Effectiveness of Exercise Programs in Reducing Fall Events of Elderly - Research Methodology Design and Methods

This research aims to evaluate the effectiveness of exercise programs in reducing fall events of elderly people. The study uses a secondary method which is a quantitative research approach. The review design includes search strategy, databases and search engines, search terms, literature screening, inclusive criteria and exclusion criteria, data extraction and quality assessment, ethics consideration, and data synthesis.

Msc Advancing Physiotherapy Practice
7006SOH - Research Methodology, Design and Methods
Topic- To assess the effectiveness of exercise programs in reducing fall events of elderly
Word count-4112
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TOPIC............................................................................................................................................................................................................................2
BACKGROUND OF THE STUDY.....................................................................................................................................................................................2
LITERATURE REVIEW....................................................................................................................................................................................................2
RATIONALE...................................................................................................................................................................................................................3
RESEARCH QUESTION..................................................................................................................................................................................................3
AIM AND OBJECTIVES..................................................................................................................................................................................................3
RESEARCH METHODOLOGY.........................................................................................................................................................................................3
Research method.....................................................................................................................................................................................................4
Research approach..................................................................................................................................................................................................4
Data collection.........................................................................................................................................................................................................4
Research philosophy................................................................................................................................................................................................4
Research paradigm..................................................................................................................................................................................................4
Ontology and Epistemology.....................................................................................................................................................................................4
REVIEW DESIGN...........................................................................................................................................................................................................5
Search strategy........................................................................................................................................................................................................5
Databases and search engines.................................................................................................................................................................................5
Search terms............................................................................................................................................................................................................6
Literature screening.................................................................................................................................................................................................6
Inclusive criteria and Exclusion criteria...................................................................................................................................................................6
Data extraction and quality assessment..................................................................................................................................................................7
Ethics consideration.................................................................................................................................................................................................7
Data synthesis..........................................................................................................................................................................................................7
DISSEMINATION...........................................................................................................................................................................................................8
TIMESCALE OF THE REVIEW.........................................................................................................................................................................................9
ESTIMATED COST FOR THE PROPOSED STUDY PROJECT.............................................................................................................................................9
REFERENCES.................................................................................................................................................................................................................9
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TOPIC
To assess the effectiveness of exercise programs in reducing fall events of
elderly people.
BACKGROUND OF THE STUDY
Falling is the most common cause that creates fractures in older adults and thus the fall related injuries are the leading cause of
hospitalisation and increased medical costs. Because of serious fractures, the older adults’ activities have been affected in a drastic manner even
in their day to day living habits. Injuries due to falls generate fractures or serious injuries at diversified locations cause long-lasting functional
decline and taking care of such older adults becomes progressively difficult (Hshieh & et.al. 2018). There are various risk factors incurred
among the falls and fall induced injuries that have been demonstrated in a way which assist in gathering actual details about the losses. These
are related to physical inactivity and reduce functional capacity.
Moreover, falls might also generate a risk of fractures in elderly people because of increased exposure to the fall hazards. The
relationship among the exercise and reduction in fall incidences has been studied earlier numerous times. Furthermore, varied systematic review
will be considered in order to perform investigation over the role and effectiveness of exercise in order to reduce or decrease the risk of falling
events that effectively might cause fractures and serious injuries.
LITERATURE REVIEW
As per the views of Ballard and et.al.(2018), it has been evaluated that physical activity refers to activity that consists of bodily
movements that requires appropriate amount of energy expenditure along with exercises that are planned, structured and repetitive with an aim
to improve or maintain one or more components related to the physical fitness. This also helps in order to provide leisure to lifestyle activities.
Exercise acts as a single intervention which is most commonly tested fall prevention intervention for the old adults. The exercise helps the elders
to make their muscles stronger and become more flexible in nature. These activities assist in enhancing the balance level and increase the time
for the old adults in order to become highly active in nature. Regularly doing the fall prevention exercises reduces the risk of falls by specifically
strengthening the key muscles along with joints in order to improve the balance criteria.
With the help of various studies, Müller and et.al., (2018) illustrated that exercise acts as a single intervention which fruitfully assists in
order to reduce the risks related to falls in old age. There are various specific programs that have been run by varied trainers in order to provide
appropriate training to the old elders. The program consists of 17 strength and balance exercises along with a walking program which has been
generally performed three times a week by the older adults at the home premises. These actions might be performed in individual or in a group
setting.
Saeidifard et.al., (2019) states that falls are the primary and leading cause of death, hospital admissions and serious injury among the old
elders. The senior citizens are more prone to falling along with being also more susceptible to getting injured. From numerous studies, it has
been identified that nearly 40 million falls that happen annually among the people who are sharing the age group of 65 plus years, among more
than 10 million people have resulted in facing fall related injuries such as broken hip and head trauma. In order to focus towards the factors that
affect and contribute to senior falls, the specific things which involve, decline into physical fitness as many elders are not active enough to do
regular physical activities or even exercises. Failure to engage in exercises results in reduced muscle mass and strength, reduced bone mass and
poor coordination or balance along with reduced level of flexibility within them that causes serious effects over the health status of the old age
people. Apart from this, age related eye diseases also makes it difficult to detect fall hazards which includes steps, puddles and outsets.
Furthermore, medication side effects, chronic diseases, surgical procedures, behavioural hazards along with environmental hazards.
In accordance with the Carli and et.al. (2020) it has been identified that physical activities on a regular basis creates one of the most
significant things one can do to reduce risks related to health hazards. With the help of proper physical activity, the thinking abilities improve
and reduce short term feelings of anxiety which also acts as a cause that creates certain circumstances of falling. Regular physical activity in the
form of exercise helps the elders to keep their thinking productive enough that makes their mind stronger and reduces the risk of falling by
generating an active mind within them.
RATIONALE
The reason behind conducting this research is to evaluate or determine whether and to what extent, fall prevention exercise interventions
for old age community people are effective in order to prevent diversified kinds of fall related injuries. This issue is considered to become a
research issue to evaluate the affectivity of the exercise practices in the most appropriate manner.
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RESEARCH QUESTION
To assess the significance of exercise programs which assist in order to decrease falling events among old age people?
AIM AND OBJECTIVES
Aim
The aim behind conducting the current study is to evaluate the impacts of exercise programs over the risks of falling events within the
old age people.
Objectives
By taking into consideration the above aim, certain objectives have been prepared:
To develop an understanding about the concept of risk of falling within elders.
To identify exercises that positively affect in order to reduce falling risks.
To analyse association between the exercise program and reduced falling risks.
To recommend various exercise programs that help to decrease the risks related to fall among the old age elders.
RESEARCH METHODOLOGY
Research methodology is mainly divided into three parts which includes qualitative, quantitative and mixed methods (Rakower &
Hallyburton ,2022). But most research mainly evaluates via uses of qualitative and quantitative research approaches for collection and
evaluation of research. This research uses a secondary method which is a quantitative research approach. It's useful for collection of data from
scientific approaches who mainly provide information from effective knowledge, perfect data identification and many more. Also, it gives
multiple options for searching and collection of data from old data, new approaches of data collection or identification and many more. So in
this research, research will be evaluated and developed by quantitative research methods or secondary data collection because it provides
effective quality of data from different digital tools application and throughout the scientific method identification as well.
Research method
There are two types of research methods: Qualitative and quantitative research methods. Qualitative research method is evaluated with
the questionnaire, interview, group discussion methods where research mainly develops questionnaire approach for evaluation of research. On
the other hand, Quantitative research approach is the one, where researchers mainly analyse data from the application of scientific ,graphical or
numerical approaches for evaluation or research for the specific term (Zientek & et.al. ,2018). In this research, the research method will
consider and prefer data from the application of the secondary research method because it can be evaluated from the old data identification
approach. Because utilization of this approach provides and develops ideas for collecting data from different sources, applications, scientific
methods, mathematical approaches and many more. This research develops by utilization of secondary data because it requires graphical data
from utilization of searching approaches.
Research approach
It is mainly divided into three parts which include the inductive, deductive and abductive research approach. Inductive research is
evaluated from the observation technique where researcher focuses towards gathering the data from analysis or observation of audience
activities. But it is not good for this research because this research has no specific idea from how to and where to collect information. The
inductive research approach is specifically used for the data that is qualitative in nature. Abductive research where research will be conducted by
utilization of primary and secondary both types of data but it takes more time and creates confusion in research as well. Deductive research
mainly evaluates data from that is scientific in nature data and where researchers evaluate overall information with the utilization and
application of theories and approaches application (Bollineni & et.al. ,2018). In this study, deductive research approach has been selected
because the data collected is in the form of numerical values. In this research, research is conducted by application of secondary methods
because it requires the use of old data and a searching process with data or information collection tools.
Data collection
There are two types of data collection: Primary and secondary: Primary research mainly makes use of interviews, survey, experiments,
observation, group discussion and questionnaires methods in order to collect the data. It’s very easy to collect or gather information but for
this study or data evaluation qualitative methods are not beneficial because it does not provide specific ratio or numerical aspects and it takes
a higher cost to determine data (Hajjar & Rey ,2020). So, in this study it is preferred to collect information from the utilization of secondary
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data where data has been collected or gathered data without incurring any kind of cost and also it takes less time as compared to primary
research. For the identification and development of data collection throughout the secondary data it mainly evaluates from the CINAHL
database because it searches articles databases from medical which are developed by American nurses’ association. CINAHL database is one
of the most authorized health literature areas or fields which is very easy to evaluate and analyses information about the medical sector.
Research philosophy
It’s mainly divided into two parts. The first is positivism and the second is interpretivism data. Positivism research paradigm is
evaluated from the quantitative research method for collection of information for new decision-making processes ( Kuçuk & Sirakaya ,2020).
On the other hand, Interpretivism research paradigm mainly evaluates from the society behavior evaluation by making use of questionnaire
that includes qualitative method. In this study positivism research approach is preferred because scientific data and graphical presentation will
be easily developed with the uses of old research and it evaluates information from limited data with proper measurement and statistical data
identification methods. One of the essential things is that the collection of information requires proper scientific theory and numerical aspect
knowledge because having all these essential terms can easily provide or develop ideas. In this research, the study will be conducted by the
application of positivism philosophy because it's a very beneficial for this particular study and provides different ideas for new decision-making
throughout the application of effective features and applications.
Research paradigm
Ontology and Epistemology
This term is mainly used to define and explain in effective research what exactly is required for evaluation and analysis of facts or
information which is beneficial for knowledge development in people. It’s essential to recognize and develop higher concern for specific or
certain topics, and they evaluate whether this specific term is useful for gathering information or not. So Ontology plays an effective role in
collection of information with proper classification and explanation of required entities. Research ontology is a mixed research approach
where it provides knowledge and reviews from reality with a qualitative method or it also includes secondary research methodology which
evaluates with the scientific data collection approach. So its totally departmental in nature of research topic or study requirement.
Epistemology research mainly evaluates from the theories and experts’ knowledge or advice application within information collection
practices Gregory (2019). Therefore, in this study information has been collected via using epistemology data identification because it gains
productive data and knowledge. So from the activities and researcher consideration towards the application of research paradigm its clearly
evaluated that epistemology approach is beneficial rather than ontology research paradigm in this study because it provides information
throughout the theories of knowledge which are the most essential and requires approach for identification of factors that determine the
agegroup of people who mainly suffer problems in legs because of lack of exercise.
From the evaluation and collection or gathering of information via secondary, quantitative, positivism research approach is the best
practice for the evaluation and identification of perfect ideas for program development.
REVIEW DESIGN
Search strategy
Identification and collection of information and data identification throughout the secondary approach require some specific methods or
framework which clearly represent data which is identified from the specific framework. In this research, design of search strategy is
developed with proper structure development like which problem faces patients, how they can manage and resolve issues of body, which
practice essential or requires for solution of problem, perfect health services, prescription identification, how and where it happened, reason
behind the issues and many more term will be clear evaluated from the expansion of structure (Lew, Yang & Harklau ,2018).
Throughout the PICO, structure define the search values based on medical department and it's one of the most effective approach for
define or classify four major different sections for proper knowledge expansion towards with the specific questionnaire approach are as
follows,
Population Intervention Comparison Outcome
Elderly people who are 60 or 60 plus. And
they suffer from issues in lags from age factors or
from low exercise.
Promotion and
development
of programs
Medical treatment throughout
the specialist advises people to
become aware so it’s essential
Health care
specialists
throughout the
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for elderly
people for
motivation
expansion
towards
exercise
because it
helps to reduce
pain and
fitness of lags.
Exercise and
other physical
activities will
be the main
intervention.
to develop an exact plan for
elderly people.
Patient care is essential for
their relatives or family
members because they suffer
problems from patients.
Effectiveness of exercise with
other fall preventive methods
will be compared.
expansion of
research mainly
decide to develop
medical awareness
programs to
develop awareness
in elderly for
managing their
health activities.
It is useful for
resolving conflicts
or health and
improving health
effectiveness with
exercise practices.
Databases and search engines
Search engines: Both options have multiple different aspects in terms of collection of data for sustainable result development.
Throughout the secondary research methods, it's a very important term to involve the best and most sustainable paradigm for searching
process effectiveness. From the evaluation and knowledge of multiple factors in the medical department it is an important term to the best
alternative for collection of information and it can be easily evaluated via uses of search engines option or method ( Vebrianto & et.al. (2020).
Because this approach has the power to provide knowledge and information with a wide range and multiple range of data evaluation from
googles, internet or other multiple services. In this for the evaluation and identification of medical terms in elderly people who do not consider
exercise on a daily basis which develop the reason for health issues. It's important to involve the best alternative for percentage and data
identification that many elderly people do not prefer to apply google searching because it's beneficial for providing exact data from last year
or specific time.
Search engines play a vital role in research study as it enables researchers in collecting accurate and reliable data. For collecting
information regarding the effectiveness of exercise in decreasing fall events in older people include: CINAHL, google scholar, PEDRO .
So in this study data will be held and evaluated by medical websites, medical programs delivery team, Health care sites and many
more. Throughout the perfect and finest utilisation of the website searching process will be definitely helpful for the research and collection of
information. Also, it is the best approach for the statistical data expansion process as well. POIC is the best approach but it can be managed
and papered by the search engines options application because research, normal research of Old people data from specific areas and many
more terms has power to provide and develop information which makes more consistency in result development and statistical data
representation (Aydin & Aydin ,2020). POIC is also considered as PICO as it stands for population/people, intervention, comparison and
outcome. Each research has a specific population. For this research main target and people that will be considered include: elder people,
intervention will be exercise.
For the secondary data identification in recent trends it is much easier to evaluate data from the internet or digital applications with
google applications because it provides and makes more substantiality in decision-making or decision development. Google is one of the most
appropriate platforms for evaluation of scientific data and it takes very less time but the major thing which is required for collecting
information is searching effectiveness and appropriate website knowledge for specific terms.
Search terms
On the basis of this research it is very clear and consistent that uses of POIC approach for information evaluation and clear
requirement identification of medical aspects. Elderly people who do not stand up properly because of lack of exercise, and they do not prefer
to do exercise on a daily basis then it badly impacts on activities on their health. So when it's clear that the health care service department
develops a program they do have a duty to evaluate specific areas where people can easily engage and attend programs ( Zawacki-Richter &
et.al. ,2020). Therefore, the idea of this term it's clearly evaluated that this research will be organized by the utilization and application of
important approaches with questionnaire approach. And essential questions identification is the best term which provides answers for specific
aspects and it’s easier to prepare proper data. So in this study research has been held by users' questionnaire approach in secondary methods
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in web searching or google's research because of appropriate answers evaluation. Also, the secondary research method's primary research
approach clearly provides instructions that questioner application with a group and large audience is the best option to provide answers and it
is easier managed via uses of technology devices within recent market trends. In Terms of multiple aspects, it’s been clear that researchers
gather or collect data throughout the internet searching which is very important in the recent trend of searching.
Literature screening
This term is mainly beneficial for research effectiveness in the secondary research approach because it provides clear knowledge from
specific articles prepared by experts and it mainly focuses towards the specific topic, and they do have great ability to define which factors
mainly create issues in successful decision development. It also includes that when evaluating and gathering data they do have a duty to apply
exact information from specific article applications. Perfect and sustainable tool for the research, its important term to engage and that
experts develop ICSR, having this term within business practices makes more efficiency in collection of information. It has been an
understanding term that medical research or study makes sure to develop focuses towards with the appropriate data evaluation because it's a
very serious aspect or matter (Zhu, 2019). Collect articles via the use of appropriate publishers who mainly provide ideas and knowledge of
medical issues and health care program organisers who decide to develop this plan they do have the duty to involve perfect and finest
information because it impacts on health. So literature screen in terms of medical aspects it’s important for searching terms for safety and
security development in issues identification. Articles and journals published on google scholar, CINAHL within 5 years will be selected for
knowing effectiveness of exercise for decreasing falls in elderly people.
Inclusive criteria and Exclusion criteria
Inclusive criteria is defined as it determines and engages target audience who do have ability to explain some essential aspects of
specific study and the other hand exclusion criteria it mainly refers to exclude factors who do not have characteristics, qualification and
knowledge within a specific group of people in terms of research study. Also, Inclusive criteria is all above research to evaluate and gather data
from the specific individual who expertise in research question answers distribution and who mainly develop focuses towards with the specific
study Zaki, Alashwal & Ibrahim (2020).
Some inclusive criteria of this study are: articles published within 5 years. Data is being collected that is published only on CINAHL, Google
scholar, PEDRO . Only that information has been considered that is related to the effectiveness of exercise for elderly people.
Exclusion criteria is used to evaluate and provide information from inappropriate information and knowledge they do hav e. In this
research, research has determined the idea and knowledge of specific terms such as specific sections, research questionnaires, throughout
databases, search engines and many more important aspects of the specific number of target audience who have power to manage activities
of individuals in terms of collection of data. Collection of information from age 50 or more, because they do have exact idea which major
aspects impacts on activities of individual.
Exclusion criteria of this study include: data that are published and are older than 5 years. That information that is not relevant to
exercise effectiveness for elderly people.
Data extraction and quality assessment
Data extraction is the process which is necessary for information in primary research methodology, data and quality is obtained. For such
research CASP tools have been used as they encourage comprehensive assessment of the validity and quality of research. However, they do not
include the scoring system for traditional hierarchy of evidence and will not weight quantitative evidence and also lead with including the
randomised controls about the qualitative research (Baima & et.al.,2021). Therefore, the checklist which will be required for possibility and this
will reduce the consistency of the proper data extraction and also have the further complication of proper data synthesis stages. Along with the
review of data extraction which must be required for having demonstrated considerable variation and also seems content with their lack of
rigour, as the majority have not undergone reliability testing.
Ethics consideration
In this, collection or gathering of information is from ethical approval and it is required for systematic review. It is also seeming to be
important in considering the ethical principles when assessing and reviewing literature while preventing with proper biassed and unethical
approaches. The collection of data or sources have been done through using the ethical websites and not more than five-year have been
collected. Along with this no international standards or framework lead for following the ethical assessment in their working systematic reviews
(Harris & Anthi ,2021). Therefore, having such things this could keep the effective process which does not cover some specific consideration
and also include concern that initial informed consent for the valid at review level. This also keeps research for having relevant sources and
collection of methods have been used in research with approvals.
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Data synthesis.
It is the combination or summary of the findings in individual studies which might include the systematic review. While this could also keep
the mixed systematic review and difference between methodology, due to having lack of techniques and also make the integrating finding which
seems to be different (Xue & Matni ,2021). An integrated approach also requires the data to be more similar in order for performance to be
Task Sep.2
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Finalis
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of
strateg
y
related
to
search
es over
specifi
c topic
Study
selecti
on
criteria
along
with
imple
mentat
ion
proced
ure
Data
extract
ion
stage
Assess
ment
over
the
quality
of
researc
h
Data
analysi
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Data
synthe
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Writin
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introdu
ction
Illustra
ting
metho
ds
along
with
final
results
in
written
format
Writin
g final
conclu
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Disse
minati
on
combined into their themes and then quantified before including with qualitative data. Alongside, these methods start with being criticised
as lacking, at risk of introducing bias and lacking clarity about how to process with contradictory evidence. An integrated approach which
allows for describing the joint synthesis.
DISSEMINATION
In order to fulfil the requirements of the research project, the PICO method will be utilized through which the older people, senior
citizens over the age of 65 years and patients will be considered. The community will be considered as location of the study along with history
of falls will be acknowledged. In the context of illustrating the interventions, a fall prevention program will be chosen with taking traditional
rehabilitation along with a multifactorial fall prevention program. For comparison, another intervention will be recognized (Lobelo &
et.al.,2018). And for the final outcome the effects of decreased incidents of falls, severity and the ways through which the hospitalization
circumstances will be reduced. The final report will be submitted to authorized people with the intention of securing an oral presentation.
TIMESCALE OF THE REVIEW
ESTIMATED COST FOR THE PROPOSED STUDY PROJECT
Item Cost in £
Material and supplies 40
Printing 20
Stationary 10
Total £70
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