The the knee. The abstract provides information on

The
current healthcare policy proposals support the use of evidence-based practices
in improving patient outcomes. Evidence-based practice, according to Gerrish
and Lacey (2010), has three general components namely the best research
evidence available, clinical specialists, and preferences from the patient. The
approval of information derived from research is not absolute, and
consideration of healthcare personnel experience and assistance from more
experienced medical practitioners is important for intervention decisions
during care provision. The goal for nursing research, as Blake (2016)
indicates, is to establish evidence and apply it to achieve better standards of
care and functions for both patients and their families. This critical review
analyses the work of Jorge et al. (2015). The paper evaluates the research
process used by the researchers, section by section, seeking to establish
whether proper procedures were followed and whether the work provides adequate
and reliable information for use in nursing practice.

Critical
Analysis

We Will Write a Custom Essay Specifically
For You For Only $13.90/page!


order now

Abstract

The
article titled “Progressive
Resistance Exercise in Women with Osteoarthritis of the Knee: A Randomized
Controlled Trial” by Jorge et al. (2015) presents the findings of a
study on the impacts of an exercise program on women with osteoarthritis of the
knee. The abstract provides information on what the reader can expect to find
in the article, and explains the method used for research. The researchers used
random selection to place 31 subjects in a control group and 29 on an
experimental group for the purpose of result comparison. However, the abstract
does not explain why the subjects were not equally divided into the two groups.
The study results indicate a significant change in the subjects who were placed
on Progressive Resistance Exercise (PRE) program. The results included pain
reduction, improvement of functionality and increased strength and life quality
for patients.

Introduction

In
the introduction, the authors report that women are more prone to osteoarthritis
than men are, with 80% of those suffering from the condition experiencing
limited mobility and pain. The global population affected by the condition is
approximated at 20% (Jorge et al. 2015). According to the article, the
condition affects the quadriceps muscles of the knee, which makes it difficult
for the patients to perform normal life functions such as walking. Intervention
through aerobic exercises to strengthen the muscles has been acknowledged as
one of the ways to improve patients’ quality of life. The authors define PRE as
a muscle strengthening exercise where weights are used to improve the patients’
hip and knee muscle strength. However, it is reported that proper measures for
progress in exercise intensity are lacking. This prompts the need for research
to identify the response of women with osteoarthritis of the knee after the
introduction of PRE program. The results can then be used as a base for
evidence in the clinical practice. The introduction provides sufficient
information about the program, enabling the reader to comprehend the topic
under discussion, the statistical data available, and the extent to which
research has been done, as recommended by Burns and Grove (2010). The
introduction also provides readers with a thesis statement as required by the
research procedures according to Winsett and Cashion (2007).

Methods

The
subjects’ selection criterion is clear and matches the requirements of nursing
research. First, permission is obtained from the Human Research Ethics
Committee. Secondly, the samples are determined, and they include women between
the ages of 40 and 70 years with severe knee osteoarthritis whose pain at rest
ranges between 3 cm and 8 on the Visual Analog Scale. However, the researchers
fail to explain why they chose women alone, yet the condition affects both men
and women. While it is indicated in the introduction that the condition mostly
affects women, it would be reasonable to include men in the research and
observe their reaction to the program. The researchers also fail to explain why
the preferred the measure of pain is between 3 cm and 8 cm, as opposed to any
other values between 0 and 10 cm on the scale. The elimination of subjects was
dependent on the availability of the subject, recent involvement of drugs and
treatment that could affect the measure of pain, and history of recent
injuries. This gave the researchers an appropriate sample to determine the
reliability of results. Other information collected included age, race, gender,
body mass index, education level, among other relevant information aimed at
helping the researchers to determine the most affected demographic group.

As
reported by Webb (2009), it is necessary to gather adequate and relevant data
about a study sample to increase the validity and reliability of findings.
Other measures considered in the study included secondary outcomes ranging from
quality of life, functionality, walking distance, improvement of the condition
after treatment, patient strength, and side effects. The researchers provide
information on the processes involved in the research to improve the readers’
understanding of the scope of the research. All the subjects for both
experimental group and control group received equal treatment in terms of
medication for pain control during the experiment period. Statistical analysis
was calculated using mean and standard deviation on different groups that
participated. Usually, the purpose of the methodology section is to enlighten
the reader on the nature of data analysed in the study, as well as how the
study was conducted (Webb 2009).

In
the study, the researchers used the qualitative method of research, and data
was collected and analysed within the guidelines of the Brazilian version of
the Western Ontario McMaster Universities Osteoarthritis (WOMAC) (Jorge et al.
2015). The use of narrative inquiry, as Hesse-Biber and Leavy (2011)
illustrates, is evident in the research. This is because data collection was
based on onetime assessment, where subjects were considered depending on the
last results on their assessment records. The researchers also used the
case-control design for the study, whereby subjects were required to perform
pre-determined exercises at given intervals and using specific weights in order
to meet one of the study objectives, which was to determine the intensity of
exercise required to make the anticipated impact on patients which would act as
the evidence base for practitioners. The sampling method is also well
elaborated and provides the reader with all necessary information in order for
them to understand what is happening and why. 

Results

The
results section is aimed at providing information on the findings of the
research. According to Grove, Burns, and Gray (2014), the section explains the
relationship between different variables and the actual results of the
research. In this case, the researchers have used different categories of
subjects for the research and identified challenges faced during the study. The
results of each category are provided and compared to report the difference
between those categories as Kumar (2010) suggests. This makes it easier for the
readers to understand the findings. However, according to Junyong and Lee
(2017) and the World Health Organization (2014), there are other convenient
methods of presenting data. These methods include the use of graphs and charts,
in addition to the mean and median data that are easier to understand than the
tables used by the researchers in the article.

Nevertheless,
the reader is well informed on the progress of the research and any
interventions made to address shortcomings, as suggested by Neil, Hanton,
Fleming, and Wilson (2013). For instance, personal and health-related
challenges led to the dropping off of six subjects, some of whom returned for revaluation.
The rest of the subjects were treated within the constraints of the group they
were placed in, and evaluation concentrated more on the most affected knee. The
results indicated that the condition of subjects in the experimental group
improved in terms of mobility, pain reduction, muscle strength and quality of
life after use of different weights in exercise. However, the response of those
in the control group was worse in terms of pain, muscles strength and quality
of life.

Discussion

The
discussion section starts by summarizing and identifying gaps in previous
studies, which, according to Bavdekar (2015), should be the first step in the
discussion section. The article also provides adequate information about the
known literature results as recommended by Motsitsi (2014). According to the
article, involvement of hip exercise during the PRE program significantly
improved results in regard to pain levels as measured by the health scale,
motion, as measured by the distance walked, physical functions, and social
aspects including mental health. Use of professionally recommended exercise
procedures in the research is acknowledged by Jorge et al. (2015). The research
identified that noteworthy improvement in the level of pain and functionality
for subjects in the experimental group was achieved on the sixth week, which is
comparable to the available literature that indicates improvement in the eighth
week after intervention.

The
study reports the adherence level to be 96% for subjects in the experimental
group and 89% for those in the control group, as opposed to other studies that
provided varying results ranging between 78% and 92%. In addition, Jorge et al.
(2015) determined the amount of medication used by the subjects under the
experimental group to be lower. Such medication was meant to improve the
condition by reducing pain and inflammation. The researchers also expounded on
the interventions made to the subjects who were affected by the experiment and
the impact of the intervention. For example, the article indicates that some
subjects complained of high levels of pain during the initial stages, and they
were taken to physicians and given a one-week break. The pain complaints ended
and the subjects went through the program comfortably.

The
researchers have identified some limitations in the study. As reported by
Gerrish and Lathlean (2015), limitations provide the reader with knowledge on
areas that would have affected the findings of the study and areas that require
further research. In this case, some of the limitations identified include lack
of inclusion of medication used before the intervention program, the original
diagnosis of osteoarthritis of the knee, consideration of women alone in the
study and lack of follow-up to identify long-term effects of the PRE program.
The authors conclude that implementation of PRE program improves the condition
for women patients with osteoarthritis of the knee where hip joint exercises
and progressive weight adjustment is done. This improves the patients’
functionalities, reduces pain and improves their quality of life. The authors
recommended for further research to determine whether men would exhibit the
same results.

Conclusion

This
review has analysed the assigned article to determine whether proper procedures
were followed in the collection, analysis, and reporting of data in the
selected study. The abstract and introduction parts are well written, and they
provide adequate information as required by the research standards.
Specifically, the abstract provides the objectives of the study, the methods
used, results, and a summative conclusion sufficient for a reader to decide
whether to read the other details. The introduction also provides background
information on the known information about the condition, the shortcomings of
previous research, and an accurate thesis statement. The methods part is also
highly informative and elaborate, and the discussion section provides precise
information regarding the limitations and successes of the program. For
instance, the choice of women as the ideal candidates for the study was not
discussed, yet the condition affects both men and women. Generally, the article
meets the objectives anticipated and provides adequate, reliable and accurate
information that can be used in evidence-based clinical practice.