Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil. 2014;28(1):3-19.
Critically appraise the above Systematic Literature Review (SLR) based on the suggested resources and any other resources relating to scientific literature critique.
Must explain WHY an aspect of an article is good or bad. It is not sufficient to simple state that “The authors restricted their search to only articles published in English which is bad.” Must explain why this exclusion may jeopardize the results of the review.
Headings to include in your review:
1.Title of the Critique
2.Introduction to the critique
3.Critique of the article’s Introduction/Background Section
4.Critique of the article’s Methodolgy Section
5.Critique of the article’s Results Section
6.Critique of the article’s Discussion and Conclusion Sections
- Introduction to the Critique
The manner in which research is conducted, analyzed and presented is an important aspect especially coming to the 21st Century. Thus the need to categorically ensure that all requirements are handled in the research process remains the most important and fundamental element that a researcher should attain to have. This paper will therefore examine an article by Frances L Cullinane, Mark G Boocock and Fiona C Trevelyan (2014) named Is Eccentric exercise an Effective Treatment for Lateral Epicondylitis? A systematic Review and thereby give a comprehensive in-depth overview of the literature review used in the article. [i]
- Critique Of The Article’s Introduction/Background Section
In the introduction part, the authors have been able to present various aspects concerning the effectiveness of using eccentric exercise as an ideal treatment for lateral epicondylitis. For instance, the author has highlighted figures of people affected by the diseases condition as standing at 3% and thereby has adverse effects on their personal, psychosocial, and economic livelihoods.[ii] The author just also showcased the essence of using other available methods which can be used for their treatments purposes. However, the authors foaled in that they used only one electronic source as their basis for the research. Similarly, much of the information given at the introductory part was drawn from a few articles written on the causes and effects of epicondylitis.[iii]
- Critique Of The Article’s Methodology Section
In the quest for the treatment of epicondylitis, the authors used six electronic sources such as ProQuest, EBSCO, AMED, and MEDLINE among others, which were quite helpful. With these sources, the authors sought to get the appropriate research terms for conducting their studies.[iv] Here the authors failed in terms of the numbers of sources, which were mostly from the electronic sources. Indeed information from other sources would have proven to be more beneficial and add more weight on the research work. [v]
The use of randomized control studies or controlled clinical trials would have to be incorporated by other means of research methodologies since this method is known for its limitations on the external validity.[vi] Equally, the authors used only the randomized control studies in the review and ignored other sources such as observation studies, which would have reinforced the validity of the method in the end. The use of RCTs also not only makes it hard for studying rare events such as the epicondylitis aspect but also make it extraneous in studying outcomes in the distant future.
- Critique Of The Article’s Results Section
The use of the flowchart in presenting the findings of the report is an effective aspect, which nonetheless was systematic. Correspondingly, the fact that most of the results such as eccentric exercise programs presented in the tables was also an important element that made the comprehension of the results in an easy and well-elaborated manner. Questionnaires were also used for the purposes of ensuring the function and the disability levels are presented in a table format.
The authors used employed the use of grouping the intervention and treatment into four categories for one to comprehensively understand the different diagnosis presented by the findings[vii]. For instance, category one introduced the isolation of eccentric exercise programs which they included first therapies as suggested by the authors. In this regard, the study failed to show comprehensively the effectiveness of using exercises as a way in which epicondylitis can be treated through exercises. In addition to that the study failed to prove any greater benefits which can be achieved through exercise for patients who are suffering from lateral epicondylitis in trying to relieve their pain.
Further to that, both the low-quality study and the high-quality study offered below and insignificant results which would have facilitated in getting the treatment for the epicondylitis.[viii] The results listed in the low- quality study for instance showed that even with the use of the eccentric exercise programs, the pain relieving among the patients was not reduced. As shown in the low-quality study (Cochrane Musculoskeletal Injuries Group Score of 20 out of 26) and the low quality study (Cochrane Musculoskeletal Injuries Group Score of 12 out of 26).
- Critique Of The Article’s Discussion And Conclusion Sections
The discussion part of any research conducted forms an integral part which should be well researched with an in-depth analysis of the results and main points of the project.[ix] Here the authors stated presenting the opening statement by acknowledging that indeed, patients who underwent the eccentric exercise program showed major improvements in terms of their illness. For instance they had less pain, improved grip as compared to their baseline measures. [x]
The indication that seven out of nine studies showing improvements of the effects of the epicondylitis condition gives the studies a lot of reliability and strength as being quite factual. The authors in this case presented a clear and more comprehensive detail as to how the effects of the epicondylitis condition. Indeed, some of the results reached in this reach have been consistent with another similar results carried out by Woodley et al which found insignificant results reached on using eccentric exercises as a form of treatment for this condition.
The comparison of different studies carried out on a similar investigative research projects is an effective way in which a deeper insight in the particular project can be well understood. It is for this case that it has been able to compare with Woodley et al. where the findings proved insignificants. However, in other studies such as those conducted by Raman et al, there were moderate significant claims that proved the eccentric exercise could work for such patients.
Within the discussion part, some of the weaknesses in the methodological stage were also evident as can be seen in the RCT approach. Here, it was clear that lack of blinding participants as well as the treatment for the providers. This aspect was also acknowledged as being a challenge towards such studies resulting to inaccurate results.[xi] Other aspects that failed to be met include the lack of reporting of intended policies and a deeper adherence towards exercises programs.
Although the study was able to show a great improvement in the use of eccentric measures for treating epicondylitis, it failed to show the measurement which can be taken for the same to be achieved. [xii]Similarly the texts selected information from just English sources as other studies have been carried out in other parts of the world that would have added more worth towards the arrival of results. [xiii]Similarly, the terminologies used in this context have not been well explained and have difficulty of some of the jargons employed by the authors.
The use a systematic literature approach towards this text is a vital part in criticizing the texts in terms of the application of the literatures used and its effectiveness[xiv]. Scientific literature is an important area in the discipline of scholarly and thus should be comprehensively evaluated to ensure that it meets the target needs in terms of the introduction, methodologies and discussions of the reached results in a comprehensible manner.
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