Think of a problem in exercise science that can be addressed through evidence-based practice. Develop a question in the EBP style that will accurately address the problem. Then, use the tools mentioned in this week’s lesson to research your topic. Include at least 5 links to research papers on your topic. Write an opening statement, a Background statement, and a Search Strategy for your case study.
Develop a fictional case study in the style of the case studies presented in chapters 12 through 15 of your textbook. Be sure to save your assignment in a safe place on your computer to build upon for next week’s lesson.
Text Book: Evidence Based Practice Exercise Science
Lecture Notes Week 3
Developing a question and searching for evidence
Throughout the remainder of this course, we will be examining the six specific steps that we have identified in the research process. To refresh, the six steps are: developing a question, searching for evidence, evaluating the evidence, incorporating evidence into practice, confirming the evidence in the individual, and reevaluating the evidence.
To start, let’s learn about developing a good question. As an exercise practitioner, there are probably three main areas of interest that you would want to ask questions about: program interventions or exercise techniques, testing techniques, and economics.
The most common questions exercise practitioners have are around program interventions and exercise techniques. Think about times when you have practiced as a personal trainer. How do you know how many reps to assign to your client for a particular exercise? What exercises should you prescribe? An example of a good question in this area is: “Is high-intensity interval training more effective than steady-state aerobic conditioning to improve peak aerobic capacity in healthy young individuals?”
Another important question development area involves your testing techniques. When you evaluate a client’s baseline physical fitness, what questions should you ask? If your client is a senior and has a goal of climbing a flight of stairs, your assessment should include tests shown to predict stair climbing. The better your initial testing questions, the better you will be able to formulate effective interventions.
Finally, economics play an important role in question development. We might think that the most effective interventions should be used in each case, but in reality economics will often be an important deciding factor for many individuals. Questions around economics should be developed carefully so that the best interest of the client is still the most important concern.
Questions are generally thought of in two ways in the exercise-science literature: background questions and foreground questions. Background questions are broad and often used to obtain general information on a subject. These questions do not focus on the treatment or the effectiveness of an intervention. Instead, they serve to provide the practitioner with background on the given subject. An example of a good background question might be: “What is aerobic exercise?” or “What are the consequences of a sedentary lifestyle?”
Foreground or direct questions address a focused aspect of treatment, intervention, or testing (Amonette, English, & Ottenbacher, 2010). The answers to foreground questions should lead to a quantifiable component and decision. Good examples of foreground questions might include: “In seniors with osteoporosis, is resistance training more effective than aerobic training to reduce inflammation over a 10 week treatment period?” The answer to this question is quantifiable and will lead the practitioner to a specific intervention.
Good foreground questions include a standardized set of components known as PICO-T, which is an acronym for Population, Intervention, Comparison, Outcome, and Time. The question we asked in the previous slide contained each of these components. To begin, we defined the population as “seniors with osteoporosis”. You should try to be as specific as possible with your population, including only the relevant portions. In this case, we are interested in results from both men and women, but sometimes you might want to only include one or the other. The point is to clearly define the population you are asking the question about as specifically as possible.
A foreground question should include the nature of the intervention that you are investigating as well as a comparison of interventions. In our example, we are attempting to compare the effectiveness of resistance training versus aerobic training within our population. We must also list the desired outcome, in this case, the outcome is to reduce inflammation. Finally, your question should denote a finite and realistic time period. In our example, we want to see which type of exercise is more effective over a 10 week period.
Once we have determined a good question, we can begin searching for evidence to help us answer our question. As you can imagine, research has been performed on a number of important exercise topics, so your first step should be to search for published papers that might have already answered your question. Textbooks are excellent sources of information to answer questions involving basic physiology or training practice. Textbooks are generally well-respected, but can lack detail and can reduce subtle aspects to generalities. Experts can provide another source of valuable information, but expertise can vary wildly and is prone to bias.
By far the best sources of exercise science research are peer-reviewed research papers. Finding relevant research papers is significantly easier now with access to the Internet. Several searchable databases of exercise science research papers are publicly available. PubMed provides public access to the Medline database, which is the most comprehensive database of medical journals. Google Scholar is a database containing peer-reviewed papers and contains links to many free online journals, including government reports. SPORTDiscus is specifically geared towards exercise and sport science, but requires a paid subscription. Other databases exist as well, such as CINAHL, popular in nursing, Web of Science, and the Cochrane Library.
An important aspect of searching for evidence is how to perform a good search. The primary technique used in searches is with keywords. Searching for the most relevant keywords will yield the most relevant results. Most journals include a list of 5-10 keywords to facilitate others searching their databases. General keywords such as “strength training” will yield thousands of results and will realistically be unmanageable. To narrow down your choices, you should include additional keywords that are more specific to your question. In the example we have been using, your list of keywords might include: seniors, osteoporosis, strength training, and aerobic training. This should narrow down the list of results to a manageable level and provide you with the most relevant research papers available.
PubMed uses a keyword system called MeSH, or Medical Subject Headings. MeSH provides researchers with a standardized set of keywords to attach to their papers. This is different from traditional keywords that the author makes up. MeSH currently includes over 27,000 terms. Luckily, if you type a keyword into PubMed, the search bar will provide a list of suggested MeSH terms to help you along. For example, typing “strength” will reveal MeSH terms like “strength training”, “muscle strength” and “strength testing”. You can also specifically search for clinical studies.
If you’ve ever watched a video on YouTube, you’ve probably noticed that the site recommends other similar videos. In much the same way, PubMed will recommend similar articles to the one you are currently viewing. They call this feature cross-listing, and can be invaluable when looking for multiple sources of information.
Finally, we discussed previously that a well-written research paper includes a references section at the end, listing the secondary sources the researcher used during the study. These reference lists are there for a reason, and provide you with another source to explore when attempting to answer your question.
Systematic reviews are special types of research papers that collate information from a variety of other research papers. If you are able to find a good systematic review of the subject you are studying, it will provide you with a number of relevant research papers to draw from.