Discussion: Critique of a Research Study

Discussion: Critique of a Research Study ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Critique of a Research Study Complete a critique of a research study. one article will be provided, in which you will chose randomized controlled clinical trial. The critique should identify areas of strengths and weaknesses in all aspects of the study as well as the quality of the written report. I will provide 4 attachemnt which explain how would you do the assignment . pleases, follow them and read them to get the idea. there will be a file explaining the details too. the article is also there which will be doing the critique on . Discussion: Critique of a Research Study artical.pdf chapter_4.ppt research_critique_format.doc research_critique_physical_activity_in_class_answers.doc Journal of Bodywork & Movement Therapies 24 (2020) 212e220 Contents lists available at ScienceDirect Journal of Bodywork & Movement Therapies journal homepage: www.elsevier.com/jbmt Original Research Effects of Dance/Movement Training vs. Aerobic Exercise Training on cognition, physical ?tness and quality of life in older adults: A randomized controlled trial Alida Esmail a, b, Tudor Vrinceanu c, d, e, Maxime Lussier a, d, David Predovan d, f, !bastien Grenier d, j, Nicolas Berryman d, g, Janie Houle f, h, Antony Karelis d, i, Se e, k d , Juan Manuel Villalpando , Louis Bherer c, d, e, l, * Thien Tuong Minh Vu a School of Rehabilitation, Faculty of Medicine, Universit! e de Montr! eal, Montreal, Canada Institut Universitaire sur La R! eadaptation en D! e?cience Physique de Montr! eal, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada c Research Centre, Montreal Heart Institute, Montreal, Canada d Research Centre, Institut Universitaire de G! eriatrie de Montr! eal, Montreal, Canada e Department of Medicine, Universit! e de Montr! eal, Montreal, Canada f ” Montr! Department of Psychology, Universit! e Du Qu! ebec a eal, Montreal, Canada g Department of Sports Studies, Bishop’s University, Sherbrooke, Canada h Research Centre, Institut Universitaire en Sant! e Mentale de Montr! eal, Montreal, Canada i ” Montr! Department of Exercise Science, Universit! e Du Qu! ebec a eal, Montreal, Canada j Department of Psychology, Universit! e de Montr! eal, Montreal, Canada k Centre Hospitalier de L’Universit! e de Montr! eal, Montreal, Canada l PERFORM Centre and Department of Psychology, Concordia University, Montreal, Canada b a r t i c l e i n f o a b s t r a c t Article history: Received 30 April 2019 Accepted 4 May 2019 Introduction: It is generally accepted that physical activity promotes healthy aging. Recent studies suggest dance could also bene?t cognition and physical health in seniors, but many styles and approaches of dance exist and rigorous designs for intervention studies are still scarce. The aim of this study was to compare the effects of Dance/Movement Training (DMT) to Aerobic Exercise Training (AET) on cognition, physical ?tness and health-related quality of life in healthy inactive elderly. Methods: A single-center, randomized, parallel assignment, open label trial was conducted with 62 older adults (mean age ¼ 67.48 ± 5.37 years) recruited from the community. Participants were randomly assigned to a 12-week (3x/week, 1hr/session) DMT program, AET program or control group.Discussion: Critique of a Research Study Cognitive functioning, physical ?tness and health-related quality of life were assessed at baseline (T-0), and posttraining (T-12 weeks). Results: 41 participants completed the study. Executive and non-executive composite scores showed a signi?cant increase post-training (F(1,37) ¼ 4.35, p ¼ .04; F(1,37) ¼ 7.01, p ¼ .01). Cardiovascular ?tness improvements were speci?c to the AET group (F(2,38) ¼ 16.40, p < .001) while mobility improvements were not group-dependent (10 m walk: F(1,38) ¼ 11.67, p ¼ .002; Timed up and go: F(1,38) ¼ 22.07, p < .001). Conclusions: Results suggest that DMT may have a positive impact on cognition and physical functioning in older adults however further research is needed. This study could serve as a model for designing future RCTs with dance-related interventions. Registration: clinicaltrials. gov Identi?er NCT02455258. © 2019 Elsevier Ltd. All rights reserved. Keywords: Executive functions Cardiovascular ?tness Prevention Mobility Quality of life * Corresponding author. Montreal Heart Institute Research Centre, 5000 Belanger, S-2581, Montreal, H1T 1C8, Quebec, Canada. E-mail address: [email protected] (L. Bherer). https://doi.org/10.1016/j.jbmt.2019.05.004 1360-8592/© 2019 Elsevier Ltd. All rights reserved. A. Esmail et al. / Journal of Bodywork & Movement Therapies 24 (2020) 212e220 1. Introduction A growing body of research has emphasized the bene?ts of physical activity on cognition throughout life and during late age (Bherer et al., 2013). More speci?cally, an inverse relationship has been established between the level of physical activity and cognitive decline (Larson et al., 2006), and longitudinal studies have shown that being physically active was associated with a lower risk of developing dementia (Yaffe et al., 2001). A higher level of physical functioning abilities was also associated with greater processing speed and better executive functions (DesjardinsCrepeau et al., 2014). It is proposed that being physically active improves cognition through cellular and molecular changes, structural and functional brain adaptations, and behavioural and socio-emotional modi?cations (Stillman et al., 2016). Aerobic exercise training (AET) has often been studied in relation to executive functions in older populations. Many crosssectional studies and randomized controlled trials (RCTs) found moderate to strong associations between aerobic ?tness and executive functions (Berryman et al., 2013). In addition, some studies have linked higher aerobic ?tness to better performance on the general cognitive construct of executive functions using composite scores (Berryman et al., 2013; Netz et al., 2010). However, due to its intensity, AET might not be the most preferred program for sedentary older adults who are not used to exercising. Discussion: Critique of a Research Study In addition to the positive impact of AET on cognition in healthy (Colcombe and Kramer, 2003) and cognitively impaired older adults (Groot et al., 2016), studies have also highlighted the bene?ts of other forms of exercise on cognition (Bherer et al., 2013), namely resistance training (Liu-Ambrose et al., 2012), gross motor skills training or a combination of AET and resistance training (Berryman et al., 2014), coordination training (Voelcker-Rehage et al., 2011; Voelcker-Rehage and Niemann 2013), or yoga (Gothe et al., 2014). For example, a review of the literature suggests that a coordination exercise program (e.g., balance, hand-eye/leg-arm coordination, spatial orientation, motor learning) could also have a bene?cial effect on brain structures and functions (Voelcker-Rehage and Niemann, 2013), even though it does not impact cardiorespiratory ?tness. Accordingly, a study directly comparing the speci?c impact of this training program to an AET program over a period of 12 months shows similar improvement in executive control and perceptual speed performance (Voelcker-Rehage et al., 2011). Local community programs identify dance as one of the most preferred type of physical activity for sedentary older adults (Fan et al., 2013). As a result, interventions based on dance have also recently gained interest in the scienti?c community, as it offers a combination of physical, cognitive and social activities potentially useful for attenuating age-related decline. In a recent review, McNeely et al. (2015) report a positive effect of dance on executive functions and quality of life in older adults based on ten intervention studies involving different types of dance (e.g., salsa, ballroom, contemporary, etc.) from 8 weeks to 18 months. Forms of Dance/ Movement Training (DMT), such as dance/movement therapy, designed to use movement and dance in order to promote physical, social, emotional and cognitive integration of the individual, have also been used in the literature with both clinical and healthy participants. A meta-analysis has shown that it promotes psychological outcomes (i.e., quality of life, well-being, mood and affect, body image) and reduces clinical symptoms related to depression, anxiety, and interpersonal competence (Koch et al., 2014). It thus seems that dancing has the potential to be an affordable, accessible (Guzman-Garcia et al., 2013), and attractive exercise program for long-term sedentary older adults that can also be promising in reducing the burden of aging. However, the speci?c impacts of DMT on strength, agility and cardiorespiratory health condition, or its 213 use as continuous cognitive stimulation (Ballesteros et al., 2015) remains understudied. Limitations of past studies are, among other things (Predovan et al., 2018), the lack of a structured intervention and, with the exception of a few studies, the absence of active control groups that would allow assessing dance interventions to more structured physical activity programs commonly used with older adult populations, like AET. Discussion: Critique of a Research Study The present study compared the effects of a DMT program to an AET program on cognitive, physical and health-related quality of life (QoL) dimensions, using a structured RCT design. Given the reported effect of exercise and dance in previous studies, we hypothesized that participants in the DMT and AET groups would show improved cognition. Secondary hypotheses included increased improvement in health-related QoL in DMT compared to the AET and Control groups and an increase in cardiovascular ?tness in the AET group as opposed to the other groups. 2. Methodology 2.1. Trial design A single-center, randomized, parallel assignment, open label control trial (Clinicaltrials.gov NCT02455258) with a three-arm design was conducted from March 2015 to April 2016. All potential participants were screened over the phone with a general description of the project and a medical questionnaire to determine their eligibility. If participants met inclusion criteria, they were invited to complete a full geriatric assessment, a neuropsychological screening and pre-testing sessions (T-0). Pre-testing targeted several outcome domains: cognitive function, physical ?tness, and health-related QoL. After T-0, participants were randomized into one of three groups (DMT, AET, CG). Following 12 weeks of training, participants underwent post-testing sessions (T-12 weeks) evaluating the same outcomes as pre-test. Evaluation days lasted maximum 4 h and were scheduled within a two-week period (T-0, M ¼ 8.26, ±3.96 days before intervention; T-12, M ¼ 7.71, ±3.84 days after intervention). Assessments were completed over the course of two days and scheduled with consideration for potential cognitive and/or physical fatigue. The local Research Ethics Board of the geriatric institution where the study took place approved the project (CER IUGM 13-14-029), and written informed consent was obtained from all participants before data collection. 2.2. Participants Inclusion criteria: Men and women aged 60 and over who were inactive (i.e., not meeting the American College of Sports Medicine physical activity guidelines to engage in 150 min of moderate intensity structured exercise per week), were targeted in this study. In addition, they had not participated in another similar intervention study within the last year (i.e., had not been exposed to an AET or DMT program and/or had not been tested with a similar neuropsychological test battery). No mobility limitations were presented or any surgeries involving a general anaesthetic in the past year. Eligibility included non-smokers (within the last ?ve years) and those who consumed “2 standard measures of alcohol per day. Exclusion criteria: A diagnosis of orthopaedic, neurological, cardiovascular, respiratory progressive somatic or psychiatric problems within the last six months, or presented uncorrected auditory or visual limitations. Participants undergoing hormone therapy were excluded to avoid the interaction effects with prolonged physical activity in women.Discussion: Critique of a Research Study Participants with cognitive impairments as assessed with the Mini-Mental State Examination (MMSE) (Folstein et al., 1975) (score of “24) were also excluded. 214 A. Esmail et al. / Journal of Bodywork & Movement Therapies 24 (2020) 212e220 Once enrolled, participants were asked to refrain from changing their lifestyle behaviours (i.e., level of physical activity, diet, etc.) between T-0 and T-12. Recruitment was ongoing until the ?nal cohort using advertisements placed in newspapers, on social media, in elevators, community centers, libraries and local businesses. 2.3. Interventions Participants randomly assigned to either intervention group (DMT or AET) were enrolled in a training program with three 60min sessions per week. Both DMT and AET programs took place at the same geriatric institution research center in a gym facility dedicated to research. Participants were asked to attend at least 80% of the training sessions (i.e. could not miss more than 7 of the 36 sessions), otherwise they were excluded from the analyses. 2.3.1. Dance/Movement Training (DMT) The DMT intervention used in this study was designed according to the standards of the American Dance Therapy Association (ADTA, 2019) and adapted to the needs of the healthy older participants. An ADTA registered dance/movement therapist or a supervised trainee led the group training of 4e8 participants. Normally dance/movement therapy programs are quite ?exible in nature, however, since this was a RCT, facilitators were asked to follow a common dance/movement therapy structure for each session (opening circle, warm up, development, and closure). Since the participants did not present with any health diagnoses to be resolved, the program did not follow a speci?c therapeutic treatment plan but rather, was comprised of expressive movement and guided gestures to expand participants’ movement repertoire. Each facilitator was also given a list of themes pertinent to the healthy older adult to focus on in their intervention, such as lifestyle improvement, body awareness, relaxation, balance, self-care, socialization, rhythm and, enjoyment. Throughout the training program, props such as the Octaband©, the CoOper Blanket©, the Elastablast©, colorful scarves, exercise balls, TheraBands™ and tennis balls were used. Sessions were held in a space of approximately 4.5 m # 10 m. Music was not imposed as a part of this RCT, however, it was often incorporated. When used, music of differing styles was chosen based on the objectives of the movement, sometimes proposed by the group facilitator or the participants. 2.3.2. Aerobic Exercise Training (AET) A certi?ed kinesiologist supervised each session, which comprised of a warm up, cardiovascular training on a seated recumbent bicycle and a cool down (adapted from Berryman et al. (2014); see Supplemental Table 1 for a detailed protocol). The warm up and cool down were 5 min each, where participants used an ergometer of their choosing (bicycle, treadmill, elliptical). Discussion: Critique of a Research Study The cardiovascular training was tailored to the participant’s maximal aerobic power (MAP) determined from the VO2 peak test at T-0. The program was structured with 15-s bouts interval training (up to 110% of their MAP) twice a week mixed with continuous training (up to 70% of their MAP) once a week. Since the protocol demanded a high level of attention from the kinesiologist, a ratio of 2:1 (participants to trainer) was maintained, meaning the participants exercised in pairs. 2.3.3. Control group (CG) As a passive control group, CG participants were placed on a waiting list for the exercise group of their choosing (DMT or AET), with the opportunity to be a part of that group in the following cohort. While on the waiting list from T-0 to T-12, CG participants were asked to refrain from enrolling in any physical activity programs or changing their habitual lifestyle behaviours. 2.4. Outcomes 2.4.1. Initial screening Participants’ risk in enrolling in this study was evaluated using the self-reported Physical Activity Readiness Questionnaire (PARQþ) as well as a comprehensive geriatric assessment. A certi?ed geriatrician performed each medical evaluation during a 45- to 60min consultation. Various health components were assessed including, but not limited to, heart rate, blood pressure, current medical conditions and/or complaints in all physiological systems: cardiovascular, pulmonary, neurological, musculoskeletal, other (any condition that does not ?t in the aforementioned categories), personal and family medical history, functional capacities, allergies, list of medications, a physical exam, and a frailty assessment. Participants were also screened for short-term memory, working memory and abstraction/reasoning (WAIS-4 Digit Span forwards and backwards and Similarities) (Wechsler, 2008), processing speed and visuo-constructive abilities (WAIS-3 Substitution) (Wechsler, 1997). 2.4.2. Primary outcomes 2.4.2.1. Cognition. Graduate students in neuropsychology were trained by a certi?ed neuropsychologist to administer the cognitive test battery with each participant in a quiet room. Executive functions were assessed using three tablet tasks (Dual-task, N-back, and Digit Stroop) based on previous studies (Logie et al., 2004; Miyake et al., 2000). These tasks were administered on an iPad Air 16 GB (9.7 inches) using Safari as the browser. Firstly, the dual-task paradigm was adapted from previous studies (Bherer et al., 2005; Bherer et al., 2008; Lussier et al., 2017a; Lussier et al., 2017b; Lussier et al., 2012) and consisted of performing two concurrent visual discrimination tasks, one with each hand. Discussion: Critique of a Research Study The paradigm involved two types of blocks. In the pure blocks, participants completed only one task at a time (single-pure trials, SP) and for each task they had to discriminate between three visual objects. Mixed-blocks were composed of trials presenting stimuli from only one of the two tasks (singlemixed trials, SM) or both at the same time (dual-mixed trials, DM). In all trials, participants had to answer as fast as possible. Reaction time (RT) and accuracy were recorded. As accuracy is generally high in this task (over 98.4%) the variable of interest is RT (in ms). Secondly, the N-back task participants had to answer if a presented stimulus was the same or different than the one presented two positions before (reported as 2-back) (Owen et al., 2005). Participants also performed a 1-back task where they had to identify if a presented stimulus was the same as the one presented one position before. Stimuli were presented visually on the screen and audibly through headphones every 3 s. The variable of interest for this task is accuracy (percentage of correct responses). Finally, the Digit Stroop task was also based on previous studies (de Paula et al., 2014; Sedo, 2004) and was comprised of four different conditions: Reading, Counting, Inhibition, and Switching. During the Reading block, digits 1 to 6 were presented on the screen and the participants were instructed to identify it by pressing the corresponding button. During the counting block, a quantity of stars (from one to six) appeared on the screen, and participants had to say how many there were by pressing the correct button. In the Inhibition condition, a quantity of identical digits was present on the screen. The quantity differed from the digit (e.g., “2 2 2 2”). Participants were instructed to identify the quantity by pressing the corresponding button. In the Switching condition, A. Esmail et al. / Journal of Bodywork & Movement Therapies 24 (2020) 212e220 participants had to identify the quantity unless a white border appeared on the screen, in which case they had to identify the digit. Stimuli were presented one at a time on the screen, and participants answered by pressing one of the six possible answer buttons as fast as possible. RTs and accuracy were recorded for all conditions. However, the variable of interest for this task is RT due to the high accuracy (over 96% for Reading, over 95% for Inhibition, and over 89% for Switching). In addition to the Dual-Task, N-back and Digit Stroop, global cognition was measured using the paper-pencil Montreal Cognitive Assessment (MoCA; version 7.1 at T-0, 7.2 at T-12) (Nasreddine et al., 2005). 2.4.2.2. Composite scores. Two composite scores were created from all the cognitive tablet tasks, the ?rst representing executiv … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10