BACHELOR OF PHYSIOTHERAPY (HONS)

RESEARCH METHODS-II: WRITING

PROJECT PROPOSAL (PTRM 6313)
YEAR 3 SEMESTER 1
A STUDY ON THE CORRELATION
BETWEEN THE BODY MASS INDEX AND
PHYSICAL FITNESS AMONG ADULTS

DIVHYA SELVAN
( BPHP 20046604 )
AUGUST 2021

1
 ACKNOWLEDGEMENTS

First of all, I am grateful to The Almighty God for establishing me to start this

research. I wish to express my sincere and gratitude to Dr Mahendran , my

supervisor at Mahsa University. He provided critical assistance along the process

and always ready to help.

Furthermore, special appreciation goes to the Head of Physiotherapy, Faculty

of Health Sciences, Mahsa University for giving me opportunity

I take this opportunity to express gratitude to all of the Department faculty

members for their help and support.

Lastly, I would like to thank my family especially my parent, Mr & Mrs Selvan

for supporting me morally and spiritually throughout this venture.

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 TABLE OF CONTENTS

Chapter Topics Page

1 Introduction and Literature Review

1.0 Introduction 4
1.1 Literature Review 7
1.2 Research Objectives or/ and Objectives 9
2 Research Methodology
2.0 Research Approach and Design 10
2.1 Sampling 10
2.1.1 Sampling Frame 10
2.1.2 Sampling Design and Sample Size Calculation 10
2.1.3 Group Allocation 12
2.2 Ethical Considerations 13
2.3 Research Instruments 13
2.3.1 Primary Research Instrument/s 13
2.3.2 Secondary Research Instrument/s 14
2.4 Data Gathering Procedure 14
2.4.1 Preparation Phase 14
2.4.2 Implementation Phase 15
2.4.2 Data Collection Phase 16
2.5 Data Analysis 16
2.6 Resources and Timeline 16
2.7 Delimitations of the Study 17
3 Conclusion
3.1 Summary 19
3.2 Practice Implications 19
3.3 Recommendations 20

References

Appendices
Appendix 1 – Information Sheet 24
Appendix 2 – Consent Form 25
Appendix 3 – Data Collection Table 26
Appendix 4 – Table of Resources 27
Appendix 5 – Task Analysis 28
Appendix 6 – Gantt Table 29

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 CHAPTER 1

INTRODUCTION AND LITREATURE

The popularity of overweight and obesity from adolescence into adulthood are

inclining in both developing and developed countries. It is not surprising to state that

at least 2.8 million people die each year due to obesity which is the fifth most

significant preventable cause of deaths worldwide (Nizar, Tin, Vincent and Wee,

2015). The National Health Morbidity Survey indicated that in adults, 20.7% were

overweight and 5.8% obese (0.3% had BMI >40.0 kg m–2, respectively); the

prevalence of obesity was considerably higher with women than men. Obesity and

overweight is a serious problem throughout the world; hence, early prevention of this

condition is an important strategy for curbing the epidemic.

Recent studies have shown that obesity and overweight are an important

concern for the public health of 1/3 of adults classified as living with obesity in

the USA and are associated with the decrease in cardiometabolic comorbidity.

(Niemiro GM, Algotar AM. , 2019 ) Obesity is characterized by elevated of fatty

tissue in the body as a result of eating more food than is required for energy.

Obesity and overweight is a critical illness which can lead to other major

problems such as heart disease , blood pressure , high

cholesterol ,atherosclerosis , metabolic syndrome and sleep disorders . Obesity

and overweight can be caused by various reasons. Energy imbalance , some

genetic and underlying medical that increase the chances of overweight and

obesity such as hypothyroidism , Cushing’s syndrome and tumours.

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The body mass index is currently the most extensively used tool to evaluate

obesity.( Arch Intern Med. 2007) The WHO formed an Expert Consultation Group in

1993 with the intention of defining standardized BMI classifications. Four categories

were created which is underweight, normal, overweight, and obese. If a person's BMI

is in the range is below 18.5 , he or she is considered underweight , if the BMI is 18.5

to 24.9 will be normal weight , overweight will be between 25 to 29.9 and those are

30 and greater will be considered obese. ( Garrow JS , Webster J. 2009) .

In South East Asia Malaysia has the highest rate of adult obesity. ( Kasirye F.,

Wahid N., 2020) Obesity is on the rise among Malaysian adult which result in

19.7% . Institute for Public Health stated obesity among individuals in Selangor

increased at an alarming pace between 2011 and 2019 . National Health and

Morbidity Survey States that Sabah , Pulau Pinang and Perlis showed the lowest

obesity rates (15.7%–18.6%) in compared to other Malaysian states. In Malaysia, the

prevalence of obesity among adults grew four times from 1996 to 2015, from 4.4% to

17.7%. (Lim K.G. , 2017)

Obesity has been attributed to a number of mental health issues, including low

self-esteem, depression, anxiety, stress, suicidal behavior, and poor quality of life.(

Dixon JB,2010). Increased BMI is intimately correlated to stressful life events and

stress perception. As reported by Hallal et al. , 31.1% of adults aged 15 years or

older are not physically active all over the world. Higher BMIs are linked to worse

performance in weight-bearing activities, which require moving bodyweight through

space. (Bovet P,2007) This is a significant issue because physical fitness has been

linked to enhanced health outcomes and may be more predictive of health

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outcomes. Muscle strength, vascular features, and risk factor alteration, such as

blood lipids, insulin, and blood pressure, are examples of these outcomes.. ( Ruiz

JR, Ortega FB ,2006) Physical inactivity and poor physical fitness are linked to

morbidity and mortality in adults.

1.1 LITERATURE REVIEW

Many documents have been examined for this research as supporting literature.

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In 2020 Xiaobin’s study has revealed the BMI and PFI relations were non-linear

among college students. Underweight, overweight and obese students were poorer

than normal weight students in their physical fitness index. Future, longitudinal

cohort studies are needed to properly identify causal relationships and the likely

mechanism.

Besides that , The combination of PA-fitness was stronger than OW-fitness on the

basis of linear regression models. The strongest association with PA (standardised ß

coefficients 0.31–0.49) were the set-ups, endurance shuttle runs and fitness index.

No OW test (coeefficient of 0.04) and only the ball test (coefficients of −0.10 to

−0.12) were associated with weak OW. In the end ,The OW had the worst

cardiorespiratory and muscle endurance associations as well as explosive power

assessments. (Andreas Åvitsland , 2021)

Meanwhile , Hassib Narchi (2021) stated in his study that the underweight of the

girls' bent arm hang test was associated with higher performance compring to a

regular weight . The young adults were overweight and obese, with a 20m shuttle,

bent arm hang, long jump test, but with a significant increase in grip strength

compared to their normal weights. In the end they concluded that not overweight and

obese but also underweight also a casual factor for fitness related health problems .

And lastly , there was another study conducted by Booth ( 2012) among childrens

who aged from 3 to eight years old. This study was conducted to investigate the

relationship between BMI and performance in standing broad jump and shuttle run in

7
young children whether this relationship is similiar while the age range studied . One

of the main reason to conduct this study is because the proportion of overweight

childer doubled over the last two decades in many countries . The study’s result

highly indicates hight proportional body weight was associated with less

performancein standing broad jump and shuttle run test among three to eight years

old children.

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1.2 RESEARCH OBJECTIVES AND HYPOTHESIS

1.2.1 Research Objective

 To identify the relationship between BMI and physical fitness using 20m

shuttle run

1.2.2 Research Hypothesis

 Research hypothesis

There is relationship between BMI and physical fitness level among

adults

 Null hypothesis

There is relationship between BMI and physical fitness level among

adults

CHAPTER 2

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2.0 RESEARCH METHODOLOGY

This is a comparative cross-sectional study between overweight or obese

adult and adult with normal weight of body mass index (BMI) . The independent

variables of this study will be the body mass index groups which are normal,

overweight or obese that will be determine using the WHO growth chart cut-off point

at 18 to 40 years adults. The dependent variable was the fitness level that will be

determined by using 20m shuttle run test.

In addition, this design will be convenience to target sample of adults who falls under

category of underweight , overweight and obesity in BMI. Therefore, this study will

help to acknowledge whether overweight and obesity affect the fitness level.

Each subject will receive an informed consent form (IFC) declaring that they

are prepared for the study at the beginning.

2.1 Sampling

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 2.1.1 Sampling Frame

2.1.1.1 Inclusion Criteria :

 participants age from 20 to 39

 Individual that categorized under overweight , obesity and

normal weight in BMI Categories:

Underweight = below 18.5

Normal weight = from 18.5 to 24.9

Overweight = from 25 to 29.9

Obesity = BMI of 30 or more than that( NIH , 2020)

2.1.1.2Exclusion Criteria :

 Resting HR >120 bPM , systolic blood pressure less than 180 

mmhg and diastolic pressure less than 100 mmHg ( Sophia

Giannitsi , 2019 )

 Preganant ladies

 Post hip , knee surgery - non weight bearing status

 Participant without any underlying health issues such as

unstable angina , myocardial infarction (American thoracic

society , 2016)

2.1.2 Sampling design and sample Size calculation

Due to the ease of use and the equal generality of the population,

convenience sampling was selected as a sample design. These methods will

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 be using to select subjects that represent the adult population in Selangor,

Malaysia, based on availability. Following the inclusion and exclusion criteria

subject will be chose. Consent should be established (craig Mellis, Katrina

Williams and Wei Xuan, 2002). Subject’s participation is entirely optional in

this study.

Sample size of this study whill be 200 , which is calculated using

Survey monkey . Subject will be divided into two groups , one group will

consisting overweight and obesity and another group will be consisting normal

weight adult according to BMI classification.

Acorrding to NCBI , The calculation of ample sizes is a very essential

component of each and every study. Many null studies may be

underpowered to detect the desired difference due to a smaller sample

size. The underpowered studies should be interpreted cautiously

and the ‘absence of evidence’ in these studies should not be taken as

‘evidence of absence’.

2.1.2 Group allocation

Participants that meets the inclusion and exclusion criteria will divided in

to two groups according to their BMI category

2.2 ETHICAL CONSIDERATION

Initially this study require consent from ethics approval from Mahsa

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University . Data collection will begin and participant need to sign the consent

from prior to the study . Prior to signing the consent form, the participants are told

about the objectives, research procedures and guidelines throughout the

evaluations. All participant requirements and the benefits of participation are

described in the forms of consent since there is no invasion of the subject in the

investigation. Each participant will be assured of confidentially and the option to

withdraw at any time without penalty.

2.3 RESEARCH INSTRUMENTS

2.3.1 Research primary instruments

The anthropometric data will be obtain in this study to provide essentials

for height measurement a wall mounted stadiometer(Seca Bodymeter 208,

Germany) , and a weighing scale for weight measurement (Seca, Seca 813)

Then the body mass i ndex (BMI) were calculated by participant’s weight in

kilogram divided by the square of his height in meters (kg/m2). Waist-hip

circumference were also be measured by using non- elastic measuring tape.

Body fat analyzer (Omron) were used to measure the percentage of

body fat.

2.3.2 Secondary instrument

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 20 m shuttle run is commonly used for aassess a individual’s

physical fitness level by by predicting maximum oxygen uptake (VO2max)

and performance. This test involves running between two lines that are 20

metres apart in time with recorded beeps. At first the speed will start

slow , after one minute a sound will played to notify to increase the speed.

This will be contunie each minute up to 21 levels. If the subject reach the

line before beep sound , the subject should wait for the next sound beep

before continue. If the subject unable to reach the targeteted line , a

warning will be givenand continue run to catch up with the phase. The

subject will be elimated after 2 warnings.

2.4 DATA GATHERING PROCEDURE

2.4.1 Preparation Phase

As this study will be conducted using convenient sampling

method. Whoever fits into the inclusion and exclusion criteria will

be choosen at various time . A thorough explanation regarding this

study will be given and get the consent form signed. This study will

be carried by myself a physiotherapist. After a subject has agree to

take part in this study their body measure and proportions will be

taken and will be categorized under either normal weight ,

overweight or obese according to BMI. Prior to the test , two cones

will be place at the begging and end of a 20meter. The beep sound

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 will be played and introduced to the subject for better

understanding. Ensure that the subjects are adequately warmed-

up.

2.4.2 IMPLEMATION PHASE

Once the subject understand the test ,a proper warm session

will be conducted. Subject will begin to run between two cone

which is 20m apart in time to recorded beeps. Participants take a

position behind one of the lines, facing the another  line, and start

running when the recording indicates it. At first, the pace is quite

slow.After one minnute , a sound will signifies an increase in speed

and the duration will be shorter. This will continue every one minute

as the level goes up to 21. If the subject failed to reach to the line

before the beep sound will recieve a warning and have to continue

run and must catch up with pace within two more beeps. The

subject will elimated after second warning. Subject’s result will the

level they achieve and the number of shuttles that they have

accomplished.

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 2.4.3 DATA COLLECTION PHASE

All data that have collected at the beginning of the test and

post test results will be state down in data collection form which be

used to draw a conclusion at the end of the study.

2.5 DATA ANALYSIS

The relationship of BMI to physical fitness will be analysed

using Pearson. All the collected data will be analysed using

Statistical Package for the Social Sciences (SPSS) version 12.0 .

Confidence was set at 95 percent while p value was set at less

than 0.05

2.6 RESOURCES AND TIMELINE

Relevant object and resources will be used for this study includes

internet , stationary item , printing prices will be state down as a

refference purpose.

This study roughly will take about 6months .The first month will be

used to revise proposals and obtain relevant clearances and approval

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 from Mahsa University ethical board.The study's real implementation will

be covered in the second month.The third and fourth month will be

dedicated to data gathering, preparation, and analysis, while the fifth and

sixth month will be dedicated to writing the results and presenting the final

report.

2.7 DELIMITATION OF THE STUDY

This studyis to determine relationship of Physical ftness between

normal weight , overweight and obese adults . This study may or may not

reach the aim of this study . But I believe there might be some

unavoidable limitation.

Firstly , As this study’s samples are all adults and their nature of

job and lifestyle should be taking in considaration. Some adults might live

very sedentary lifestyle and some might active in sports . Some adult’s job

nature might be based in heavy workload where it requires them prolong

walking , running or climbing stairs whereas some might work static in

desk. In this matter their stamina might be vary from one and another.

On the other side, there are limitations to the availability and

acquisition of information. The number of free journal articles and

research websites is restricted.These constraints will limit the research's

ability to obtain information and data.

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 Last but not least , due to Covid-19 pandemic might face some

problems . As need to follow the SOPs which set by goverment , subject

need to wear mask during the test . According to WHO , (2020) wearing a

mask during physical activity has a higher risk of reducing breathing

capacity . This will affect the outcome this study.

CONCLUSION

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 3.0 SUMMARY

The researchers will begin a research study by choosing a topic

that interests her and formulating a research problem through a literature

review, which will allow them to identify any potential gaps or weak points

in the previous study. The study will conduct among adults with aim of

adentifying the relationship between body weight and physical fitness.A

correlative cross sectional study and convienient sampling design.Before

participating, all subjects must sign an informed consent form. After that,

data will be gathered and sent to be statistically analysed. This research

will be conducted over a six-month period.

3.1 PRACTICE IMPLICATION

In the end if the result of this study support the hypothesis ,

there’s clearly some relatioship between body weight physical

fitness level in an individual. This study will prove that overweight

and obese cause bad for the health and can lead to severe health

issue in future. This study also will provide enough evidence and

will be help to create awareness to lead a healthy lifestyle.

3.2 RECOMMENDATION

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 In future suggest the researcher to conduct this study with

more than one fitness test . And advice to be more specific in

sampling methos sucha as take a job nature into consideration .

References

 Garrow JS, Webster J. Quetelet’s index (W/H2) as a measure of fatness.

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 Int J Obes. 2009; 9( 2): 147–153.

 Wardle J., Chida Y., Gibson E.L., Whitaker K.L., Steptoe A. Stress and

Adiposity: A Meta-Analysis of Longitudinal Studies. Obesity. 2011

 Pereira-Miranda E., Costa P.R.F., Queiroz V.A.O., Pereira-Santos M.,

Santana M.L.P. Overweight and Obesity Associated with Higher

Depression Prevalence in Adults: A Systematic Review and Meta-

Analysis. J. Am. Coll. Nutr. 2017

 Bovet P, Auguste R, Burdette H. Strong inverse association between

physical fitness and overweight in adolescents: a large school-based

survey. Int J Behav Nutr Phys Act. 2007

 Ruiz JR, Ortega FB, Meusel D, Harro M, Oja P, Sjöström M:

Cardiorespiratory fitness is associated with features of metabolic risk

factors in children. Should cardiorespiratory fitness be assessed in a

European health monitoring system? The European Youth Heart Study.

J Public Health. 2006

 Blair SN, Brodney S: Effects of physical inactivity and obesity on

morbidity and mortality: current evidence and research issues. Med Sci

Sports Exerc. 1999

 Chen, X., Cui, J., Zhang, Y. et al. The association between BMI and

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 health-related physical fitness among Chinese college students: a

cross-sectional study. BMC Public Health 20, 444 (2020)

 Andreas Åvitsland, Eva Leibinger, Elin Kolle, Tommy Haugen, Sindre M.

Dyrstad, Associations between changes in physical fitness and

psychological difficulties status among Norwegian adolescents, Mental

Health and Physical

Activity, 10.1016/j.mhpa.2021.100411, 21, (100411), (2021).

 Hassib Narchi, Afaf Alblooshi, Maisoon Altunaiji, Nawal Alali, Latifa

Alshehhi, Huda Alshehhi, Asma Almazrouei, Ahmed R.

Alsuwaidi, Abdul-Kader Souid, Prevalence of thinness and its effect on

height velocity in schoolchildren, BMC Research Notes, 10.1186/s13104-

021-05500-3, 14, 1, (2021).

 Booth, F.W.; Roberts, C.K.; Laye, M. Lack of Exercise Is a Major Cause

of Chronic Diseases. Compr. Physiol. 2012

 Malhotra RK, Indrayan A. Simple nomogram for estimating sample size

for sensitivity and specificity of medical tests. Indian J

Ophthalmol. 2010

 Sigmundová D, El Ansari W, Sigmund E, Frömel K: Secular trends: A

ten- year comparison of the amount and type of physical activity and

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 inactivity of random samples of adolescents in the Czech Republic. BMC

Public Health 2011, 11:731. doi:10.1186/1471-2458-11-731

 Teo, P. S., Nurul-fadhilah, A., Aziz, M. E., & Hills, A. P. (2014). Lifestyle

Practices and Obesity in Malaysian Adolescents, 0, 5828–5838.

http://doi.org/10.3390/ijerph110605828

 Teo, P. S., Nurul-fadhilah, A., Aziz, M. E., & Hills, A. P. (2014). Lifestyle

Practices and Obesity in Malaysian Adolescents, 0, 5828–5838.

http://doi.org/10.3390/ijerph110605828

 World Health Organization. Obesity: preventing and managing the global

epidemic. Gene`ve, Suisse: WHO; 1998.

APPENDIX - 1

INFORMATION SHEET

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Study Title :
A STUDY ON THE CORRELATION BETWEEN THE BODY MASS INDEX AND
PHYSICAL FITNESS AMONG ADULTS

Name of the Researcher : Divhya Selvan

Phone Number : 016-7015097
E-mail : [email protected]

The above study is undertaken to determine the correlation between body mass
index and physical finess and therefore we are currently looking for subjects in adults
age group who may be willing to participate in this study.

Please read the information given below carefully and if you have any further queries
or would like any additional information about the study please do not hesitate to
contact the above Physiotherapist on the telephone number or through e-mail.

What is the study about?

The aim of this study is to find out the correlation between body max index and
physical fitness. This study will be mainly focused to know whether overweight and
obese affect the health and fitness , it will be rule out using 20m shuttle run test.

What will be the role of you in this study?

Your role will be taking part in 20 m shuttle run test for once only.

Are there any risks? Does it have any side effects?

There will be no risks and any side effects from the test. The possible risk that
involves in this test will be trip and fall .

What will the study be benefetting in you ?

At the end of this study you will be able to know your fitness level.

What will the data be used for?

To be used for the purpose of this study and will remain strictly confidential. The
results of the study will be shown only to the relevant health professionals.

THANK YOU.

Appendix - 2
Consent Form

24
Study Title: A STUDY ON THE CORRELATION BETWEEN THE BODY MASS
INDEX AND PHYSICAL FITNESS AMONG ADULTS

Name of the Researcher: Divhya Selvan

Please tick the box if you agree with the statements below:

1. I have read and understood the information sheet provided by the researcher
for this study. [ ]

2. I have had the opportunity to ask questions about this study and these have
been answered to my satisfaction. [ ]

3. I understand that my participation is voluntary and without giving any reason,

without my medical care or legal rights being affected.
[ ]

4. I understand that relevant sections of any of my medical notes and data

collected during the study will be kept confidential and will only be used for the
purpose of this study.
[ ]

5. I give my written consent to take part in this study

[ ]

(If you haven’t ticked all the above boxes then please do not sign this form)

Name of the Subject:

Signature of the Subject:

Date:

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 Appendix – 3
Data Collection Table

DATE

NAME:

AGE:

BMI CATEGORY: NORMAL WEIGHT / OVERWEIGHT / OBESE

NO SHUTTLE ACCOMPLISHED

1 1 2 3 4 5 7

2 1 2 3 4 5 7 8

3 1 2 3 4 5 7 8

4 1 2 3 4 5 7 8 9

5 1 2 3 4 5 7 8 9

6 1 2 3 4 5 7 8 9 10

7 1 2 3 4 5 7 8 9 10
LEVEL

8 1 2 3 4 5 7 8 9 10 11

9 1 2 3 4 5 7 8 9 10 11

10 1 2 3 4 5 7 8 9 10 11

11 1 2 3 4 5 7 8 9 10 11 12

12 1 2 3 4 5 7 8 9 10 11 12

13 1 2 3 4 5 7 8 9 10 11 12 13

14 1 2 3 4 5 7 8 9 10 11 12 13

15 1 2 3 4 5 7 8 9 10 11 12 13

16 1 2 3 4 5 7 8 9 10 11 12 13 14

17 1 2 3 4 5 7 8 9 10 11 12 13 14

18 1 2 3 4 5 7 8 9 10 11 12 13 14 15

19 1 2 3 4 5 7 8 9 10 11 12 13 14 15

20 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16

21 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16

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 Appendix – 4

Table of resource.

No. Resource Use Quantity required

1. Consent form For assessment consent 200

2. Information sheet For assessment 200

Assessment, treatment and data

3. Audio player 1
collection.

Assessment, treatment and data

4. Recording sheet 200
collection.

Assessment, treatment and data

5. Cones 10
collection.

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 Appendix – 5
Task Analysis

Month Days Involved Task Undertaken by

Jan’22- May’22 50 days Review of literature ● Researcher
Jan – Feb’2022 14 days Planning Research ● Researcher
Design
Feb-Jun’2022 50 days Sample Identification ● Researcher
● Research
assistant
Mar-Oct’2022 120 days Data ● Researcher
Collection/Procedure ● Research
Assistant
May - Oct’2022 14 days Data Analysis ● Researcher
Oct - Dec ’2022 40 days Report Writing ● Researcher
Jan- March ’2023 30 days Process of ● Researcher
Publication

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 Appendix - 6
Gantt Table

Task                          
fe ma ap ma ju jul au se oc no de fe Ma
  jan b r r y n y g p t v c jan b r

Literature Review                              

Research Design                              

Sample
Recruitment                              

Data Collection                              

Data Analysis                              

Report Writing                            

Publication
Process                              

29