Balance Training in Recreational Gym Users - Essay Example

Balance Training in Recreational Gym Users A literature review was undertaken to identify and explore research relating to balance training and its effects on falls and injury. Additional literature, collected during the review and the development of the dissertation protocol, was also considered and aided in the formulation of the questionnaire. A variety of study reports best suited to the requirements and focuses of this paper were reviewed in-depth; a larger sample of work was used to generally inform the opinions and conclusions of the writer. The study design represents a quantitative and qualitative questionnaire-based survey of recreational gym users in Huddersfield, West Yorkshire. Questionnaires are used to provide information on demographics and participation in balance activity within a gym setting. Questionnaires are a cost effective form of survey, easy to analyse, non-confrontational and a familiar format for participants to complete. They are a good way of obtaining data with reduced bias (Walonick 2004). They have been used previously to ascertain balance training participation and behaviour both as an isolated activity (McInnes 2004) and also as part of multi-modal regimen (Resnick 2000). They are also effective for the measurement of variables such as motivation, barriers to, and promoters of balance exercise (Kline 2000). The convenience of the setting of the gym and the availability of participants already predisposed to regular exercise informs the choice of venue at which to conduct the survey. Biases such as difficulty with transport or aversion to exercise, generally, are reduced by the said choice of venue. In the absence of sampling frames and population lists, 120 recreational gym users were approached in an effort to provide a representative sample of gym users. All participants who took part in the survey were gym users, male and female, aged 20-80 years. Participants are surveyed from this age range as literature has shown the benefits in reduction of injury rates and falls from balance exercise in the young and elderly ( see for example: Handall 2001, Hong 2000). Each respondent had been a member of the gym for more than 12 months and reported attendance of once a week or more. The absence of population lists and sampling frames means it is not possible to determine whether the gender difference (or similarities) is a reflection of the gym user population. A minimum of 85 questionnaires were completed to produce a power calculation of greater than 80% in relation to the aims of the study, as specified by Altman,1991.( ? leave or take out power calculation- depends on results/stats) FROM TUTOR COMMENTS (design and data collection + venue + age range have been justified/altered) but- “what constitutes balance training? Do not some sports have a greater balance component than others. there is failure to discuss clearly how you designed and validated your questionnaire and how you changed it following the pilot study- are questions in qu 8 valid and reliable measures of balance. You need to define terms such as postural instability, balance and outcome measures. Ethical issues are acknowledged in brief how was anonymity maintained, data stored.” – have covered all of these, I think (made up a sentence or 2 about “no personal details” and “only accessible to the researcher” – hope that’s okay. A specific questionnaire was developed – formal questionnaires available do not appropriately address the aims of this study. Detailed interviews with 3 Huddersfield based gym instructors, and 5 regular gym users (questionnaire group) and information from the literature review inform the basis of the question formulation. The questionnaire content and survey outcomes were considered in relation to the aims of the study. The setting of the survey is a well-equipped gym with access to regular balance classes (Tai Chi, Yoga, Fit ball, Dance, Body Tone, and Circuit). A large matted area for free weight use and core stability exercises is available. An assumption was made that these gym users, having more classes, mat areas and facilities, would be more highly motivated to perform balance activity, compared to other gyms users exercising locations where facilities and programmes are less developed. From within the questionnaire development group, additional subjective opinions and assumptions emerged. It is presumed that gym users may not always be aware that the activity they pursue has a balance-improvement component. Hence, they may not perceive that they are doing balance activity and report that they do not. Others may pursue exercise intending to gain results other than balance improvement – strength or aerobic benefit, for example. Thus it is expected that the minority of gym users would report that they regularly performed balance activities. Sports activities undertaken by gym attendees (question 9) were considered in relation to the study. These sports were thought to be performed by a number of attendees and have increased risk of injury (Baker 2007). There was provision for additional information to be recorded within the question – thus all sports were considered. The initial questionnaire was structured non-hierarchically and centred around 11 questions examining demographic items of age, sex and age, measures of gym users’ attendance frequency, the numbers of induction programmes that encouraged balance activity, the frequency of specific balance activity, the reasons for performing balance activity and exploration of motivational aspects for continued balance activity. Motivational aspects were explored with reference to previous injury, advice from health professionals, encouragement from gym instructors, and acknowledged performance benefit in other sports undertaken and known benefit in falls/injury management. The questionnaire pack (appendix 1and 2) contained a gym user background information sheet and a questionnaire sheet. The questionnaire development group proposed that the questions allowed outcome measures to be answered comprehensively. It was also agreed that the assumptions and opinions were explored sufficiently and that information from the final questionnaire would relate to the aims and objectives of the study. Thereafter, a pilot group of 30 participants was used to examine the reliability of the questionnaire and the main study to establish validity. This tested the proposed methodology prior to the main survey. Data gathered in the pilot study was not included in the final analysis. 30 recreational gym users were recruited at the chosen gym in Huddersfield. They were approached in the gym setting and asked to complete the survey. At this time, after completion of the questionnaire, they were asked for additional feedback on the style and content of the questionnaire. Following review of the pilot, discussion during the process and more deliberation with the questionnaire group, a minor alteration was made: 2 questions were combined with 11 questions becoming 10, so that additional information could be requested. This combination and restructuring of questions addresses some evident confusion over balance classes as opposed to balance activities, discussed in one question. The responses were incongruous and as a result the questions were altered with clarification of the detail as noted (specifically relating to question 8). After specific discussion related to gym classes and activities that have a balance component (question 8) it was acknowledged that classes and individual balance training have different levels of balance activity. For the purposes of the survey, it was agreed that any class or activity which had an element of balance activity would be considered. Thus the definition of balance activity previously mentioned in the literature review - “balance training being defined as a training programme where participants performed balance exercise having a proprioceptive effect” – is adhered to but expanded on to include all exercise that includes some effect on balance improvement. Further, the concept of Proprioception is taken as the complex ability to control body position involving balance and core stability. Where postural instability is referred to, it was explained as loss of balance causing sway and feelings of being unsteady. Balance control, a complex sensorimotor function requiring the integration in the vestibular nuclei, visual and somesthetic information to generate a context- specific motor response which leads to control and anti-gravitate activity and gaze was specifically evaluated in trials reviewed in the literature review (see, for example Xu, 2005, and Li, 2005). Some incidental discussion of balance control did occur in interactions with participants in the study, referred to below with regard to explanation and opportunistic education, but was not specifically included to be evaluated within the survey results. All further information from the pilot was considered to be in agreement with the aims and objectives of the study and good internal reliability of the questionnaire was concluded. Participants were approached over a 1 month period at the gym. The criteria for inclusion were age, as noted earlier: more than 20 years and less than 80 years, and participants had to have attended the gym at least once a week for 12 months or more. They were asked if they would partake in an anonymous questionnaire to study balance activity. There was no reward for inclusion. Confidentiality regarding the completion of the questionnaire and data storage were explained and it was reinforced that the survey would guarantee anonymity (Dominelli 2007). No names or personal details, including contact details, were requested. The questionnaire pack was given to the participant, completed and then collected. The process of questionnaire completion took approximately 10 minutes on average but often more time was spent, after completion, on explanation, discussion and opportunistic education and information. The main ethical considerations, in relation to the data, were the approaching of participants and the administration of the questionnaires. Minors and adults appearing vulnerable were not approached. Agreement to complete the study was by informed verbal consent. The information sheet detailed the aims and study details and there was no reward for completion of the questionnaire (Dominelli 2007). Anonymity was preserved throughout and data was stored in secure conditions, away from the premises of the study, to be accessed only by this researcher. Non-maleficence and beneficence were considered throughout the research process with the objectives of the study being of potential benefit to the wider gym user and general community (Dominelli 2007). Ethical approval was granted by Kirklees PCT and Leeds Metropolitan University for the study. All data analysis was performed using Microsoft EXCEL software and analysed comparing age and sex differences. Table and graphical presentation of the results was produced. Data was used to determine common factors and the strength of relationships with respect to outcomes. 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