What type of research design is used in this study? Please, explain.

Procedures

Patients with signed consent forms from caregivers, who were mobile with a diagnosis of dementia and were residing in a locked unit, were selected to participate in this study. Participants were administered a pretest while sitting in the common room in the unit where they ate their meals and participated in most recreation activities. This test was administered between 1 and 3 times based on the availability of the patient. The test was read and administered 20 minutes later to evaluate whether the passing of time alone changed the patients' answers. The initial administration included asking the patient about the color of an object and the identity of an object. The second administration repeated the same questions but included different colors or objects. For example, in the first round, a patient may have been asked to identify the color blue and then a banana, and in the second administration the color brown and then an apple. The inclusion of only 2 questions was necessary to avoid any passage of time factors, as the patient's ability to focus was extremely limited, especially prior to group participation. 

Participants also participated in seated movement therapy groups. The number of groups varied between 1 and 10, depending on the patients' availability on the day and time of the group. Patient availability was not reliable as their proneness to wandering or to "bad days" was unpredictable and it was against hospital policy for groups to be mandatory. Prior to the start of the group and at the end of the group a recreation therapist, certified nursing assistant, or nurse who was not in the room for the group asked each participant the same questions as mentioned previously. The group included activities designed to provide the patient with body orientation and spatial awareness with the intention of increased mental organization. An outline of the 20- to 30-minute session is broken down in Table 1. The group was designed on the basis of standard movement therapy work with patients with dementia. The session included the same format for every administration.

Analysis

Analysis was carried out using the Statistical Package for the Social Sciences version 11.0. Correlational analyses were conducted to rule out the possibility that the variance in the number of times each member received the test or attended a group could affect his or her ability to identify objects or colors. A repeated measures t test was calculated to measure the impact of the movement intervention versus no intervention.

Results

Correlational analysis indicated that the number of sessions did not significantly relate to the participants' ability to identify objects or colors. T tests indicated that there was a statistically significant increase in participants' ability to identify objects correctly when comparing
scores from the time lapse testing (M = -0.09, SD = 0.19) to scores from the movement intervention testing, M = 0.25, SD = 0.38, t (14) = -3.47, P = .005,  n2- 0.46.There was also a statistically significant increase in participants' abilities to identify colors correctly when comparing scores from the time lapse testing (M = -0.08,SD = 0.30) to scores from the movement intervention testing, M = 0.35, SD = 0.36, t (14) = -3.78, P = .005, n2 = 0.51.The n2 statistic for both items indicated a large effect size, suggesting a considerable difference in the scores. The control pretests were generally higher than those participating in movement groups. This may be a result of the inclusion of several patients who were slightly more verbal and refused to attend groups.

DISCUSSION

The results for this study indicate that the specialized movement therapy program has the ability to provide immediate acute effects on memory recall of patients with late-stage AD. After 20 minutes of movement therapy, participants appeared more organized in their speech abilities. This is consistent with Diesfeldt and Diesfeldt-Groenendijk's research focused on midlevel functioning AD patients.

Perhaps the difference in results between the current study and Diesfeldt's versus Sobel's, which did not register an increase in word recognition and retrieval after participation in physical activities, is in the severity of patients with AD. The participants in the current study were in the last stages of AD, whereas Sobel's participants were in the early stages of AD; this study's participants could not have completed the cognitive tests administered to Sobel's participants. The type of program may also be a factor in the differences. Sobel's exercise program included walking or leg and arm exercises, whereas movement therapy utilizes purposeful movement intended to help organize a patient mentally through the use of movement rather than exercise physically.

This is an important finding as it suggests that some forms of physical activity—in this case movement therapy—can help mentally organize patients with AD as severe as those in the late stage of dementia in which they often have limited to no speech.
This is an important finding as it suggests that some forms of physical activity—in this case movement therapy—can help mentally organize patients with AD as severe as those in the late stage of dementia in which they often have limited to no speech.

One limitation of this study, as with the exercise studies referenced earlier, is the small number of participants due to the limited number of residents on this particular dementia unit. Future research should include a larger number of participants from various residents in the hope of gaining additional subgroup comparisons. For example, the small sample size prevented the examination of possible medicinal effects. Future research should also investigate the duration of the increased object and color recall following the movement session. Furthermore, future research should include a more comprehensive cognitive assessment before and after movement sessions.