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8/3/2019 FIRST STEP TO RESEARCH
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My First Step to Research
1. Introduction
Evidence-based practice [EBP] has been increasingly promoted as a
model for physiotherapy practice (Ritchie, 1999).
“ Evidence-based practice is „conscientious, explicit and judicious use
of current best evidence in making decisions about the care of individual
patients”(Sackett et al., 1997).
The main aim of the EBP is to provide better result for the patient care
and the members of the family, to improve the attribute of the health care team
members and the systematic arrangement of the health care (Craig and Smyth,
2007).
The first step to research can be challenging to most researchers and
may seem an impossible task. According to Hicks (2004), the rise of EBP
encourages all health professionals to be research minded in developing and
assessing empirical evidence that corroborates their professional practice.
The aim of this essay is to outline a research journey to find the
effectiveness of mental practice [MP] in stroke patients. A review of the
available evidence base will guide the area of investigation and formulate a
research question.
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2. Background
Stroke is a very limiting disease for the patient and a major health
problem in most parts of the world (AHA, 1997). The World Health
Organisation (1988) has defined stroke as a condition with “rapidly developing
clinical signs of focal loss of cerebral function, with symptoms lasting more
than 24 hours or leading to death, with no apparent cause other than that of
vascular origin”.
Stroke accounts for around 53,000 deaths each year and estimated
150,000 people have a stroke in the United Kingdom [UK] each year, at least
450,000 people are severely disabled as a result of stroke in England (Stroke
Association, 2011). The National Commission on Macroeconomics and
Health, India, estimates there will be 1.67 million stroke cases in India in 2015
(WHO, 2010).
Neurological conditions play a significant role in economic, social and
personal burden on the NHS and patient‟s families, as most of the neurological
conditions need long term rehabilitation (Neurological Alliance, 2003).
A research agenda should reflect the appropriate ways to answer the
questions. The acknowledgement of where the evidence falls short and how the
evidence falls short is essential to the development of important research
questions and in providing guidance in how to direct those questions.
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3. L iterature Review As a process, EBP is about finding, appraising and applying scientific
evidence to the treatment and management of health care (Timmermans and
Mauck, 2005). It‟s ultimate goal is to support practitioners in their decision
making to eliminate the use of ineffective, inappropriate, too expensive and
potentially dangerous practices (Hamer and Collinson, 2005).
Heller et al. (2008) suggests that many clinicians are also cautious to
critically appraise published literature. However, a logical review of the
literature can identify clear research questions building on what is already
known and identifying areas to be addressed (Burns and Grove, 2002).
MP according to Richardson (1967) is “the symbolic rehearsal of a
physical activity in the absence of any gross muscular movements”.
MP has been proven to be useful in sports training and other skills
training (Athletic Insight, 2004). Still, much is yet to be determined if the same
assuring results may be derived when this training method is used in persons
with brain lesions, like stroke (Dizon and Calayan, 2009).
2001-2011 Eighteen studies, in which six Randomised Controlled
Trials (RCT‟s) (Page et al., 2001a, 2005; 2007;2011; Liu et al., 2004; Riccio et
al., 2010), two Controlled Clinical Trials (Dijkerman et al., 2004; Muller et al.,
2007), one is pre-post treatment study (Simmons et al., 2008) and remaining
are case studies and case series. All studies included both men and women as
participants. Study sizes were small, in 12 studies had 63 participants and 6
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study had 180 participants (Dijkerman et al., 2004; Muller et al., 2007; page et
al., 2007; 2011; Liu et al., 2004; Riccio et al., 2010). Few studies had good
randomization procedures (Page et al., 2001a; 2005; 2011; Riccio et al., 2010;
Liu et al., 2004). In few studies, subjects in the chronic phase of recovery were
recruited (Page et al., 2005; 2011; Dijkerman et al., 2004). Liu et al., (2004)
included exclusively patients in the subacute phase of recovery (7 – 27days
poststroke). Page et al., (2001a) included patients in the chronic and acute
phase of recovery (4weeks to 4years poststroke).
MP intervention was given by using, audiotaped instructions (Hewett
et al., 2007; Page et al., 2001a; 2005; 2007), written instructions (Dijkerman et
al., 2004), self regulation (Liu et al., 2004), videotaped instructions (Crosbie et
al., 2004; Muller et al., 2007), computer-generated image (Gaggioli et al.,
2006), or visual displays of the less affected limb via a mirror box (Stevens and
Stoykov, 2003).
Additionally, the studies used various tasks such as functional reaching
and grasping tasks (Crosbie et al., 2004; Dijkerman et al., 2004; Page et al.,
2005), line tracing (Yoo et al., 2001), selective finger opposition sequences
(Muller et al., 2007), during the MP sessions. In several studies, the perspective
used was not clearly articulated (Crosbie et al., 2004; Dijkerman et al., 2004;
Yoo et al., 2001).
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The intensity and duration of MP, in RCT studies varied substantially
regarding the number of trials or minutes engaged in practice, with participants
receiving around 4 – 5 hours of MP over a 3-weeks (Riccio et al., 2010) to 10
weeks period (Page et al., 2011). In each study, frequency with which the MP
was given varied, but a minimum of 2 times a week for 20-30 minutes was
reported.
Most studies used the Fugl-Meyer Motor Assessment (Gaggioli et al.,
2006; Page et al., 2001a; 2001b; 2009; 2011; Stevens and Stoykov, 2003), the
Jebsen Test of Hand Function ( Muller et al., 2007; Stevens and Stoykov,
2003), the Arm Function Test (Riccio et al., 2010), the Motricity Index
(Crosbie et al., 2004; Simmons et al., 2008; Riccio et al., 2010), or the Action
Research Arm Test (Gaggioli et al., 2006; Page et al., 2001a; 2005; 2007;
2011) as primary outcome measures. Hewitt et al. (2007) used a kinematic
analysis of functional reaching tasks, and Dijkerman et al. (2004) used
outcome measures aimed at complex task function.
Few studies showed statistically significant differences favouring MP
on at-least one outcome measure (Crosbie et al., 2004; Dijkerman et al., 2004;
Hewett et al., 2007; Muller et al., 2007; Page et al., 2005). MP alone did not
result in a clinically meaningful improvement in upper-limb impairment and
also the researchers described how these interventions may elicit “plastic”
changes in the brain (Butler and Page, 2006).
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Moreover, from the studies, it appears that MP combined with physical
practice yields better outcomes than physical practice alone or conventional
therapy (Dijkerman et al., 2004; Muller et al., 2007; Page et al., 2005; 2007).
Interestingly, only three studies included a follow-up, after 1 month (Liu et al.,
2004), after 3 months(Page et al., 2009) and after six months(Page et al., 2011)
therefore little is known about possible long-term effects of MP.
Gentili, Papaxanthis and Porro (2006) compared the improvement in
arm motor performance in which the MP groups improved significantly in the
pointing task by decreasing their duration time that engaged in eye-movement
training. However, Gentili et al. (2006) study had participants with an intact
nervous system function. So, further studies employing quality research
designs are needed to strengthen the evidence.
The fact that intensive training on tasks, which have shown activate
motor regions in neuroimaging studies does not result in behavioural change,
may question the functional relevance of cortical activation in mental
simulation of action (Cinzia and Jean-Claude, 2003). Numerous neuroimaging
studies had demonstrated non-motor tasks (Rizzolatti and Craighero, 2004).
The consideration of existing evidence often highlights important areas
where deficiencies in information limit our ability to make decisions.
Encouraging outcomes were noted in some RCT‟s and much of the literature
suggests further studies are needed to evaluate the effects of MP in stroke
rehabilitation.
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4. Research Question
By analysing the literatures thoroughly the research question will be
well-organised and formulated (LoBiondo and Haber, 2010). Reviewing of the
articles and literature has come into the conclusion of development of research
question by the identification of the gaps.
Possible methods of approach to the research journey will concentrate around
the question:
“I nvestigating evidence for the effectiveness of mental practice
in stroke rehabil itation to improve function ”
According to Sackett et al. (1997) a well structured research question
should answer PICO framework. The above research question answers the four
parts:
Population : Stroke patients
Intervention : Mental Practice
Comparison (If any) : Null or No Comparison
Outcome : Function Improvement
.
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5. Methods of Approach
The kind of role adopted by a researcher determines what kinds of
methods can be utilised, means the extent to which the aims and methods of a
piece of research match and link to the way the researchers account for their
purpose (Ballinger; cited Finlay, 2006).
How researchers set about offering a convincing and relevant
interpretation may also vary according to the methodology employed. In
reference to discourse analysis, Potter and Wetherell (1994) suggest that
presenting work to a variety of different audiences helps researchers evaluate
how compelling their explanations are. When it comes to choosing criteria,
there is considerable divergence of opinion (Willig, 2001; cited Finlay, 2006).
5.1. Quanti tative Approach
The quantitative approach is called the “logical positivism”. Positivism
contends that there is a single reality and therefore seeks to identify causal
relationships through objective measurement and quantitative analysis
(Firestone, 1987; cited Doyle et al 2009). The only known way to avoid
selection and confounding bias is to use randomisation (Schulz and Grimes,
2006) as it heightens the internal validity of the study.
There are numerous ways of designs in the quantitative; they are
descriptive to represent the variables, correlation to exam relationship between
the variables, quasi-experimental and the experimental to figure out the cause
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and effect among variables, which includes the range from uncontrolled
method to controlled methods (Burns and Grove, 2010).
Historically the approach in health care research was nearly exclusively
of the quantitative or positivist tradition for the researcher to be objective and
unbiased, (Firestone, 1987; cited Doyle et al 2009) and for many, it is
considered to be the „gold standard‟ (Bowling, 2005) of research strategies in
healthcare where the results of objective testing on samples of patients are
applied to wider populations. In corresponding to the question, RCT appears be
the most appropriate and well controlled approach method to conduct a
research.
5.1.1. Randomised Control Tr ial Approach
According to Bolyai and Bova (2010) when the intervention is more
efficient it presents the identical outcomes even when it is trialled more number
of times. To answer the question with RCT, the samples are enrolled into two
groups with an experimental group receiving the MP intervention and the other
control groups receiving the normal and usual guidelines. So, that whatever
may be variance in outcome is the effect of intervention.
Gray (2001, pp. 133) suggests that for RCT‟s to be ethical there needs
to be equipoise, that is, genuine doubt prior that one option is better than
another. Alternative quantitative strategies that may need to be considered
include cohort studies, which may have limited internal cogency due to
confounders as a result of neglecting the essential element of randomisation
(Schulz and Grimes, 2006). However, the RCT is determined not to be the
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suitable method of approach for the research question owing to shortage of
perceptibility and the training of techniques, though it contributes the desired
result in the clinical effectiveness (Evans and Pearson, 2001), then the clinical
experimental method using the design of controlled pre-test and post-test or
can be done only with the design of controlled post-test group can be
considered.
5.1.2. Quasi Experimental Approach
The research question can also be approached by the quasi experimental
research. The non-equivalent control group design is effective, because the
researcher can collect the data in the pre-test and the independent variable can
be introduced by relating the sameness of two groups (Bolyai and Bova, 2010).
Although, there are advantages of using the design, but it cannot be approached
as it has threats to selection, maturation, testing and morality are probable
within this design (LoBiondo and Haber, 2010).
5.1.3. Non Experimental Approach
The other method to approach the question is by using the non-
experimental research to investigate the relationships and the dissimilarity
among the variables (LoBiondo and Haber, 2010). However, the results
produced by the non-experimental are not stronger than the experimental study,
since the independent variables are not manipulated, the randomisation of
participants are not considered and there is an absence of a control group
(LoBiondo and Haber, 2010).
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Meanwhile the qualitative research method also considered although
most of the methods of quantitative approaches are applicable to the research
question.
5.2. Quali tative Approach
Qualitative researchers study things in their natural settings, attempting
to make sense of or interpret Phenomena in terms of the meanings that people
bring to them (Denzin and Lincoln, 1994 pp.2). Mason (2002) described the
qualitative research as “encom passes modes of inquiry oriented towards how
the social world is interpreted, understood, experienced, produced or
constituted”.
5.2.1. Grounded Theory Approach
Grounded Theory [GT] is a method of qualitative approach; the
development of a systematic understanding, the data can be obtained from
variety of sources, is clearly recognisable and understandable to the members
of the setting and is done as much as possible in their own terms (Holloway
and Todres, 2010) such as uses their words, ideas and methods of expression,
but cautiously goes beyond these‟ (Glaser and Strauss, 1967).
GT can also be approached for the research question. Though, this
method is very good at constructing theories and lead to future research in
testing theories, it has drawbacks like measuring the effectiveness of MP is
unwieldy; consumes more time for collecting and analysing data; due to
subjective nature it may even be difficult to ascertain validity, reliability and
prevent bias (Chenitz and Swanson, 2010, pp.14).
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Qualitative investigators are concerned with the beliefs, motivations,
and experiences, as well as the actions and interactions of people, organisations
and institutions (Gibson and Martin, 2003). Qualitative research is concerned
with describing and explaining complex social phenomena that occur in natural
settings (Pope and Mays, 1995).
5.3. Mixed Method Approach
Both the qualitative and quantitative methods are equivalent in nature.
No method is considered to be the comprehensive design because they vary
a lot, in which each and every method has its own strengths and limitations.
Burns and Grove (2002) described that RCT‟s are good for all the studies,
but it needs much time and effort.
Giddings (2006) describes that mixed method is widely used in the
health care settings which answers in positive way for the difficult questions
which can be done only with the approach of different methods. Wooley
(2009) suggested that mixed methods can be used to contribute an efficient
methodology in “multiple studies”. Therefore, mixed methods can be used for
the research question. Brannen (cited Finlay 2006) claims that it is quite rare
that the mixed method research or indeed the individual researcher, is likely to
put equal emphasis on qualitative and quantitative methods (Bowling, 2005).
It was only with the rapid development of statistical methods that these
two strands diverged and the field of health research does seem particularly
keen on combining qualitative and quantitative research methods, given the
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pragmatic nature of the discipline, coupled with the complexity of the many
factors that influence health and health care (Bowling, 2005).
5.4. Acti on Research
Action research is a form of self-reflective enquiry attempted by
participants in social situations in order to improve the rationality and justice of
their own practices, their understanding of these practices, and the situations in
which the practices are carried out (Carr and Kemmis, 1986). Positivism, used
in scientific and applied research, has been reckoned by many to be the
antithesis of the principles of action research (Winter, 1989; cited O‟Brien,
2001) and it is useful method to answer the question.
Though, sharing a number of perspectives with the interpretive
paradigm, and making considerable use of its related qualitative
methodologies, there are researchers who feel that neither it nor the positivist
paradigms are sufficient epistemological structures under which to place action
research (Morley, 1991; cited O‟Brine, 2001). Because action research is
carried out in real-world circumstances, and involves close and open
communication among the people involved, the researchers must pay close
attention to ethical considerations in the conduct of the work (Ahmed, 2009).
Although, I felt this approach as appropriate initially because of direct
involvement of researcher to understand people needs, values and beliefs
regarding the effectiveness of MP which is required for the study. On the other
side, it makes me really think of its applicability because of its nature of data
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overload leading to misinterpretation of information and even sometimes
resulting omitting the information.
6. Evaluation Morris and Williams (2009) recommends that further research is
needed to explore new ways of working and delivering focused interventions in
stroke, and that physiotherapists can play a key role in achieving this.
Delivering MP interventions that meet the needs of people with stroke
will require thorough research, careful planning and good communication
networks in order to understand the perceptions of those affected, and to ensure
adequate funding and training (Physiotherapy, 2010).
Processes of functional redistribution have been presented in early post-
stroke, if the neural principle of „firing is rewiring‟ applies to MP in stroke,
expect to find a clinical benefit in patients (Nelles et al., 2001).
The rationale for the efficacy of MP in stroke, which is subscribed by
researchers and clinicians, generates a feeling that this is a useful rehabilitation
method, that activation of motor brain areas through imagery will enhance
brain plasticity (Nelles et al., 2001).
The evidence is limited to suggest MP to be beneficial in improving
function, when compared to other treatments in stroke rehabilitation (Barclay
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et al., 2011). Evidence of MP regarding, improvement in motor recovery;
quality of movement; effectiveness; ideal dosage required to improve function
is less clear.
7. Systematic Review ‘ A systematic review is an overview of primary studies which contains
an explicit statement of objectives, materials, and methods and has
been conducted according to explicit and reproducible methodology‟
(Trisha, 1997)
In clinical care for many interventions the evidence base is relatively
weak (Bowling, 2005 pp. 47) because comprising studies with small group of
participants and poor methodological back up with evidence. Grootens et al.,
(2003) claims that systematic reviews and meta-analyses have assumed an
increasing role in healthcare literature reviews during the past decade because
it provides the best evidence from the numerous literatures for the EBP.
Systematic reviews of all relevant research about the efficacy of a
treatment are progressively seen by clinicians and healthcare suppliers as
providing the most reliable basis for conclusions about treatment effects (Gray,
2001). In order to achieve reliable and valid systematic reviews and meta-
analysis the studies being compared must be directing the same hypothesis in
the same direction (Bowling, 2005).
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A systematic review carried to investigate MP describes quality of
movement is less clear (Barclay et al., 2011) which shows lack of in-depth
empirical evidence regarding the MP.
A systematic review is suggested at this stage as the treasure and
influence they posses for clinical deciding (Gray, 2001) makes thoughtfulness
of this approach worthy for further enquiry of the research question as it offers
a problem solving and practice development strategy that can evaluate (Walsh
and Wigen, 2003).
8. Conclusion The emergency of EBP has thrown many involved in clinical care into
the daunting research world (Burns and Grove, 2002). Many approaches are
very near to address the research question but there are disadvantages in the
models to investigate and find the effectiveness of MP. In a Cochrane review
Barclay et al., (2011) also suggested that further studies are required to
evaluate the effectiveness of MP; to affect the outcomes on the post stroke as
numerous ongoing studies might improve the evidence base of MP. So, the best
way to find the effectiveness of MP can be answered by a systematic review of
quantitative studies. (Appendix 1)
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Bibliography
References:
Athletic Insight (2004) Mental Skills Training for Sports: A brief review.Volume 6 (1).
American Heart Association. (1997) Stroke facts. Dallas: AHA.
Ahmed, J U. (2009) Action Research: A New Look. KASBIT Business Journal
2(1&2): pp.19-32. http://www.kasbit.edu.pk/journal/index.htm
Burns, N. and Grove S.K. (2002) Understanding nursing research. 3rd Edition
ISBN 13: 9780721600116 ISBN 10: 0721600115
Burns, N. and Grove, S. K. (2010) Understanding nursing research: building
evidence based practice. 5th Ed. Philadelphia Saunders. ISBN-10: 1437707505
Butler, A J. and Page, S J. (2006) Mental practice with motor imagery:
evidence for motor recovery and cortical reorganization after stroke. Arch
Phys Med Rehab 87(12 Suppl 2):S2-11. http://www.archives-
pmr.org/article/S0003-9993(06)01272-X/abstract
Barclay-Goddard, R E., Stevenson, T. J., Poluha W. and Thalman, L. (2011).
Mental practice for treating upper extremity deficits in individuals with
hemiparesis after stroke. Cochrane Database of Systematic Reviews 2011,
Issue 5. (2006, Issue 2) Art. No.: CD005950. DOI:
10.1002/14651858.CD005950.pub4.
Bowling, A. and Ebrahim Shan. (2005) Hand book of health research methods:
Investigation, measurement and analysis. Open University press ISBN-
10: 0335214606
Bolyai, S. S. and Bova, C. (2010) Experimental and Quasi -experimental
Designs. In: LoBiondo-Wood, G. and Haber. J. (Eds) Nursery Research:
Methods & critical appraisal for Evidence-Based Practice. 7th edition, Elsevier
Mosby: pp.177 – 193.
Dizon, J. M., and Calayan, L. M. S. (2009) A systematic review on theeffectiveness of mental practice with motor imagery in the neurologic
rehabilitation of stroke patients. The Internet Journal of Allied Health Sciences
and Practice 7(2). Available: http://ijahsp.nova.edu/articles/Vol7Num2/pdf/dizon.pdf
Carr, W. and Kemmis, S. (1986) Becoming critical: Education, knowledge, and
action research. Philadelphia: Flamer Press.
Craig, J. V. and Smyth, R. L. (2007) The evidence based practice manual for
nurses 2nd edition, Philadelphia: Elsevier: pp.3-16.
8/3/2019 FIRST STEP TO RESEARCH
http://slidepdf.com/reader/full/first-step-to-research 18/23
| VN Mummadisetty | Page | 18 |
Cinzia, C. and Jean-Claude, B. (2003) Functional Neuroimaging Studies of
Motor Recovery After Stroke in Adults: A Review Stroke 34: pp.1553-
1566, doi:10.1161/01.STR.0000071761.36075.A6 Stroke. Available at
http://www.strokeaha.org
Chenitz, W. and Swanson. (2010) Triangultion of qualitative methods:Heideggerian hermeneutics and grounded theory [Online] Available at
www.qhr.sagepub.com/content/1/2/263.short
Crosbie, J. H., McDonough, S. M., Gilmore, D. H. and Wiggam, M. I. (2004).
The adjunctive role of mental practice in the rehabilitation of the upper limb
after hemiplegic stroke: A pilot study. Clinical Rehabilitation 18; pp.60 – 68.
doi:10.1191/0269215504cr702oa
Denzin, N. K. and Lincoln, Y. S. (1994) Handbook of Qualitative Research.
London: Sage. ISBN-10: 0803946791
Dijkerman, H. C., Ietswaart, M., Johnston, M., and MacWalter, R. S. (2004).
Does motor imagery training improve hand function in chronic stroke patients?
A pilot study. Clinical Rehabilitation 18: pp.538 – 549.
doi:10.1191/0269215504cr769oa
Doyle, L., Brady, A. M. and Gobnait, B. (2009) An overview of mixed
methods research. Journal of Research in Nursing 14: 175 DOI:
10.1177/1744987108093962 http://jrn.sagepub.com/content/14/2/175
Evans, D. and Pearson, A. (2001) Systematic reviews: gatekeepers of nursing
knowledge. Journal of Clinical Nursing 10: pp.593 – 599.
Gaggioli, A., Meneghini, A., Morganti, F., Alcaniz, M. and Riva, G. (2006). A
strategy for computer-assisted mental practice in stroke rehabilitation.
Neurorehabilitation and Neural Repair 20; pp.503 – 507.
doi:10.1177/1545968306290224
Gibson, B. E. and Martin, D. K. (2003) Qualitative research and evidence-
based physiotherapy practice. Physiotherapy 89(6): pp.350-358.
http://www.sciencedirect.com/science
Grootens K. P., Assendelft, W. J. and Overbeke, A. J. (2003) Increased number of systematic reviews in the Netherlands in the period 1991 – 2000. Nederlands
Tijdschrift voor Geneeskunde 147(45): pp.2226 – 2230.
Gentili, R., Papaxanthis, C., and Pozzo, T. (2006) Improvement and
generalization of arm motor performance through motor imagery practice
Neuroscience 137(3): pp.761 – 772. doi:10.1016/j.neuroscience.2005.10.013
Gray, J. A. M. (2001) Evidence-based Healthcare: How to Make Health Policy
and Management Decisions. 2nd edition Edinburgh: Churchill Livingstone.
ISBN-10: 0443062889.
8/3/2019 FIRST STEP TO RESEARCH
http://slidepdf.com/reader/full/first-step-to-research 19/23
| VN Mummadisetty | Page | 19 |
Glaser, B. and Strauss, A. (1967) The discovery of grounded theory: Strategies
for Qualitative Research. New York: Aldine. ISBN 0-202302601
Giddings, L. (2006) Mixed-Methods research: positivism dressed in drag?
Journal of Research in nursing 11(3): pp.195-203
Hicks, C. M. (2004) Research Methods for Clinical Therapists. Applied Project
Design and Analysis. 4th edition. Churchill Livingstone. ISBN 0 443074305;
Hamer, S. and Collinson, G. (2005) Achieving evidence-based practice: a
handbook for practitioners. 2nd Edition. Bailliere Tindall. ISBN-
10: 0702027766
Heller, R. F., Verma, A., Gemmell, L., Harrison, R., Hart, J. and Edwards, R.
(2008) Critical appraisal for public health: A new checklist. Public Health 122;
pp.92 – 98 Available from: http://www.sciencedirect.com/science
Hammick, M. (1995). Qualitative and quantitative research: Adjuvants and
alternates. British Journal of Therapy and Rehabilitation 2(7): pp.341-342.
Hewett, T. E., Ford, K. R., Levine, P. and Page, S. J. (2007). Reaching
kinematics to measure motor changes after mental practice in stroke. Topics in
Stroke Rehabilitation 14: pp.23 – 29. doi:10.1310/tsr1404-23
Holloway, I. and Todres, L. (2010) In: Gressih, K. and Lacey, A. The Research
process in Nursing. Wiley-Blackwell; 6th Edition. ISBN-10: 1405190485
LoBiondo-Wood, G. and Haber, J. (2010) Nursery Research: Methods and
critical appraisal for Evidence-Based Practice. 7th Edition. Elsevier Mosby.
ISBN-10: 0323057438.
Finlay, L. (2006) „Rigour‟, „Ethical Integrity‟ or „Artistry‟? Reflexively
Reviewing Criteria for Evaluating Qualitative Research. British Journal of
Occupational Therapy 69(7).
Liu, K. P., Chan, C. C., Lee, T. M. and Hui-Chan, C. W. (2004) Mental
imagery for promoting relearning for people after stroke: a randomized
controlled trial. Arch Phys Med Rehabil 2004; 85: pp.1403-1408
Mason, J. (2002) Qualitative Researching. 2nd edition. Thousand Oaks: Sage.
ISBN-10: 0761974288
Morris, J. H. and Williams, B. (2009) Optimising long-term participation in
physical activities after stroke: exploring new ways of working for
physiotherapists. Physiotherapy 95: pp.227 – 33.
Muller, K., Butefisch, C. M., Seitz, R. J. and Homberg, V. (2007) Mental
practice improves hand function after hemiparetic stroke. Restorative
Neurology and Neuroscience 25: pp.501 – 511.
8/3/2019 FIRST STEP TO RESEARCH
http://slidepdf.com/reader/full/first-step-to-research 20/23
| VN Mummadisetty | Page | 20 |
Neurological Alliance
Neuro numbers (2003): a brief review of the numbers of people in the UK with
a neurological condition, the neurological alliance. Available:
http://www.neural.org.uk
Nelles, G., Jentzen, W., Jueptner, M., Muller, S. and Diener, H. C. (2001) Arm
training induced brain plasticity in stroke studied with serial positron emission
tomography. Neuroimage, 13: pp.1146 – 1154. http://www.sciencedirect.com
O'Brien, R. (2001) An Overview of the Methodological Approach of Action
Research. Available: http://www.web.ca/~robrien/papers/arfinal.html
Potter, J. and Wetherell, M. (1987) Discourse and social psychology: beyond
attitudes and behaviour. London: Sage. ISBN-10: 0803980566
Pope, C. and Mays, N. (1995) Qualitative research: Reaching the parts other
methods cannot reach: An introduction to qualitative methods in health and
health services research. British Medical Journal 311(6996): pp.42-45.
Page, S. J., Levine, P., Sisto, S. A. and Johnston, M. V. (2001a) A randomized
efficacy and feasibility study of imagery in acute stroke. Clinical
Rehabilitation, 15: pp.233 – 240. doi: 10.1191/026921501672063235
Page, S. J., Levine, P., Sisto, S. A. and Johnston, M. V. (2001b) Mental
practice combined with physical practice for upper-limb motor deficit insubacute stroke. Physical Therapy, 81: pp.1455 – 1462.
Page, S. J., Levine, P. and Leonard, A. C. (2005) Effects of mental practice on
affected limb use and function in chronic stroke. Archives of Physical
Medicine and Rehabilitation, 86: pp.399 – 402. doi:10.1016/j.apmr.2004. 10.002
Page, S. J., Levine, P. and Leonard, A. C. (2007) Mental practice in chronic
stroke results of a randomized, placebo controlled trial. Stroke, 38: pp.1293 –
1297. doi:10.1161/01. STR.0000260205.67348.2b
Page, S. J., Levine, P. and Khoury, J. C. (2009) Modified constraint-induced
therapy combined with mental practice - thinking through better motor
outcomes. Stroke, 40: pp.551 – 554.
Page, S. J., Dunning, K., Hermann, V., Leonard, A. and Levine, P.(2011)
Longer versus shorter mental practice sessions for affected upper extremity
movement after stroke: a randomized controlled trial. Clin Rehabil 25(627).
DOI: 10.1177/0269215510395793
Physiotherapy 96 (2010) Qualitative research highlights the challenges of
developing new roles for physiotherapy in the optimisation of activity
following stroke 75 – 76. doi:10.1016/j.physio.2009.09.005
8/3/2019 FIRST STEP TO RESEARCH
http://slidepdf.com/reader/full/first-step-to-research 21/23
| VN Mummadisetty | Page | 21 |
Richardson, A. (1967) Mental Practice: a review and discussion (part 1).
Research Quarterly (38): pp.95-107
Rizzolatti, G. and Craighero, L. (2004) The mirror-neuron system. Annu Rev
Neuroscience, 27: pp.169 – 92. http://www.annualreviews.org
Riccio, I., Iolascon, G., Barillari, M.R., Gimigliano, R. and Gimigliano, F.
(2010) Mental practice is effective in upper limb recovery after stroke: a
randomized single-blind crossover study. European Journal of Physical and
Rehabilitation Medicine, 46: pp.19 – 25.
Ritchie, J. E. (1999) Using qualitative research to enhance the evidence-based
practice of healthcare providers, Australian Journal of Physiotherapy 45(4):
pp.251-256
http://ajp.physiotherapy.asn.au/AJP/vol_45/4/AustJPhysiotherv45i4Ritchie.pdf
Sackett, D. L., Richardson, W. S., Rosenberg, W. and Haynes, R. B. (1997)Evidence-based Medicine: How to practice and teach EBM. New York:
Churchill Livingstone.
Simmons, L., Sharma, N., Baron, J. and Pomeroy, V. M. (2008) Motor imagery
to enhance recovery after subcortical stroke: Who might benefit, daily dose,
and potential effects. Neurorehabilitation and Neural Repair, 22: pp.458 – 467.
doi:10.1177/1545968308315597
Stevens, J. A. and Phillips Stoykov, M. E. (2003) Using motor imagery in the
rehabilitation of hemiparesis. Archives of Physical Medicine and
Rehabilitation, 84: pp.1090 – 1092. doi:10.1016/S0003-9993(03)00042-X
Schulz, K. and Grimes, D. (2006) The Lancet Handbook of Essential Concepts in Clinical
Research. (Elsevier, 2006) ISBN 0-080448666
Stroke Association (2011)
http://www.stroke.org.uk/media_centre/facts_and_figures/index.html
(Accessed online 9 March 2011)
Timmermans, S. and Mauck, A. (2005) “The promises and pitfalls of evidence
–based medicine”. Health Aff (Millwood) 24 (1): pp.18-28
Trisha Greenhalgh. (1997) How to read a paper: Papers that summarise other
papers (systematic reviews and meta-analyses) BMJ 315: pp.672-675
Available from: http://www.bmj.com/content/315/7109/672.full
World Health Organization (2010)
Workshop report on Stroke surveillance in India. World Health Organization.
New Delhi. Available: http://www.whoindia.org/
World Health Organization MONICA Project (1988) (monitoring trends and
determinants in cardiovascular disease): a major international collaboration.
WHO MONICA Project Principal Investigators. J Clin Epidemiol 41(2): pp.105 – 114.
8/3/2019 FIRST STEP TO RESEARCH
http://slidepdf.com/reader/full/first-step-to-research 22/23
| VN Mummadisetty | Page | 22 |
Walsh, M. and Wigen, L. (2003) Introduction to research: Foundation in
nursing health care. Publisher: Nelson thornes. ISBN 0748771182
Wooley, C. (2009) Meeting the mixed methods challenge of Integration in a
sociological study of structure and agency. Journal of mixed methods 3(1):
pp.7 – 25.
Yoo, E., Park, E. and Chung, B. (2001) Mental practice effect on line-tracing
accuracy in persons with hemiparetic stroke: A preliminary study. Archives of
Physical Medicine and Rehabilitation, 82: pp.1213 – 1218. doi:10.1053/apmr.
2001.25095
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Appendix 1:
As illustrated in the JBI model evidence generation that includes
discourse, experience and research (of any methodology) precedes evidence
synthesis (systematic review). It follows then that JBI reviews address
questions by systematically examining evidence that may include discourse,
experience or research.
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