Evidence and Nursing Practice - Assignment Example

? Research, Evidence and Nursing Practice Key Words: Aerobic Exercises or strengthening exercises, Knee Osteoarthritis – OA, NSAIDs, Pain, Joint, (1) Hinman, R. S., Bennell, K. L., Crossley, K. M. & McConnell, J. (2003). Immediate effects of adhesive tape on pain and disability in individuals with knee osteoarthritis. Rheumatology, 42, 865–869. DOI:10.1093/rheumatology/keg233. Level of Evidence (NHMRC Level III) (2) In this study spearheaded by Hinman from School of Health Sciences, University of Melbourne sought to ascertain effects of two knee-taping techniques on pain and observed disability among the chronic knee OA victims (Hinman, Bennell, Crossley & McConnell, 2003). Conditions used to make comparisons included untapped, therapeutic taping protocol and neutral taping protocol. (3) Authors utilized within-subjects study design, which entailed subjecting 18 participants to the three conditions at random coupled with assessing pain and observed disability. (4) Research’s scope encompassed assessing the extent of pain in each case and disability whereby the latter comprised of hindrance to the necessary knee mobility. Knee’s mobility tests used were walking speed, stepping ability, rising time and go tests. (5) Research’s content avails adequate information helpful in managing Maude’s predicament, which in this case entails reducing pain. Therefore, therapeutic taping will be of great help to her not only through reducing pain but also in preventing knee’s swelling. (6) Limitations in this study embrace “carryover effects”, use of small cohort and inadequate interval period between the tests. (7) The study concluded therapeutic taping was inexpensive strategy compared to numerous approaches used in managing of knee OA. Justification (8) The study offers adequate information regarding managing of knee pain and disability (Hinman, Bennell, Crossley & McConnell, 2003). In quest to avail reliable and valid literature meant to manage Knee OA, the study incorporated concepts from other researchers that have undertaken similar tests. Hence, ensuring each argument has a strong backing despite the mode of study lacking adequate interval time from one test to another. The article also compares its remedies with other approaches used in treating and managing knee OA whereby the researchers conclude both Therapeutic knee tape and neutral tape are cheaper. The other reason considered in selecting this article was its inexpensive remedy strategy aimed at reducing pain, whereby the people irrespective of their status can adequately afford. Therefore, its contribution in the medical field will encompass equipping medical personnel with adequate knowledge concerning varied and cheaper ways, which they will advise their patients to embrace. This is especially in managing Knee OA among the victims whereby with necessary training ailing people can adequately execute therapeutic taping in their homes. This will reduce high chances of disability commonly associated with Knee OA especially among the old people who in most cases tend to prefer sedentary life like in Maude’s case. Therefore, practitioners after advocating therapeutic taping to the people with Knee OA will compel them to be active through their relatives, hence reduce numerous chances of disability observed among people taking medicinal approaches. This is an essential intervention, which practitioners can combine with medicinal approaches in reducing pain experienced by Maude. In addition, despite the authors in this article citing certain limitations that may hinder effective testing under each condition, its analysis is meticulous. This is evident in the already analyzed tests and clear presentation of statistical data in form of tables and graphs bearing evidences of diverse remedies’ outcomes under study. (1) Roddy, E., Zhang, W. & Doharty, M. (2005). Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic Review. Annals of the Rheumatic Diseases, 64. 544- 548. DOI: 10.1136/ard.2004.028746. Level of Evidence (NHMRC Level I) (2) Roddy, Zhang and Doharty (2005) in this research compare effectiveness of aerobic walking and strengthening exercises in managing pain experienced by people having knee OA. (3) Authors reviewed RCTs involving subjects with knee osteoarthritis with the intention of comparing aerobic walking or home based quadriceps-strengthening exercise with a non-exercise control group (Roddy, Zhang & Doharty, 2005). 35 RCTs of exercise therapy for knee osteoarthritis were identified and evaluation the study utilized 13 RCTs, which had the necessary information (Roddy, Zhang & Doharty, 2005). (4) Systematic review focussed on evaluating effectiveness of aerobic walking and strengthening exercises therapy for knee osteoarthritis intended to reduce knee pain and disability (Roddy, Zhang & Doharty, 2005). (5) Information relayed by this study is helpful in managing Maude’s predicament. Since, its argument relies on excellent and reviewed sources about knee OA. Hence, offering essential information besides highlighting NSAIDs intervention as one of the inclusion criterion considered in this study. (6) Inadequacies cited in this study were, small RCTs number for aerobic and exclusion of other three strengthening RCTs’ articles, which failed to meet the set criterion due to unsuitable data (Roddy, Zhang & Doharty, 2005). (7) Authors concluded both aerobic walking and quadriceps strengthening were effective in managing knee OA though the study entails further research (Roddy, Zhang & Doharty, 2005). Justification (8) The reason for selecting this article was due to its content, which not only addresses Aerobic walking and strengthening exercises but also other medicinal approaches intended to manage knee OA (Roddy, Zhang & Doharty, 2005). For instance, authors in their evaluation and assessment before the inception of this study considered including NSAIDs. This was among other essential interventions deemed by reviewers would greatly augment the effectiveness of both Aerobic walking and strengthening exercises. Hence, aligning well with the Maude’s case whereby practitioners can also apply one of the two approaches and NSAIDs in reducing pain experienced by OA victims. This is because Maude’s case besides being old person who is overweight, she may sometimes require combination of NSAIDs intervention whereby the latter is an excellent medicinal approach (Roddy, Zhang & Doharty, 2005). Aerobic walking or strengthening exercise approach besides medicinal approaches is the best technique in managing knee OA predicament, which people like Maude can rely on especially if they can adequately keep up with physical activities (Roddy, Zhang & Doharty, 2005). Since, this is the only way besides other numerous medicinal approaches, which can help the OA victims to manage their predicaments adequately without incurring any expenses. The study’s strategy of incorporating varied RCTs data makes its information is reliable. Other interventions that can be of much help in managing Maude’s predicament besides exercises embrace medicinal approaches as cited by this study. However, the applications of these approaches best suits people whereby their conditions encompass observed disabilities. Therefore, practitioners advocating either aerobic walking or strengthening exercises to them initially may pose a challenge and end up not getting any necessary help. For instance, in the case of Maude who is overweight in advocating aerobic walking will entail extra caution initially but as she progress well the intervention may be of good help. (1) Towheed, T. E., Maxwell. L., Judd. M. G, Catton, M., Hochberg, M. C. & Wells, G. (2006). Acetaminophen for osteoarthritis. Cochrane Database System Review, 25(1):CD004257. Level of Evidence (NHMRC Level I) (2) This study led by Towheed from Department of Medicine, Queen's University sought to ascertain the effectiveness of pharmacological therapy (Acetaminophen) in managing OA. (3) Study’s aim was to compare the efficacy of Acetaminophen against placebo and NSAIDs, whereby the latter to date numerous practitioners as well as scientists cite to be the most effective drug available. Data collection in this study encompassed reviewing numerous researches done by other researchers in the same field but utilized RCTs in analyzing outcomes as the sole design (Towheed et al., 2006). (4) The study focussed on attaining adequate and valid information concerning the effectiveness of Acetaminophen as presented by varied researchers using RCTs approach. Hence, analyze data using tables with the intention of determining their respective strengths. (5) Information relayed in this study offers insight regarding how to manage OA using pharmacological approach (Towheed et al., 2006). This is extremely helpful in addressing Maude’s case whereby she is an old person and might not be in a position of undertaking physical exercises on daily basis. (6) Limitation cited in this study was inadequate information regarding respective applications of Acetaminophen and NSAIDs when prescribing medication to a particular patient. Therefore, practitioners ought to conduct further studies coupled with relying on their knowledge advocating these remedies (7) In conclusion, authors in this study cite NSAIDs medications to date are superior compared to acetaminophen in managing either knee or Knee OA. Justification (8) This article relays valid and adequate information concerning management of Knee or hip OA by using pharmacological therapy. This is via obtaining reliable information from rich sources authored by highly reputable researchers who have specialized in this field (Towheed et al., 2006). Therefore, this avails reliable information regarding effective alternative remedy meant to treat and manage OA especially among the ailing people. This is because many people at Maude’s age are not active and tend to prefer sedentary lifestyle, whereby prescribing pharmacological therapy will be of great help to them. In addition, most of the physical exercise therapies advocated by practitioners may prove detrimental to the old people due to some experiencing health complications complexities, which are hindrance to them. The study’s confirmation regarding effectiveness of NSAIDs, which is still evident to date makes it easy for practitioners to prescribe them to patients. This is evident in the study whereby Acetaminophen efficacy cannot equal that of NSAIDs despite cited as being excellent in managing knee OA (Towheed et al., 2006). Therefore, this implies in administering pharmacological therapies to the knee or hip OA victims, practitioners should consider Acetaminophen despite numerous sources to date citing NSAIDs being the best. In the medical field, this article’s analysis will act as an added knowledge to the medical practitioners regarding the effectiveness of NSAIDs besides other pharmacological therapies. Hence, offer numerous alternatives, which they can choose from based on the patient’s physical condition, or other maladies that may be a hindrance when prescribing a certain drug. Intervention advocated in this study acts as an alternative to NSAIDs, hence can adequately manage Maude’s predicament (Towheed et al., 2006).. This implies doctors can prescribe the two medicinal approaches interchangeably suppose Maude due to prolonged treatment her body seems to decline in responding to one of them as necessitated. References Hinman, R. S., Bennell, K. L., Crossley, K. M. & McConnell, J. (2003). Immediate effects of adhesive tape on pain and disability in individuals with knee osteoarthritis. Rheumatology, 42, 865–869. DOI:10.1093/rheumatology/keg233. Roddy, E., Zhang, W. & Doharty, M. (2005). Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic Review. Annals of the Rheumatic Diseases, 64. 544- 548. DOI: 10.1136/ard.2004.028746. Towheed, T. E., Maxwell. L., Judd. M. G, Catton, M., Hochberg, M. C. & Wells, G. (2006). Acetaminophen for osteoarthritis. Cochrane Database System Review, 25(1):CD004257. Read More