Impact Of Physical Exercise On The Blood Glucose Value - Research Paper Example

Single Research Design On Impact of Intervention on the fasting blood glucose value The single study was conducted on 11 years old African- American boy who was overweight and was genetically vulnerable to diabetes. He was a borderline case having depressive symptoms that had adversely impacted his academic achievements. The subject was used in the study with ABA design where the key intervention was the physical exercise after each meal for three consecutive weeks. The findings of the research revealed positive association and causal relations between the blood sugar values and physical exercise. It was found that physical exercise after meals significantly lower the blood sugar count, thus helping to manage diabetes successfully. Introduction . The key objective of all types of researches is to evaluate the impact of external and internal interventions or issues on the people, either directly or indirectly. The various approaches to research are therefore important facilitators to identify factors for reaching to relatively accurate outcome for the given research question or aim. The different research designs become vital mechanisms for validating research aims. The single subject design research has evolved as important scientific methodology to establish evidence-based practice. The emphasis is on validating the expected outcome or efficacy of the research question. Single subject research helps to demonstrate causal relation and impact of different interventions on the single subject (Capella et al., 2009). The experimental research of single subject design helps to develop empirical credibility for evidence based interventions or techniques to improve and improvise behaviour through the study of causal relations between the independent variable and dependent variable (Kratochwill, 2009). The current single subject research aims to study the impact of physical exercise on the fasting glucose level on a vulnerable participant with a borderline case having genetic history of diabetes. Research question 1. Will the 20 minutes brisk walking after meals help to control the level of glucose level? 2. To what extent physical exercise helps to manage diabetes amongst children and young adults? Research hypothesis The single subject research is based on the assumption that studying the causal relations between the independent and dependent variables promotes effective interventions for evidence based practices and techniques. The analysis of the data is used for generating outcome that reflects the impact of interventions on the subject. The researchers are increasingly adopting the design to validate common psychological or social problems in order to evolve interventions for effective outcome (Johnston & Smith, 2010). The unprecedented increase of diabetes cases has made it imperative to address the issue at the earliest. The problem of obesity amongst children has become major concern. Consequently, the issue is taken on priority and studied on single subject to study the impact of interventions. Moreover, the increasing trend of a sedentary lifestyle amongst children is seen as important factor for the increasing incidence of the type I diabetes amongst children and young adults. Outdoor sports and physical exercise therefore, need to be included within the suggested lifestyle changes for healthy life and reducing the threat of diabetes. Rationale for the study Obesity and overweight are emerging new lifestyle diseases of the current generation. Type I diabetes amongst children and young adults has been observed to be significantly related to the obesity leading to serious health problems. The sedentary lifestyle and bad food habits are important reasons for growing problems of overweight and obesity amongst children in the United States (HHS News, 2001). The preventive measures therefore, become vital facilitators for arresting this rapidly growing tendency amongst the children. The single subject study on the diabetes interventions amongst children is intended to validate the importance of interventions that could considerably reduce the tendency of obesity/ overweight amongst children. Method The research methodology would be based on single subject research. It is important research design to establish the efficacy of health intervention which involves one participant who serves as his/her own control. The measurements or observations are compared on two levels; A and B: the baseline condition and the intervention condition. In the baseline condition, no experiment variable is introduced and systematically repeated observations over time on implied behaviour are made. In the second condition, repeated observations are made when intervention is used. The ABA design allows the researchers to observe the changes in measurement before the use of intervention, during the intervention and after the intervention or when the treatment is again withdrawn. This helps to demonstrate the efficacy of the interventions. Rationale for the research design The single subject design allows systematically repeated measurements of dependent variable under normal and controlled conditions (Cooper et al., 2007). The independent variable is the intervention that is used to study the impact on the independent variable or participant. The rationale for using single subject research fundamentally relies on the fact that repeated experiments under normal and controlled conditions help to validate research aim. The large of observations are collected from single subject that is aimed at controlling within-subject variability to reduce bias. The same applies to the multiple observations of interventions that are used to establish causal relation and enhance visibility of the association. In the single subject research, the systematic replications help us to assess the extent of influence of the intervention and validate its reliability and generality. It is important to know if the intervention is producing any reliable change in the dependent variable. The repeated experiment ensures that the influence of the intervention becomes visible and is able to inform under what condition the intervention is effective. The design is significant for my research topic as the use of multiple measurements of dependent variable would facilitate better evaluation and identification of factors that contribute towards effectiveness of diabetes interventions. The replicate assessment over time is key evidence that lends more credibility to the generalizations. The Multiple-Baseline Design is not preferred mainly because the research uses only one participant and the multiple-baseline is more effective when multiple participants are used to study the efficacy of intervention and delineating the influence of other factors (Kazdin, 1982). There is no reversibility. Moreover, the design is based on the premise that change would occur only when the intervention is applied. As such, it defeats the concept of causal relations that is used to establish that change does not occur behaviour or setting until intervention is applied. The Changing Criterion Design uses changing criteria for reinforcement of the behavior which is under study when intervention is used or applied repeatedly (Luiselli, 2000). In my research topic, impact of one intervention is observed and therefore the need for this particular research design is not necessary or required. The single case experimental design is therefore the best option in the current case as it is not only cost effective but helps to provide important linkages with the external environmental factor that significantly influences the outcome of the research aims and addresses the problem of diabetes amongst the children. The ABA design helps us to assess the changes more efficiently as it rules out the influence of other sources in the observed behaviour/ measurements. Participant The participant was an African American 11 years old boy who had genetic history of diabetes. He was also overweight with strong sedentary lifestyle. The participant had borderline diabetes and was prone to flexible sugar level. He had not been part of any previous experimental research. At the time of the research, he was enrolled in regular school. The boy was not taking any outdoor sports or activities and used to be dropped and picked up by his mother, who was also diabetic. Though, the boy was bright in studies but his academic advancements were considerably reduced due to ill health caused by depression leading to frequent absence in the class. It was believed that the overweight problem was responsible for depression as he was often teased by his friends and classmates for being ‘fatty’. The participant was also not very communicative and seemed to exhibit lethargic attitude with symptoms of depression. According to his medical record, he was prone to obese behavior and tended to be addicted to television and computer at home. Thus, obesity and genetic diabetes was important criteria for taking up the case for the research. Ethical and legal considerations Ethical considerations are integral part of research and must ensure the trust and confidentiality of the respondents. The need to endorse the right to privacy of the participants and encourage confidentiality and trust building is critical factors to gain information which is accurate. Hence, it is essential that the researcher does not transgress his/ her ethical boundary to commit any serious offence that might lead to criminal proceedings. Trust and confidence are the foundation of a realistic research. Approval for the study was taken from the University’s research ethics board. The informed consent of the parents of the boy/ participant involved in the research becomes key ethical issue that need to be included within the research criteria. Thus, informed consent was obtained from the mother who was given details about the research and how the information would be used. She was assured that all information collected through the research would only be used for the purpose of this research. The contemporary social format is distinct in its pluralistic society which includes people coming from diverse background of race, culture and color. The participant belongs to Afro-American community which necessitates better understanding of cross cultural values for maintaining and working in a conflict free environment that facilitates mutual respect and motivation for working together for positive outcome of the research. Thus, efforts were made to develop better understanding of Afro-American culture and promote constructive relationship building with the participant as well as with the mother. Sampling procedures/ Instrumentation The home setting was preferred to conduct the experiment and collect blood sugar readings for fasting sugar tests. The setting refers to the environment or the context in which the intervention was introduced and later assessed with respect to the different outcome measures of the study (Reichardt, 2006: 2). The setting could encompass physical characteristics of the research investigation as well as the functional characteristics that occur in the context of the intervention. The participant was counseled for the research objectives and how it could have positive impact on his personality that would improve his relations with his friends and others within and outside school. The importance of intervention was disseminated which had motivated the boy to participate in the research. The three weeks study was observed to be sufficient to assess the outcome of the intervention. The mother was provided with the glucometer and trained on using it. She was also advised to follow systematic approach and timely meals to the respondent. Timely meal schedules were important part of the research that helped to develop routine. Moreover, the fixed routine of the meals had helped the researcher to monitor the experiment who had scheduled his timing to be at the home of the participant. The participant was allowed to have normal meals. The daily session with the child was also used to encourage him to incorporate the intervention so that its efficacy could be tested for improved health outcome. The mother was provided with the record book where she could write down the details of the readings. This included date, time of the fasting blood glucose reading during the three weeks’ study before the intervention, during the intervention and after intervention was withdrawn. Target observation/ behavior The major target observation was the fasting blood glucose reading where changes were expected to occur when intervention was to be used. Interventions Twenty minutes exercise after the meals was the key intervention that was used in the ABA single subject design. The participant was actively motivated for taking twenty minutes brisk walking or takes part in some outdoor activity that involved heavy exercise like rugby or basketball. The mother was advised to make the meals available at fixed timing with at least five hours difference between the meals. Baseline condition or phase A The first week, the fasting glucose readings were used as baseline values when no treatment or intervention was used. The fasting blood glucose value was recorded on the prescribed format by the mother. Thereafter, the participant was encouraged for brisk walking for twenty minutes or take part in vigorous outdoor activity like football. Intervention condition or phase B In the second week, the boy was encouraged to undertake 20 minutes brisk walking after each meal. The fasting blood glucose value was noted down. Baseline condition or phase A The third week again involved the baseline module when the intervention or the physical exercise was withdrawn. The fasting blood glucose value taken as per the format designed. Reliability and validity of measurements The repeated measurement and assessment of the participant was important factor that had significantly reduced the experimental bias and enhanced the reliability and validity of the intervention for the outcome. Subject was exposed to multiple levels of dependent variable such that the influence of intervention had become visible giving validity to the intervention used. Results The table shows the data for the fasting blood sugar values for three consecutive weeks under ABA experimental design with non-intervention and intervention data. The intervention consisted of prescribed exercise regimen comprising of brisk walking or participation in outdoor activities like rugby or basketball which involved heavy physical exercise. Table 1: Baseline phase A Table 2: Intervention phase B Table 3: Baseline phase A Graph 1 The graph clearly shows that the intervention has influenced the blood sugar values. The baseline values of the blood sugar were almost restored once the intervention was withdrawn, clearly giving validity to the research question and research aim. Discussion The purpose of the single subject design was to determine the effectiveness of the intervention used in diabetes management. The intervention consisted of prescribed physical exercises which were used as intervention within the study to influence and control the fasting blood sugar values. The baseline values show the above normal blood sugar count which were reduced when the intervention was introduced. To reassess and reduce external biases, the repetition of the baseline phase reflects the restored high values of blood sugar. This clearly indicates that physical exercises after meals play important role in controlling blood sugar and severity of diabetes in patients. The single case study was therefore important facilitator for giving validity to the intervention used for controlling diabetes amongst children by motivating them for physical exercise that would increase their metabolic activities, thereby establishing causal relations between the intervention and diabetes. The repeated measurements were important steps that helped to reduce biases from external sources and gave validity to the interventions used during the study. The SSDs offer more flexibility in the evaluation of the interventions than large sample design studies. One of the most interesting aspects of the SSD is its ability to modify interventions as needed that promotes wider research and clinical trials leading to the development of more innovative treatment or interventions to manage health issues. Indeed the use of continuous assessment allows investigation of the pattern of change that can be observed in the study with more clarity. Thus, SSD becomes pertinent option for developing effective interventions to manage common diseases and health problems. Internal and external validity of the study The study shows that the replication considerably enhances the internal and external validity of the variables used. While the internal validity relies on the efficacy of the dependent and independent variables, the external validity relies on the extent the outcome can be generalized and representativeness of the procedures and settings. In the case, the normal settings were used where the participant’s comfort zone was not disturbed. The independent variable or the intervention that was introduced in the study was acceptable to the participant and therefore, its validity was proved through the changed blood sugar values which were much reduced. Implications of the research The study has huge implications for the future as it is very useful in investigating the process of change within the medical arena where interventions are used to manage the medical problems or diseases. Most importantly, as the research design primarily works on single subject, the lowered cost of the research is highly useful for mediating interventions within clinical environment for effective outcome. Limitation of the study The major limitation of the study is its small sample size which could limit its generalization. Recommendation for the future research Diabetes has emerged as major threat to the health of the people, especially children in America. The health issues of children need to be tackled within the broader scope of alternative medicine that can be used as interventions for managing hall health of the children. It is expected that the findings of the research would greatly help to manage diabetes amongst the masses. The intervention would also serves as important mechanism to delay the onset of diabetes in children who are most vulnerable; for example, overweight or obese children or those who are liable to inherit it genetically. The results of the study would be made available to the libraries and universities for public accessibility. The findings would also be disseminated to the community health centres so that awareness about the interventions for diabetes could be. (words: 2837) Reference Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied Behavior Analysis. NJ: Prentice Hall. . HHS News. (Dec. 13, 2001). Overweight and obesity threaten U.S. health gains. Available from: Read More