Nursing Assignment – Physical Activity Plan Presentation

Physical Activity Plan Presentation (CLO #6)

Develop a presentation outlining a physical activity plan for populations with a medical/physical limitation, or populations in a specific setting (e.g. public school system). Background information regarding the population and how you will assess the group will be presented. One activity plan specific to the population chosen will be presented. Health benefits of the exercise plan for the population will be reviewed. Nursing Assignment – Physical Activity Plan Presentation

Charts and handouts to share with the class are encouraged. Presentations should be 7-10 minutes in length. Online students will submit recorded presentations. Onsite students will present in-class.

Example PA Plan Presentation – PowerPoint File (986.9 KB)

– This is an example and not a “perfect” presentation.

Prostate Cancer

Physical activity plan

Targeted Population

Prostate cancer only affects men

Most at risk are black males

Asian Pacific Islanders are at lowest risk

Men greater than age 60 are at greatest risk

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6/100 men over age 60 will develop Prostate cancer by age 70

Division of Cancer Center and Control, 2015. Nursing Assignment – Physical Activity Plan Presentation

All race incidence total, age adjusted, 2009-2013

Total combined rate was 123.2

Among blacks 194.8/100,000

Whites 113.3

Hispanics 104.4

AI/AN 65.9

Asian/Pacific Islander 63.5

Division of Cancer Center and Control, 2015

Incidence Rate by State

Risk varies greatly among states

Louisiana has the highest incidence while Arizona has the lowest rate

Louisiana 131.2

Delaware 129.4

Mississippi 127.2

New York 125.6

Maryland 124.4 Assignment – Physical Activity Plan Presentation

New Jersey 123.4

District of Columbia 120.1

Alabama 118.5

Georgia 117.7

New Hampshire 115.6

Utah 111.9

Kansas 108.5

Arizona 69.1

Division of Cancer Center and Control, 2015

Incidence Rates

Division of Cancer Center and Control, 2015

Death Rate by State

DC has the highest rate of death and the 7th spot for incidence

Mississippi has the 2nd highest rate but the 3rd highest incidence

District of Columbia 33.2 (7th in Incidence)

Mississippi 24.8 (3rd in Incidence)

Nevada 23.5 (33rd in Incidence)

Maine 23.2 (45th in Incidence)

Georgia 22.8 (9th in Incidence)

Alabama 22.1 (8th in Incidence) Assignment – Physical Activity Plan Presentation

Idaho 21.8 (28th in Incidence)

Nebraska 21.6 (16th in Incidence)

Wisconsin 21.5 (21st in Incidence)

South Carolina 21.4 (17th in Incidence)

Louisiana 21.1 (1st in Incidence)

Oklahoma 21.1 (36th in Incidence) Assignment – Physical Activity Plan Presentation

Division of Cancer Center and Control, 2015

Death Rate by State

DC has the highest rate of death and the 7th spot for incidence

Mississippi has the 2nd highest rate but the 3rd highest incidence

Overall Blacks suffer the greatest burden of death from Prostate Cancer

The overall incidence and death rates are lowering

Division of Cancer Center and Control, 2015 Nursing Assignment – Physical Activity Plan Presentation

Death Rates

Division of Cancer Center and Control, 2015

Why Physical Activity is important

Research indicates that exercising during cancer treatment can significantly improve mood, social and cognitive well being as well as overall fitness (Garber, et al., 2007)

Furthermore, physical activity can reduce or prevent overweight and obesity, two factors that have been linked to longer term survival among cancer patients (Garber, et al., 2007)

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Assessment

All patients who are screened for participation in a physical activity program would need to be screened using a set of standard questions such as

The revised Physical Activity Readiness Questionnaire (PAR-Q)

The RAPA questionnaire can also be used

Any patient should be excluded if any exercise precaution is identified such as fever, severe cachexia, extreme fatigue, sickness or bone pain. Assignment – Physical Activity Plan Presentation

High-intensity or high-impact exercise should be avoided in the beginning

Calculate a baseline physical activity level utilizing a self-reported physical activity questionnaire

The Walking Exercise Program

Walking exercise program composed of

Progressive structured exercise and progressive target daily step counts

The structured exercise routine will initially begin with a 10-minute walking session, 3 sessions per week

Patients will be instructed to perform a 5-minute warm-up period by walking slowly prior to the 10-minute walking session

This will be followed up by a 5-minute cool-down period by walking slowly

Finally, each patient will follow a stretching routine after the walking session. A stretching instruction sheet will be given to each person as well

During the warm-up/cool-down periods the goal will be to maintain an exertion level between 7.5 and 8 on the Borg Scale of Ratings of Perceived Exertion (RPE)

Walking Exercise Program cont’

During the 10-minute walking session, each person will gradually increase their speed until they attain and maintain an RPE level between 9 and 13, the exact target will be calculated based on the initial self reported physical activity questionnaire. Nursing Assignment – Physical Activity Plan Presentation

9 being the target for initially sedentary men and 13 being the target for initially physically active men

Modifications may be made based on physical limitations

Each participant should perform this routine 3 times per week

Walking Exercise Program cont’

Daily step counts measured using pedometers will measure goals

Goals will increase every two weeks by 1,000 steps until a total goal of 10,000 is reached

Step counts will start at 4,000, 6,000 and 7,000 respectively for each initial physically active level, sedentary, moderately active and very active

The end goal is to have each person aerobically exercising at a level of 15 RPE after 6 months and maintain that level throughout treatment

Muscle Strengthening

Muscle strengthening has been shown to increase bone density and muscle loss among men being treated for prostate cancer (Galvão, Joseph, Newton, Spry & Taffe, 2009)

Testosterone levels are reduced in men undergoing treatment

Regular exercise, especially muscle building exercises have been shown to restore testosterone levels, leading to increased bone density, lower reported rates of fatigue and overall better quality of life (Galvão et al., 2009)

Muscle Strengthening

Muscle strengthening doesn’t need to involve weights or the gym. Nursing Assignment – Physical Activity Plan Presentation

Body weight can be used

Even bed ridden patients can benefit

Start by performing mild intensity exercises such as

Ankle exercises

Knee bends (in the bed)

Static quadriceps exercises

Abductor/Abductor exercises

(Christie MHS Foundation Trust, 2014) Assignment – Physical Activity Plan Presentation

Muscle Strengthening

For those able they can perform exercises

Seated in a chair

Inner range quadriceps

Sitting to Standing (Christie MHS Foundation Trust, 2014)

Pool

Water Aerobics

Swimming

Water Weights

Gym

Free Weights

Muscle Strengthening

Machines

Machines can help reduce the occurrence of injury by helping to ensure proper form

Assessment

Pre and Post assessment are key

Pre-assessments include

RAPA

PAR-Q

As well as psycho-social assessments

These are needed to determine if the patient is eligible to participate and if so at what level

Also measures the level of a persons cognitive abilities as well as their mental status. Nursing Assignment – Physical Activity Plan Presentation

Assessment cont’

Important to measure reported fatigue levels both before, during and after the intervention to determine effectiveness

Goals and exercises can be modified according to the individuals abilities

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References and sources

Christie MHS Foundation Trust. (2014, July). Retrieved August 24, 2016, from http://www.christie.nhs.uk/media/2538/540.pdf

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2015, December 15). Prostate Cancer. Retrieved August 24, 2016, from http://www.cdc.gov/cancer/prostate/statistics/age.htm

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2016, July 06). Prostate Cancer. Retrieved August 24, 2016, from http://www.cdc.gov/cancer/prostate/statistics/state.htm

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. (2016, June 16). Prostate Cancer. Retrieved August 25, 2016, from http://www.cdc.gov/cancer/prostate/statistics/race.htm

Galvão, D., Joseph D., Newton R.U., Spry, N., & Taafe, D.R., (2009, January 10). Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: A randomized controlled trial. Journal of Clinical Oncology, 28(2), 330-347. Nursing Assignment – Physical Activity Plan Presentation doi:10.1200/JCO.2009.23.2488

Garber, S.L., Kerrigan, A.J., Monga, T.N., Monga, U., Thornby, J., Vallbona, C., & Zimmerman, K.P., (2007, November). Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil, 88, 1416-22. Assignment – Physical Activity Plan Presentation

Keog, J., & McLeod, R.D. (2012). Body Composition, Physical Fitness, Functional Performance, Quality of life, and fatigue benefits of exercise for prostate cancer patients: A systematic review. Journal of Pain and Symptom Management, 43(1), 96-110. doi:http://dx.doi.org/10.1016/j.jpainsymman.2011.03.006

Lau, Y. J., Lee, C. E., & Leslie, W. D., (2012). A pilot study of exercise in men with prostate cancer receiving androgen deprivation therapy. BMC Cancer, 12(103). doi:10.1186/1471-2407-12-103

References and sources cont’

U.S. Cancer Statistics Working Group. (2016). United States Cancer Statistics: 1999–2013 Incidence and Mortality Web-based Report. Retrieved from United States Cancer Statistics: https://nccd.cdc.gov/uscs/cancersbyraceandethnicity.aspx

Nursing Assignment – Physical Activity Plan Presentation