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The research comparison of effects eccentric training

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This essay will analyze the research comparison of effects eccentric training, eccentric – concentric training and eccentric – concentric training combined with an isometric contraction in the treatment of lateral elbow tendinopathy by Dimitrios Stasinopoulos and Ioannis Stasinopoulos.

The title was not long in length, this is a positive as it can draw in the attention of the reader (Litwak, 1996). It is important in drawing in the attention of the reader, so they have an understanding in regards to what the research will entail. Furthermore, this works in association with the title succinctly referring to what the research would be about, therefore they can comprehend if the research would be of relevance to them (Paiva, Lima and Paiva, 2012).

An abstract has a purpose of giving the reader a summary of the different subheadings, for example, the method, results, and conclusions (Andrade, 2011) this was effectively done by the researchers. This is imperative in allowing the readers to easily conclude what the research consists of. On the other hand, there were defects made present, the statement of further research being required can suggest to a reader there is no significance in the findings due to the importance behind the statement being made.

An aim was made prevalent in the introduction. This is key in investigating variables (Barrass, 1978), therefore there is a direct approach demonstrated by the researchers to the readers. This can provide the readers with confidence that the researchers have a direction they are heading towards.

Reference was made to the research conducted by other researchers. This is important as it shows the previous work that researchers had done and how they can have an impact on the researcher’s current work (Kennett, 2014). A case study is a comprehensive account of a single individual (Thomas, 2016), however, the issue that can be noticed is that the case of a single individual can not equate to everybody else in the population, thus there is a decreased population validity (Shuttleworth, 2009). Furthermore, a pilot study is smaller studies which take place *add ref* which allow the researchers to identify any mistakes that were made and allow the mistakes to be rectified (Leon, Davis and Kraemer, 2011). This would be beneficial for the researchers because there would be a lower likelihood of flaws, they would have the knowledge and know not to make the same mistakes in their research; as it would reduce the research being credible.

Additionally, there was an objective provided as to why the research was carried out, this was because there was no previous research which had compared the effectiveness of exercise programmes in relation to managing lateral elbow tendinopathy. This is vital as it demonstrates other researchers have investigated in similar areas (Brian Haynes, 2006) but also, it indicates how previous research can be taken into consideration and implemented into ongoing research (Agnoli, n.d.).

A parallel group design was used involving a randomized monocentric trial; it can be analyzed that participants were assigned to a treatment based on the random allocation. (Stasinopoulos and Stasinopoulos, 2016). This is advantageous because a random allocation reduces the chances of bias being involved (Pannucci and Wilkins, 2011); simultaneously whilst reducing the chances of order effects occurring for example being fatigued or exhibiting signs of boredom causing false conclusions to be drawn.

An independent variable alongside a dependent variable was not provided. Such variables should be evident within research (Babbie, 2008). This is because the readers would find it challenging in order to understand what is being changed and measured. The mentioning of variables should allow the reader to easily understand the approach the researchers are trying to take. As this does not occur it can be noted that fundamental aspects of research are being ignored, therefore it decreases the validity of the research.

As this research was conducted in Greece, the assumption can be drawn that a majority, if not all of the participants are from that country. This is a limiting factor, as the research, it can be argued that there is decreased population validity; due to the results being limited to those within the sample (Houser, 1998). Additionally, the results may not be replicable in another country (Kirk and Miller, 2005), therefore this reduces the reliability of the research.

No details were provided in relation to the participants, for example, the researchers did not state the sex of the participants and their occupations. This is a weakness of the study as a gender may be more susceptible to lateral elbow tendinopathy (Woo, Renstr?m, and Arnoczky, 2007). Moreover, occupations may be a direct influence of developing lateral elbow tendinopathy, for example using a job where the wrist is excessively used, therefore specific details should be provided as a relationship can be acknowledged and taken into consideration. As a specific gender or occupation is more susceptible to it this would affect the overall validity of the research.

It was publicised in the results section that the participants were amateur tennis players. It can be argued that the results may not be applicable to individuals who differ to tennis players. As such the findings are limited to those the participants of the study. Therefore, a diminishing the overall external validity of this piece of research (Trochim, Donnelly and Arora, 2016). Furthermore, a small sample size of 34 participants was illustrated. This is problematic as the participants were split into three groups, which means that the subjects could not have been evenly distributed into the groups. The findings of the research cannot be generalized and lack validity and reliability as the size of the sample was too small (Walliman, Donnelly and Arora, 2015); 34 tennis players are not reflective of the general population.

The measurement tools used in the research was the visual analog scale, to measure pain and function was also measured using pain-free grip strength. The visual analog scale is subjective as people have differing levels of pain tolerance, as such to conclusively state that the findings would be relevant to everyone due to individual’s experiences of pain is not particularly good research being conducted. Therefore, because of its subjective nature has lower population validity (Yang and Tsui, 2002). On the other hand, it is a scale which is commonly used throughout research, so it can be argued that it does have benefits and is an appropriate scale to be applied (Bijur, Silver and Gallagher, 2001).

Pain-free grip strength was another measurement tool applied by the researchers. It was a valid tool to use because it is also highly recognized in research *add ref.* Throughout the research, the participants had carried it out three times whilst having a one-minute rest between each attempt *add ref*. This reinforces the idea of the measurement tool being well known but also it indicates there was a good valid thought process behind the reasoning why the researchers had done it. Henceforth it highlights clinical justification as to why it was used; as such it can be demonstrated that due to the clinical reasoning there is credibility in the research and the findings.

Insufficient details were given as to why the researchers had carried out specific things, for example, 3 reps of 15. The minute details provided can leave the reader in confusion as vital aspects of research are not being explained; henceforth through this, it can disengage a reader *add ref.* This further reinstates that the research can have reduced validity but also it can have reduced credibility.

Finally, informed consent was given by the participants. this demonstrates that the research met ethical guidelines, henceforth it is deemed ethically appropriate and can expand its credibility. *add ref* In turn, if research was to have further credibility more researchers would be interested in it but also it would allow the reader to appreciate that harm in no format, for example, mental or physical harm, was caused to the participants *add ref*. Acknowledging that harm was not caused to the participants allows the research to be accepted by the wider public. *add ref*

Results: An error noticed in the research was there was no hypothesis stated. A hypothesis is a statement which predicts a connection between variables *add ref* nonetheless the elimination of a hypothesis results in no guidance of research being given to the readers. *add ref* Therefore, in doing so, the readers are left dubious with the research; potentially disengaging them *add ref.*

The researchers carried out a paired t-test which is a statistical test. This choice of test is appropriate as it allows the researchers to draw comparisons between their sets of data *add ref*; the comparisons were drawn between post-treatment improvements as well as the pre-treatment baseline. Concluding that the t-test satisfies the criteria of what it proposed to do. The paired t-test works in conjunction with the significance level of 0.05 and the p-value of .0005.

The p-value must be equal to the significance level of 0.05 or less than it. In doing so it would allow the researchers to bring about the conclusion that there is a statistically significant result *add red*. Theoretically, it is a significant result yet on the other hand due to no identification of a hypothesis it can be summarised that neither a null or experimental hypothesis is accepted or rejected. In turn, the findings of the research can have a lower validity whereby its acceptance from the public is diminished. *add ref.* A significance level of 0.05 is widely used in research *add ref* that does not highly sensitive due to carrying the possibility of causing mortality. Sensitive research must be equal to or lower than 0.01 to be classified as significant data. *add ref.*

Gender bias was perceived within this research; this was primarily down to the treatment groups containing more females than males, therefore one gender is not adequately embodied *add ref.* Moreover, the findings of the results have reduced population validity which means that the results may not necessarily reflect the general population *add ref.*

Discussion: A definitive statement asserting the requirement of further research was highlighted by the researcher. This was illustrated when researchers had said future well-designed studies were needed to confirm the results of the current trial. Such a statement best exemplifies the uncertainty the researchers have in their own findings. *Add ref* Thus, the uncertainty can transfer to the readers whereby they can begin to doubt the findings also. Additionally, it demonstrates the researchers believe their work is of a low standard. *add ref*

A positive within the research was the identification of limitations. This can be analyzed as positive because the limitations need to be taken into consideration when the results are summarised, as these limitations may indirectly affect the findings. *add ref.* henceforth it would reduce the overall validity of the results. Moreover, if there is recognition of the limitations future researchers can make adjustments and in doing so, there would be more credibility in the research.

The most significant, result was revealed. Showing the most important result is crucial as the reader can apprehend there were significant differences between the treatment groups and through research this was the most fundamental. Through this, it makes it easier for the reader to identify such a result. *add ref*

In conclusion, because of the main points identified for example the requirement of more research indicates that the findings should not be implemented and used by practicing physiotherapists. On the other hand, if there was more credibility within the findings with a reduced number of flaws the findings could be used.

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