Applied Exercise and Sport Science: Plan (Project Synopsis) 1200 words total (maximum)
Applied Exercise and Sport Science: Plan (Project Synopsis) 1200 words total (maximum)
Complete the below sections by typing over any italicised blue font
Question (5 marks): Type your question (which will also act as your project title) here. In less than 180 characters with spaces, use the PICO framework to construct an appropriate question for your project.
Character count (with spaces): Type number here
Introduction (~550 words; 20 marks total)
Complete the sub-sections below using traditional sentence/paragraph responses. Use references to support your statements and summary of the literature.
Sub-section 1: Problem/population
What is the problem/population?
What is the significance of this problem/population? (Why is it important to address/focus on)
Type your Sub-section 1 paragraph here
Sub-section 2: Control/comparison condition
Define, review and critique the control/comparison condition
What has been done to address the problem currently (i.e. what is the control/comparison)?
What is wrong/limited with the current solution to the problem?
That is, there must be something wrong/limited with the control/comparison for you to want to investigate the intervention/alternative condition
Type your Sub-section 2 paragraph here
Sub-section 3: Alternative/intervention condition
What is the alternative (intervention) to addressing the problem that you want to investigate?
What evidence is there to support the alternative (intervention) at this stage (i.e. why might it work in your context)?
Type your Sub-section 3 paragraph here
Sub-section 4: Novelty/gap in the literature
State the novelty of your project/gap in the literature that your project will fill
How is it different to what has been investigated previously?
Type your Sub-section 4 paragraph here
Aim(s) and hypothesis(es) (10 marks)
Aim(s): Type your aim(s) here
Hypothesis(es): Type your hypothesis(es) here
Methodology (~550 words; 30 marks total)
Complete the below methodological sub-sections using traditional sentence/paragraph responses. Remember to provide enough detail that a researcher or applied practitioner could replicate your project.
Participants (5 marks)
Describe who the data will be collected in.
Notes on ethical consideration is not required.
Type your Participants detail here
Experimental overview (5 marks)
Provide a broad but brief description of your methodology/study design.
Draw your methodology/study design in a figure.
Type your Experimental overview detail here
Data collection procedures / processes (15 marks total)
Describe
Your treatment(s) / intervention(s) 5 marks
The assessment of your outcome measures around those treatments / interventions 5 marks
Justify the use of your treatments / interventions and outcome measures 5 marks
Validity and reliability
Type your Data collection procedures / processes detail here use additional subheadings if you wish
Statistical analysis (5 marks)
Describe how your data will be analysed to answer your question.
Type your Statistical analysis detail here
Template word count: 306 (that is, 306 words belong to this template)
Total word count: highlight from introduction (including the introduction sub-heading) to the end of the methodology and insert Total word count here (including template headings)
Figure/s and table/s word count: highlight your figures and tables and insert their word count here (tables and figures which includes their captions and legends/footnotes do not count toward your total word count)
Student word count (Total word count MINUS Figure/s and table/s word count MINUS 306): insert student word count here
References
Insert references here
Applied Exercise and Sport Science: Plan (Project Synopsis) 1320 words total (maximum)
Question:
(P) stroke patients with a slight to moderate disability (Modified Rankin Scale [MRS]) and Brunnstrom motion recovery stage 4.
(I) functional electrical stimulation device (FES) in combination of standard care
(C) standard care physiotherapy
(O) muscle strengthening and motor recovery for paralysed limb.
Title (5 marks): In stroke patients, does the use of Functional electrical stimulation with or without standard physio care impacts muscle strength and motor recovery of the paralysed limb.
Character count (with spaces): 172
Section 1: Introduction, aim(s) and hypothesis(es), and methodology (660 words maximum; 65 marks)
Introduction (25 Marks)
Stroke is one of the most common type of neurological condition that has a high social and financial burden worldwide (Cohen & Dimyan 2011). In fact, according to the 2018 review by the Australia Institute of Health and Welfare, stroke was identified to be the 10th primary cause of disease burden in Australia, accounting for 8,400 deaths in that year. Moreover, a recent study estimated that Australia pays a direct economic cost exceeding $6.2 billion and an additional economic loss of $26.0 billion per year, due loss of life and wellbeing, and the required continues support for short to long term disability (Stroke foundation 2020). As such, rehabilitation of motor impairment and accommodation of the patients limitation remains to be the focus in supporting stroke patients.
The effects of rehabilitative training and exercise to the bodys capacity to restore motor function after a neurological injury has long been established (Cohen & Dimyan 2011). As such, this has resulted in the establishment of clinical disciplines for rehabilitative therapy and, more specifically, neurorehabilitation (Bao et al 2020). The Innate physiological and anatomical plasticity are essential mechanisms that underscores the significant gains in muscle activity following a stroke. As such, task-specific therapy along with general aerobic exercise are recognised as the gold-standard procedure for rehabilitation (Cohen & Dimyan 2011). Nevertheless, patients with hemiplegia are often excluded from intensive rehabilitative training and exercise due to the lack of voluntary muscle control (Lee 2020). As a result, novel therapeutic devices that uses electrical stimulation to augment and support neuroplasticity have increasingly become the popular field of research.
Consequently, recent meta-analysis on the Neuromuscular electrical stimulation (NMES) has shown positive result in restoring lower limb muscle control as well as improve posture and gait control (Lin et al 2018). In fact, neuromuscular electrical stimulation (NMES), especially functional electrical stimulation (FES) is already in used to compensate for voluntary motion in some clinical settings, while therapeutic electrical stimulation (TES) is used to strengthen muscles (Takeda et al 2017). Moreover, research on active EMG/ECG triggered (FES) shows significantly greater improvement of (p < 0.05) in muscle control and balance than passive non- EMG/ECG triggered (FES) (Lee 2020). As such, the use of FES devises have become increasingly popular as a novel therapeutic technique in rehabilitation for stroke. In fact, older studies have already shown the benefit of NMES device in facilitating individuals with spinal cord injuries to better participate in a stimulation of indoor rowing, implying a comparable exercise volume and intensity to able-bodied rowers (Hettinga & Andrews 2007). As such, the implication of (NMES) would not only be centred in the field of rehabilitation but also in modified physical training of paraplegic athletes since it can enable movement impaired athletes to train in a comparable volume and intensity as able-bodied individuals.
Therefore, with the current and continued innovation in biomechanical and electrical science, it has become evident that the future of stroke care and recovery will involve some form of integration of neuromuscular electrical stimulation and physiotherapy (Bao et al 2020). Nonetheless, the use of (FES) device has not yet become mainstream and the current gold standard remains to be a physiotherapy-based program (Bao et al. 2020; Cohen & Dimyan 2011). Therefore, the purpose of this study is to investigate if functional electronic stimulation (FES) device in conjunction of the standard physiotherapy is more effective at improving muscle strength and motor recovery of the paralytic limb than a typical care.
Aim(s) and (if applicable) hypothesis(es) (5 Marks)
Aim(s): To determine if functional electrical stimulation with standard care is more effective in promoting muscle strength and motor recovery in the paralysed limb than usual care.
Hypothesis(es): It is hypothesised, that there will be significant difference in the muscle strength and motor control between pre-post group, and among intervention and control group due to increase stimulation.
Methodology (~250 words; 30 marks)
Complete the table below using concise, dot-pointed responses. Remember to provide enough detail that a researcher or applied practitioner could replicate your project.
Subsection Criteria Response
Participants Describe who the data will be collected in.
Notes on ethical consideration is not required.
5 marks 40 Stroke patients must have a slight to moderate disability (Modified Rankin Scale [MRS]) (Kim et al 2015)
Brunnstrom motion recovery stage >4 (Lee 2020) with ability to walk.
Age <65, gender irrelevant.
No signs and symptoms of other diseases or impairment, that can affect movement apart from hemiplegia caused by stroke
Experimental overview / approach to the experiment / research approach Provide a broad but brief description of your methodology/study design.
Draw a schematic of your methodology/study design.
5 marks For 6 weeks, 40 stroke participants are divided into 2 cohorts, (randomised control design assessor are blinded to clinical data) - muscular strength & motor controlled are measured pre-post.
intervention group = FES device + standard physio program
control standard program
the participants are matched in level of disability (Modified Rankin Scale [MRS]) (Kim et al 2015) and Brunnstrom motion recovery stage (Lee 2020).
-25401651000
Data collection procedures / processes Describe
Your treatment(s) / intervention(s) 5 marks
The assessment of your outcome measures around those treatments / interventions 5 marks
Justify the use of your treatments/interventions and outcome measures 5 marks
Validity and reliability
You may draw a schematic of your data collection procedures / processes if it assists clarity. Both Brunnstrom motion recovery stage (Lee 2020) and Modified Rankin Scale (MRS) (Kim et al 2015) to be used at pre-post measurement to see if a degree of change in muscle strength and motor recovery occur.
Further test includes Pre -Post.
Motor recovery will be measured using static balance via (BioRescue software program) and dynamic balance via (TUG). BioRescue software and TUG has an intraclass coefficient (ICC of 0.99 and 0.83) respectively (lee 2020).
Muscle strength and power is measured using EMG analysis (Sabut et al 2011)
EMG power - a high reliability (Kellis & Katis 2006).
Lastly, Physiological Cost Index (PCI) of walking PCI=[HR(w)HR(r)]/S is calculated using Casio heart monitor, measure gait efficiency (Sabut et al 2011) motor control/recovery
Statistical analysis Describe how your data will be analysed to answer your question.
5 marks Analysis: changes on motor control and muscle strength
The data within group pre vs post of both controlled and intervention group.
Then difference between of controlled vs intervention group
Template Section 1 word count: 160 (introduction sub-heading to the end of the methodology table)
Total Section 1 word count: 427
Student Section 1 word count (Total Section 1 word count minus 160): 267
Section 2: Exercise science subdisciplines/study areas integration (660 words maximum; 30 marks)
Template Section 2 word count: 58 (integration table headings)
Total Section 2 word count: 484
Student Section 2 word count (Total Section 2 word count minus 58): 426
References
Bao, S, Khan, A, Song, R & Tong, R 2020, Rewiring the lesioned brain: Electrical stimulation for post-stroke motor restoration, Journal of Stroke, vol. 22, no. 1, pp. 4763.
Cohen, L & Dimyan, M 2011, Neuroplasticity in the context of motor rehabilitation after stroke, Nature Reviews. Neurology, vol. 7, no. 2, pp. 7685.
Hettinga, D & Andrews, B 2007, The Feasibility of Functional Electrical Stimulation Indoor Rowing for High-Energy Training and Sport, Neuromodulation (Malden, Mass.), vol. 10, no. 3, pp. 291297.
Lin, S, Sun, Q, Wang, H & Xie, G 2018, Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis, Journal of Rehabilitation Medicine, vol. 50, no. 1, pp. 37.
Lee, K 2020, Balance Training with Electromyogram-Triggered Functional Electrical Stimulation in the Rehabilitation of Stroke Patients, Brain Sciences, vol. 10, no. 2, p. 80.
Kim, K, Lee, S, Kim, D & Kim, K 2015, The effects of ankle joint muscle strengthening and proprioceptive exercise programs accompanied by functional electrical stimulation on stroke patients balance, Journal of Physical Therapy Science, vol. 27, no. 9, pp. 29712975.
Kellis, El & Katis, A 2006, Reliability of EMG power-spectrum and amplitude of the semitendinosus and biceps femoris muscles during ramp isometric contractions, Journal of Electromyography and Kinesiology, vol. 18, no. 3, pp. 351358.
Mitsutake, T, Sakamoto, M & Horikawa, E 2019, The effects of electromyography-triggered neuromuscular electrical stimulation plus tilt sensor functional electrical stimulation training on gait performance in patients with subacute stroke: a randomized controlled pilot trial, International Journal of Rehabilitation Research, vol. 42, no. 4, pp. 358364.
Sabut, S. K, Sikdar, C, Kumar, R & Mahadevappa, M 2011, Improvement of gait & muscle strength with functional electrical stimulation in sub-acute & chronic stroke patients, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, vol. 2011, pp. 20852088.
Stroke foundation 2020, The economic impact of stroke in Australia 2020, stroke foundation, last viewed 10 April 2020, <https://strokefoundation.org.au/News/2020/11/04/02/57/No%20Postcode%20Untouched>.
Takeda, K, Tanino, G & Miyasaka, H 2017, Review of devices used in neuromuscular electrical stimulation for stroke rehabilitation, Medical Devices (Auckland, N.Z.), vol. 10, pp. 207213.
