Does Exercise Have A Benefit On Parkinson's Disease - Research Paper Example

DОЕS ЕХЕRСISЕ HАVЕ А BЕNЕFIT ОN РАRKINSОN'S DISЕАSЕ? 1.0 INTRODUCTION 1.1 Research question/problem The research will seek to answer this question: Does exercise have a benefit on Parkinson’s disease? 1.2 Statement of hypothesis It is hypothesized in this proposal that: Exercise does have a benefit on Parkinson’s disease. 1.3 Topic This study will delve into the whole issue of exercise for people suffering from and Parkinson’s disease. The scope of the study will involve the benefits that Parkinson’s disease patients get from exercise. It will also touch on the types of exercises that are deemed beneficial to people with Parkinson’s disease. There are varying opinions on whether exercise can benefit people with Parkinson’s disease (Ronken & ‎Scharrenburg, 2002, p. 158) and therefore, this study will seek to find out where the truth lies in this matter. 2.0 LITERATURE REVIEW Exercise is important and healthy for all people. However, those with Parkinson’s disease (PD) find that exercise is more important for the maintenance of mobility, balance and day to day activities (Jankovic, & ‎Tolosa, 2007, p. 36). Exercise for PD patients gives them a good sense of well being in all disease stages. Researchers agree that exercise come with both short term and long term benefits for individuals with PD. Exercise is important for managing symptoms. Researchers on the topic have proved that exercise is important in the management of tremor, gait, balance, motor coordination, flexibility and grip strength. Examples of exercises that have been proved to help in symptom management are biking and treadmill training (Parashos & ‎Wichmann, 2012, p. 40). Exercise has also been found to have the effect of slowing down the progression of disease. Physical therapists and doctors agree that improved mobility has the effect of reducing the risk of PD patients falling as well as other PD complications. There is consensus between these two groups that mobility can be improved when a patients takes part in occupational therapy, physical therapy and exercise. Studies done on animals have also revealed that exercise improves Parkinson’s disease. Neurologists recommend that patients and those in danger of PD should get involved in intense exercise (Pepper, 2011, p. 67). Recent research shows that exercise gives protection to dopamine producing nerve cells that get lost in Parkinson’s disease and this helps them to work better and have a longer time of survival. This has the effect of slowing down disease progression. Current treatment cannot achieve this. Researchers have proven that more intense exercises are better because they have higher benefits (Rosenstein, 2002, p. 78). Experts do recommend that those with Parkinson’s whether in early stages or otherwise should exercise more often and as much as possible. More benefits accrue when exercise is done many times. Exercise is termed intense if it can raise the heart rate and cause heavy breathing. Some studies suggest bicycle riding and running although there are other exercises that are intense enough to bring the same effect (Duvoisin, & ‎Sage, 2001, p. 37). 2.1 Suitable exercises for people with PD Formal exercise programs bring together different criteria for fitness in a beautiful balance. These criteria include coordination, endurance, balance and flexibility (Saxton 2011, p. 47). Each one of these areas benefits people with Parkinson’s disease and experts warn that none of them should be taken for granted. The goal of the patient should be to achieve a suitable balance that works for him and one that can engage him in a program that he can keep, begin, maintain and even expand (Bizière, & ‎Kurth, 1997, p. 29). People with Parkinson’s disease can benefit from many types of exercises but experts recommend intensive sports training, resistance training, treadmill training, aerobic exercise, work-out tapes, yoga and practice of movement. Exercise is known to reduce stiffness and to improve mobility, posture, gait and balance. People with PD can do aerobic exercises, flexibility activities, strengthening activities and balance activities (Weiner, ‎Shulman, & ‎Lang, 2013, p. 81). Aerobic activities are important in such cases because they make the large muscles of the body move rhythmically for longer. They also improve physical fitness and give strength and endurance to the patient. Aerobic activities also reduce stiffness, elevate the mood and make the quality of life better. Flexibility exercises have the effect of improving mobility, reducing stiffness and increasing the range of motion. Improved range of motion has an effect on walking ability and posture. This makes the day to day activities easier (Warren, ‎Fabrizio & Lang, 2011, p. 128). Strengthening activities improve the strength of the muscles, speed of walking, posture and general physical fitness. Improving the patient’s strength makes it easier to mage daily activities such as rising from a chair. Examples of strengthening activities include gardening and resistance or weights (Pfeiffer, ‎Wszolek & ‎Ebadi, 2012, p. 139) Balance activities improve the stability and posture of the person with PD and improved balancing lowers the fear of falling and aids in the performance of daily tasks. Examples include hiking and yoga. Exercise is important for all and is especially critical for those with Parkinson’s disease because their joints often get rigid and stiff. A regular exercise routine can help the patient maintain his abilities, make his muscles stronger, increase mobility and help him to build health and body fitness. Regular exercise gives the person with PD a sense of achievement and may prevent them from feeling stressed, anxious and depressed (Pahwa, & ‎Lyons, 2013, p. 90) In many cases people living with Parkinson’s disease, abandon the routine of exercise because of stiffening muscles and joints and difficulty in moving. Nevertheless, exercise makes the person more agile and flexible (Jankovic, & ‎Tolosa, 2007, p. 117). Exercising with a friend or group could also add to the fun. Clinical trials have been used to demonstrate the benefits of exercise in terms of rang of motion and gait. The person with PD may also benefit by gaining better control of his movements, improved flexibility, improved circulation, increased energy, improved sleep, better balance, lesser constipation, better cardiovascular health and fewer injuries to joints and muscles (Ronken & ‎Scharrenburg, 2002, p.56) Concepts & Key Words Parkinson’s disease – A degenerative disorder of the central nervous system Correlation- Statistical dependence between two sets of data or two random variables Grounded theory- Research method for discovery of theory through data analysis 3.0 METHOD 3.1 Design Researcher will collect both qualitative and quantitative data by way of primary research. The study will not be experimental but descriptive. The researcher will carry out a survey in which questionnaires will be used for data collection (Punch, 2006, p. 44). Questionnaires will therefore be used for collecting data from the field. This will basically be a correlational design. A survey is better because they are easy to develop using modern advanced software and the researcher is able to collect data from a huge number of participants. Surveys are also cost effective. They also take less time to develop compared to experiments and other methods of data collection (Msweli 2011, p. 29). 3.2 Research Instruments Collection of data will be done using questionnaires and interviews. The researcher will have two types of questionnaires. The first type will be issued to respondents while the second type will be used by the researcher as a guide in conducting interviews (Maree ‎& Westhuizen, 2009, p. 45). Apart from questionnaires, the researcher will also have audio and video recording equipment which will also be used in information gathering and storage. Questionnaires and interviews are preferable in this study because they provide a long lasting record of the information gathered (Denscombe, 2012, p. 104). They also have the ability to collect and store as large volumes of information. The researcher will make use of the Hospital Anxiety Questionnaire because it is not based on multiple choices. Beck’s Depression Inventory is based on multiple choices and this might serve as a limitation to the information and clarification the respondent may want to give. The hospital anxiety questionnaire also gathers information on both depression and anxiety as opposed to Beck’s Depression inventory which dwells on depression alone (Maxwel 2005, p. 119). 3.3 Sample The sample will strictly be made up of people with Parkinson’s disease and their care givers. There will be no age restrictions but respondents will be allowed on condition that they have done physical exercise before, while suffering from the disease. Respondents will be both male and female. The sample size will be made up of 120 participants of which 60 will be patients and the remaining 60 will be care givers. The category of care givers will include relatives, friends and doctors or nurses. The sample will be created using random sampling through which the researcher will pick the medical facilities in which the patients and care givers will be found. 20 medical facilities will be chosen for the study. Random sampling is simpler than other methods and it does not require too much work (Blaikie, 2009, p. 50). 3.4 Procedure Ethical approval Ethical approval is recommended for any research based on the risks involved (Taylor, ‎Kermode & Roberts, 2006, p. 89). The researcher will have to contact the management of the hospitals to be involved in the study and if allowed, he will go and seek the consent of the doctors, nurses and patients about their involvement in the study. For the parents, relatives and other care givers he will contact them by phone or in person and seek to have them agree or refuse to take part in the study. The contacts of parents and relatives will be obtained from the patients and hospital records. Approval for all participants will be sought after they have been served with all the details pertaining to the research (Brink, Van der Walt, & ‎Van Rensburg, 2005, p. 30). Sample recruitment For the recruitment of the sample, the researcher will do random sampling and then the hospitals chosen for the study will be contacted by phone or in person. The researcher will make a list of hospitals in a given locality of choice. From this list he will choose randomly, the hospitals that will be allowed to take part in the study. Every medical facility will contribute 6 participants -3 patients and 3 care givers. Accessing relevant tools Before commencing the research, the researcher will take time to look for all the relevant tools and instruments to be used in data collection (Bowling 2009, p. 73). Designing the questionnaire, purchase of the video and audio recording equipment, books, pens, cameras and others will be done 3 weeks to the time of data collection. The researcher will also purchase the Hospital Anxiety Questionnaire. In order to collect data within the shortest time possible and without causing much disturbance to the activities in hospitals, the researcher will enlist the help of research assistants (Thomas, ‎Nelson & Silverman, 2011, p. 78). Each will be assigned 3 hospitals with the research taking the rest. Each participant will be contacted to give information on what time he/she will be free and ready for the interviews and questionnaires. This will be done within a period of 3 weeks. Data collection The researcher and his assistants will plan for interviews with participants before hand and visit the hospitals on the agreed upon days and times. Questionnaires will be issued earlier than the date of the interview so that the respondents can fill and submit them at the time of the interviews. Where interviews are not possible at all, the researcher will use questionnaires only (Shi, 2007, p. 66). 3.5 Ethics The researcher will seek to get informed consent from the participants before they are allowed to take part in the study (Brink, Van der Walt, & ‎Van Rensburg, 2005, p. 29.). Some ethical issues that may arise include the difficulty of doctors and nurses to give out information about their patients that may be deemed confidential, the fear by parents and relatives to share such information as well for fear of embarrassing or jeopardizing their relationships with the patients and the fear of patients to volunteer information not knowing by who, for what and where it will be used (Taylor, Kermode ‎& Roberts, 2006, p. 89). The researcher will issue a consent form to participants for them to agree to take part in the study. An information sheet and debriefing information will also be used. 3.6 Data analysis Data will be analyzed using both quantitative and qualitative methods. Qualitative data will be analyzed using the grounded theory method. Statistical analysis will be done using the correlations method (Brink, Van der Walt, & ‎Van Rensburg, 2005, p. 45.). Descriptive statistics will be used to obtain answers for descriptive questions. Measures of central tendency will be used to analyze the experiences of participants with exercise. The level of preference for exercise will be calculated using standard deviation. Differences based on gender and age will be assessed using sample t-tests. Peer debriefing will be used to analyze qualitative data. 3.7 Outcomes, Potential Benefits of Study and Limitations The study is expected to large confirm that exercise benefits people with Parkinson’s disease. The study will be of much use because it will add on to the existing pool of knowledge about Parkinson’s disease and exercise. Researchers and students in this area will be able to refer to the findings of the study (Offredy & ‎Vickers, 2010, p. 70). Patients and care givers will also benefit because they can apply the findings to their own cases. The study may be limited in the area of data collection. It is not clear whether doctors and patients in hospitals will fully cooperative given that they have very busy schedules. Their lack of full cooperation may limit the quality of data collected (Blaikie, 2009, p. 55). ANSWERS TO QUESTIONS 1. Purpose/Aims I want to do this study because I believe there are many misconceptions about the relationship between Parkinson’s disease and exercise. I would like to study this relationship if at all it exists and create awareness about it. From the study, other people will know whether they can advise Parkinson’s disease patients to exercise or not. 2. Terms Work means to exercise, change means to shift from one practice or thing to the other and attitude to means the feelings one has about something. It is possible to make he research question more manageable through the creation of sub-questions. 3. I am an employee in one of the institutions where I will collect data for the study. The study based on the assumption that exercise benefits people with Parkinson’s disease in many ways. The study results may be exaggerated and biased because of the assumptions. My role could cause a bias because I can be tempted to try cover-up the truth in order to protect the image of the hospital. 4. My proposed research relates to a certain theory. This is the health behavior theory which explains the relationship between health and physical activity which is believed to be a type of behavior. 5. The question will be answered in approximately 3000 words. Information reliability will be obtained by ensuring that the research instruments are well constructed, data collection is perfect and that all possible error are eliminated through careful practice. I will use care givers and patients of Parkinson’s disease. I will do both qualitative and quantitative analysis. 6. Interviews and questionnaire methods will yield the required data. I have the knowledge on how to implement all these methods. I will be able to access the participants I need because I work in one of the hospitals. If I fail to get access to the other hospitals I will do the study in only one hospital where I work. 7. To ensure anonymity, participants will be asked not to disclose their personal information through questionnaires and interviews. There are no sources of physical risk but participants may suffer psychological risks by getting embarrassed and feeling guilty. I will need ethical approval and I know how to get it. There will be debriefing. Bibliography Bizière, K. & ‎Kurth, M.C 1997. Living with Parkinson’s disease. Demos Medical Publishing, p.. Blaikie, N. 2009. Designing Social Research. Polity, p. 55. Bowling, A. 2009. Research Methods in Health: Investigating Health and Health. NcGraw Hill International. Brink, H., Van der Walt, C. & ‎Van Rensburg, G. 2005. Fundamentals of Research Methodology for Healthcare. Juta & Company Ltd. Crombie, I.K. 1996. Research in Healthcare: Design, Conduct and Interpretation of Health Care. John Wiley & Sons. Denscombe, M. 2012. Research Proposals: A practical Guide. McGraw Hill International. Duvoisin, R.C & ‎Sage, J. 2001. Parkinson’s disease: A guide for Patient and Family. Wolters Kluwer Health. Grosset, D., ‎Fernandez, H. & ‎Okun, M. 2009. Parkinson’s disease: Clinican’s Desk Reference. Manson Publishing. Jankovic, J. & ‎Tolosa, E. 2007. Parkinson’s disease and Movement Disorders. Wolters Kluwer Health. Maree, K. ‎& Westhuizen, C. 2009. Head Start in Designing Research Proposals in the Social Sciences. Juta & Company Ltd. Maxwell, J. 2005. Qualitative Research Design: An Interactive Approach. Sage. Msweli, P. 2011. Writing a Research Proposal: Practical Guide for Business Students. Juta. Offredy, M. & ‎Vickers, P. 2010. Developing a Healthcare Research Proposal: An interactive Student Guide. John Wiley & Sons. Pahwa, R. & ‎Lyons, K.E 2013. Handbook of Parkinson’s disease. CRC Press. Parashos, S. & ‎Wichmann, R. 2012. Navigating Life with Parkinson’s disease. Oxford University Press. Pepper J. 2011. Reverse Parkinson’s disease. Dorrance Publishing. Pfeiffer, R.F. & ‎Wszolek, Z.K & ‎Ebadi, M. 2012. Parkinson’s disease, Second Edition. CRC Press. Punch, K. 2006. Developing Effective Research Proposals. Sage. Ronken, E. & ‎Scharrenburg, G. 2002. Parkinson’s disease. IOS Press. Rosenstein A., 2002. Water Exercise for Parkinson’s: Maintaining Balance, Strength, Endurance and Flexibility. Idyll Arbor. Saxton, J. 2011. Exercise and Chronic disease: An Evidence Based Approach. Taylor & Francis. Shi, L. 2007. Health Services Research Methods. Cengage Learning. Taylor, B., ‎Kermode, S. ‎& Roberts, K.L 2006. Research in Nursing and Healthcare: Evidence for Practice. Cengage Learning. Thomas, JR. ‎Nelson, J. & Silverman, SJ. 2011. Research Methods in Physical Activity. Human Kinetics. Warren O.C, ‎Fabrizio S., ‎Lang, A. 2011. Parkinson's Disease: Non-Motor and Non-Dopaminergic Features. John Wiley & Sons. Weiner, W.J., ‎Shulman, L.M. & ‎Lang, A.E. 2013. Parkinson’s disease: A complete Guide for Patients and Families. JHU Press. Willow, M. 2006. Focus on Parkinson’s disease Research. Nova. Appendix Questionnaire (descriptive questions) 1. What is exercise?................................................ 2. Do you think it has any benefit to a person with PD?.................................... 3. When did you start hearing about people with PD exercising?............ 4. Have you heard of people that have PD and are exercising?............ 5. Have you been exercising since you started having PD?.............................................. 6. I yes, have you noticed any changes in the state of your health?...................................... 7. From whom did you hear about exercising for those with PD? …………………… 8. What type of exercise have you seen people with PD doing?................................... 9. What kind of exercises do you engage in?............................. 10. Would advice would you give to those with PD and are yet to start exercising?....................... Read More