physicians and six who were less experienced. It also consisted of nineteen patients whose ages ranged from 36 to 79 years. Sixteen patients were males, and three were female. Of the nineteen patients, three were diagnosed with type 1 diabetes while sixteen were diagnosed with type 2 (Pals et al., 2015).

5)    Was the sampling approach adequate for the research design that was selected and explain why?

The sampling approach was adequate for the selected research design because interviews and observation, which were the primary methods of collecting data, were favoured research design used (Shaikh, & Rufa, 2018).

6)     Describe the data collection procedure.

Data was collected involved identification of patients who had received the CAN test and were scheduled to receive the results at a subsequent medical sultation through the EPR with the help of a patient coordinator at the clinic (Pals et al., 2015). Observations were conducted during days when consultations were scheduled. Additionally, interviewers organized correspondence with a nurse who helped in keeping them up to date about the future discussions where tests were expected to be provided. A series of observation sessions of medical consultations in which CAN test results were reported. 

7)    How were the data analyzed?

The qualitative analytical technique was used to analyze both the patient and physician’s perspectives on the CAN test. The data collected through field observations and interviews were analyzed using content analysis to systematically make inferences about the infections and interpretations of physicians and patients (Shaikh, & Rufa, 2018).

8)    Discuss the limitations found in the study?

If all patients who were diagnosed with diabetes were included in the research, more refined and insightful results would have emerged about these patients, but most patients did not remember their tests hence, unable to give more information about their experience with the CAN test (Pals et al., 2015). Secondly, there are high chances the interviewers selected a specific group of physicians who took part in the interview because only a few physicians were invited to participate. Lastly, the research did not draw a comparison between the proposed technology and other established technologies that have been in use for relatively long period in the clinical sector.

9)    Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

The authors’ concluded that it is important to integrate samples from both patients and physicians when doing a risk assessment on new technology before introducing it in the clinical practice because new technologies can be characterized with diverse challenges (Buetow, 2016). The authors also concluded that more information about the CAN test technology needed to be made available to patients and recommended a dialogue-based strategy when communicating the test results to enable them to gain full knowledge of the technology and support it. More patients were not included in the study because of inadequate information about their test results because they were not fully informed about the test.

I feel that these conclusions were based on the collected data because they talk about the actual challenges that were encounter during the research.

10)    How does this advance knowledge in the field?

The incorporation of the CAN technology in clinical practices will help to advance both the patients’ and physicians’ knowledge about the causes, management, and treatment of diabetes and place them in a position to explain their test results (Buetow, 2016).

References

Buetow, S. (2016). Person-Centered Health Care: Balancing the Welfare of Clinicians and Patients: London: Routledge Taylor & Francis Group

Creswell, J.W. (2014). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. (4th ed.). Washington DC: SAGE Publications, Inc.

Pals, R. S., Hansen, U. M., Johansen, C. B., Hansen, C. S., Jørgensen, M. E., Fleischer, J., & Willaing, I. (2015). Making sense of a new technology in clinical practice: a qualitative study of patient and physician perspectives. BMC Health Services Research, 15(1), 1-10. doi:10.1186/s12913-015-1071-1

Shaikh, A.G., & Rufa, A. (2018). Ocular Motor and Vestibular Function in Neurometabolic, Neurogenetic, and Neurodegerative Diseases. New York: Frontiers in Neurology

Velayutham, S. G., Chandra, S. R., Bharath, S., & Shankar, R. G. (2017). Quantitative balance and gait measurement in patients with frontotemporal dementia and Alzheimer diseases: A pilot study. Indian Journal of Psychological Medicine, 39(2), 176-182. doi:10.4103/0253-7176.203132

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