NR222 African American Men and Strokes Discussion

Running head: STROKES IN AFRICAN AMERICAN MEN Topic: African American Men and Strokes • Definition of stroke (should be in the intro) • Topic sentence 1. Talk about the culture • Statistics • Risk factors • Diet • Lifestyle 2. Why do AA are at high risk to getting Strokes? • High Blood Pressure • Diabetes • Smoking • overweight • eating too much salt • genetic 3. Healthy People 2020 (one paragraph by itself) 4. SUMMARY OF THE ARTICLES. (ONE PARAGRAPH ) 5. Health Promotion/ Prevention • • • • • • • Education Eat healthy Exercise/losing weight Get other health conditions under control, such as diabetes and heart disease, cholesterol less alcohol consumption Aspirin Blood pressure 5. Health Restoration • Physical Therapy • Speech Therapy • Mental health therapy 2 STROKES IN AFRICAN AMERICAN MEN Conclusion 2 EVIDENCEBASED CARE SHEET Stroke Rehabilitation: Cardiovascular and Strengthening Exercise Following Stroke What We Know › Cerebrovascular accident (CVA; commonly called stroke) is a leading cause of long-termdisability, primarily due to motor impairment that results in muscle weakness, changes in muscle tone, muscle atrophy, hemiparesis, impaired walking, and lowered endurance(1,3,8,14) › The goal of current stroke rehabilitation programs is to improve patient ability regarding physical function and performing activities of daily living (ADLs) through physical therapy and occupational therapy, respectively; common exercises and other activities that patients learn and practice in a stroke rehabilitation program include(1,7,10,14) • stretching to reduce spasticity (i.e., muscle stiffness) • balance and lower limb strength training • ambulation with or without assistive devices (e.g., a walker or a cane) • transferring (e.g., from the bed to a wheelchair and from the bed to a commode) • ADLs (e.g., dressing, toileting, grooming) • compensating for impairment (e.g., using uninvolved hand to perform ADLs independently) › Current stroke rehabilitation programs include cardiovascular and strengthening exercises ICD-9 434.91 ICD-10 I64 Authors Diane RainesGass, RN, BSN Cinahl Information Systems, Glendale, CA Orna Avital, RN, BSN, MBA Cinahl Information Systems, Glendale, CA Reviewers Alysia Gilreath-Osoff, RN, BSN, CEN, SANE Cinahl Information Systems, Glendale, CA Obiamaka Oji, DNP, APRN, FNP-BC Cinahl Information Systems, Glendale, CA Nursing Practice Council Glendale Adventist Medical Center, Glendale, CA Editor Diane Pravikoff, RN, PhD, FAAN Cinahl Information Systems, Glendale, CA June 1, 2018 to achieve increased muscle mass and aerobic benefits(3,11,14) • Exercises that improve cardiovascular health include ambulation, bicycling, leg lifts, and use of weights/dumbbells(8,14) • NR222 African American Men and Strokes Discussion

Functional strength training intervention (i.e., performing resistive exercises during the performance of a functional task) effectively increases muscle strength in stroke survivors(8) –Progressive resistance training exercises have long-term benefits in patients with chronic stroke(8,13) › Results of studies regarding the implementation of structured cardiovascular exercise programs for patients following a stroke have demonstrated high-intensity interval training as a potential effective alternative to the current moderate-intensitycontinues exercise stroke rehabilitation programs in reducing cardiovascular risk because they(4) • maximize physical capabilities (e.g., muscle endurance, gait)(4,6) • decrease cardiovascular risk factors (e.g., blood sugar, cholesterol)(6) • improve cognitive and executive functions (e.g., working memory, attention)(6) • improve aerobic exercise capacity (i.e., a measurement of the body’s ability to utilize oxygen)(3,6,11) › There are several barriers to widespread use of structured cardiovascular exercise programs(2) • Lack of experience and insufficient training on psychological problems associated with post-stroke patients(2) • Deficient equipment and/or lack of access to adequate equipment necessary for post-stroke training programs(2) Published by Cinahl Information Systems, a division of EBSCO Information Services. Copyright©2018, Cinahl Information Systems. All rights reserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher. Cinahl Information Systems accepts no liability for advice or information given herein or errors/omissions in the text. It is merely intended as a general informational overview of the subject for the healthcare professional. Cinahl Information Systems, 1509 Wilson Terrace, Glendale, CA 91206 › In results of clinical trials • cardiovascular exercise was found to be superior to no intervention in improving cardiorespiratory endurance, gait recovery, independence in ADLs, and quality of life (e.g., as demonstrated by improved ability to move and increased sense of independence)(4) –Walking on a treadmill while submerged in water resulted in greater improvement in gait recovery, balance, leg strength, muscle spasticity, and cardiovascular function than standard treadmill walking and other overground gait therapies(5,9) › There is evidence to support the use of strengthening and cardiovascular exercise to • increase walking speed(13,14) • reduce the amount of assistance required while walking(13) • increase muscle strength(6,14) • improve functional performance(6) • increase endurance(6) • decrease patient anxiety(6) › Improvement in gait, ADLs, and strength are • greater with –moderate-intensity continues exercise time (e.g., > 30 minutes), or high-intensity short-interval training lasting 1-4 minute(4) –social support from family members(12) –exercise that is related daily activities (e.g., practicing sit-to-stand)(4,6) What We Can Do › Become knowledgeable about the benefits of cardiovascular and strengthening exercise following stroke so you can provide guidance to patients and their family members following stroke; share this information with your colleagues › Request referral to physical therapy for patient evaluation and formulation of an individualized regimen of cardiovascular and strengthening exercises; inform the physical therapy clinician about the scope of your patient’s physical deficits so he/ she can appropriately individualize the patient’s therapy-related needs › Evaluate your patients for obstacles to performing exercise following stroke, which can include • lack of social support • psychological and cognitive issues, as stroke-induced cognitive impairment is often associated with physical dysfunction and delayed recovery(3) • poor medical status and/or comorbidities › Request referral to a social worker, if appropriate, for identification of local resources that will assist your patient in overcoming obstacles to exercise, including support groups, transportation, subsidized mental health counseling, in-home services, and durable medical equipment sources if assistive devices are needed › To promote quality of care and avoid injury, rehabilitation professionals should • carefully tailor the treatment plan for each patient following stroke according to the patient’s –extent and type of impairment –goals –prior functional level –medical status • modify the treatment plan based on consistent monitoring of the patient’s –vital signs –functional progress –level of musculoskeletal pain • arrange for short sessions of activity with frequent rests • incorporate low resistance and fewer repetitions, when appropriate • use caution when adding new activities • consistently monitor for pain Coding Matrix References are rated using the following codes, listed in order of strength: M Published meta-analysis SR Published systematic or integrative literature review RCT Published research (randomized controlled trial) R Published research (not randomized controlled trial) RV Published review of the literature RU Published research utilization report QI Published quality improvement report L Legislation C Case histories, case studies PGR Published government report G Published guidelines PFR Published funded report PP Policies, procedures, protocols X Practice exemplars, stories, opinions GI General or background information/texts/reports U Unpublished research, reviews, poster presentations or other such materials CP Conference proceedings, abstracts, presentation References 1. Bruno-Petrina, A. (2016, April 15). NR222 African American Men and Strokes Discussion

Motor recovery in stroke. Medscape. Retrieved May 6, 2018, from http://emedicine.medscape.com/article/324386-overview (RV) 2. Condon, M., & Guidon, M. (2017). A survey of exercise professionals’ barriers and facilitators to working with stroke survivors. Health and Social Care in the Community, 26(2), 250-258. doi:10.1111/hsc.12517 (R) 3. Constans, A., Pin-Barre, C., Temprado, J. J., Decherchi, P., & Laurin, J. (2016). Influence of aerobic training and combinations of interventions on cognition and neuroplasticity after stroke. Frontiers in Aging Neuroscience, 8, 1-43. doi:10.3389/fnagi.2016.00164 (RV) 4. Crozier, J., Roig, M., Eng, J. J., MacKay-Lyons, M., Fung, J., Ploughman, M., … Tang, A. (2018). High-intensity interval after stroke: An opportunity to promote functional recovery, cardiovascular health, and neuroplasticity. Neurorehabilitation and Neural Repair, 1-14. doi:10.1177/1545968318766663 (RV) 5. Dolbow, J. D., Gassler, J., Dolbow, D. R., & Stevens, S. L. (2016). Underwater treadmill training after neural-paralytic injury. Journal of the American Kinesiotherapy Association, 70(1), 1-8. (RV) 6. Gambassi, B. B., Coelho-Junior, H. J., Schwingel, P. A., De Jesus Furtado Almeida, F., Gaspar Novais, T. M., De Lourdes Lauande Oliveira, P., … Rodrigues, B. (2017). Resistance training and stroke: A critical analysis of different training programs. Stroke Research and Treatment, 2017(4830265), 1-11. doi:10.1155/2017/4830265 (RV) 7. Gillen, G. (2018). In H. McHugh Pendleton & W. Schultz-Krohn (Eds.), Pedretti’s occupational therapy practice skills for physical dysfunction (8th ed., pp. 809-810). St. Louis: MO: Elsevier. (GI) 8. Hunter, S. M., Johansen-Berg, H., Ward, N., Kennedy, N. C., Chandler, E., Weir, C. J., … Pomeroy, V. M. (2018). Functional strength training and movement performance therapy for upper limb recovery early poststroke-efficacy, neural correlates, predictive markers, and cost effectiveness: FAST-INdiCATE trial. Frontiers in Neurology, 8(733), 1-24. doi:10.3389/fneur.2017.00733 (RCT) 9. Mehrholz, J., Thomas, S., & Elsner, B. (2017). Treadmill training and body weight support for walking after stroke. Cochrane Database Systematic Review, 8. Art. No.: CD002840. doi:10.1002/14651858.CD002840.pub4 (SR) 10. Persson, C. U., Hansson, P. O., Lappas, G., & Danielsson, A. (2016). Physical activity levels and their association with postural control in the first year after stroke. Physical Therapy, 96(9), 1389-1396. doi:10.2522/ptj.20150367 (R) 11. Pin-Barre, C., Constans, A., Brisswalter, J., Pellegrino, C., & Laurin, J. (2017). Effect of high- versus moderate-intensity training on neuroplasticity and functional recovery after focal ischemia. Stroke, 48(10), 2855-2864. doi:10.1161/STROKEAHA.117.017962 (PGR) 12. Pitthayapong, S., Thiangtam, W., Powwattana, A., Leelacharas, S., & Waters, C. M. (2017). A community based program for family caregivers for post stroke survivors in Thailand. Asian Nursing Research, 11(2), 150-157. doi:10.1016/j.anr.2017.05.009 (R) 13. Vahlberg, B., Cederholm, T., Lindmark, B., & Hellström, K. (2017). Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: A randomized controlled trial. Disability & Rehabilitation, 39(16), 1615-1622. doi:10.1080/09638288.2016.1206631 (RCT) 14. Wist, S., Clivaz, J., & Sattelmayer, M. (2016). Muscle strengthening for hemiparesis after stroke: A Meta analysis. Annals of Physical and Rehabilitation Medicine, 59(2), 114-124. doi:10.1016/j.rehab.2016.02.001 (M) NR222 Health and Wellness Required Uniform Assignment: Health Promotion Paper Guidelines Purpose This assignment allows the learner to apply knowledge gained about health promotion concepts and strategies, enhance written communication skills, and demonstrate a beginning understanding of cultural competency. Course outcomes: This assignment enables the student to meet the following course outcomes: 1. Discuss the professional nurse’s role in health promotion activities. (PO 1 and 2) 3. NR222 African American Men and Strokes Discussion

Discuss health promotion, illness prevention, health maintenance, health restoration, and rehabilitation in relation to the nurse’s role in working with various populations. (PO 1, 2, and 8) 7. Identify health promotion strategies throughout the life span. (PO 1, 2, and 4) Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment. Total points possible: 100 points Preparing the assignment Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. 1) Identify a health problem or need for health promotion for a particular stage in the life span of a population from a specific culture in your area. 2) Choose one of the Leading Health Indicators (LHI) priorities from Healthy People 2020: https://www.healthypeople.gov/2020/Leading-Health-Indicators 3) Research a topic related to health and wellness associated with one of the Healthy People 2020 topic areas. 4) Submit your topic to the instructor for approval at least 2 weeks prior to the final assignment due date, but earlier if desired. All topics must be approved. 5) You will develop an educational health promotion project addressing the population/culture in your area. 6) Use TurnItIn in time to make any edits that might be necessary based on the Similarity Index prior to submitting your paper to your faculty. Consult with your faculty about the acceptable Similarity Index for this paper. 7) For writing assistance (APA, formatting, or grammar) visit the Citation and Writing Assistance: Writing Papers at CU page in the online library. 8) Include the following sections (detailed criteria listed below and in the Grading Rubric). a. Introduction and Conclusion- 15 points/15% • Introduction establishes the purpose of the paper and describes why topic is important to health promotion in the target population in your area. • Introduction stimulates the reader’s interest. • Conclusion includes the main ideas from the body of the paper. • Conclusion includes the major support points from the body of the paper. b. Relate Topic to Target Population- 25 points/25% • Describes the topic and target cultural population. • Includes statistics to support significance of the topic. • Explains how the project relates to the selected Healthy People 2020 topic area. • Applies health promotion concepts. c. Summary of Articles- 25 points/25% • A minimum of three (3) scholarly articles, from the last 5 years, are used as sources. • Articles meet criteria of being from scholarly journals and include health promotion and wellness content. • At least one article is related to the chosen cultural group. • Summaries all key points and findings from the articles. • Includes statistics to support significance of the topic. 1 NR222 Health Promotion Project Guidelines V3.docx Revised: 05/2019 11 NR222 Health and Wellness Required Uniform Assignment: Health Promotion Paper Guidelines • Discusses how information from the articles is used in the Health Promotion Project, including specific examples. d. Health Promotion Discussion – 25 points/25% • Describes approaches to educate the target population about the topic. • The approaches are appropriate for the cultural target population. • Identifies specific ways to promote lifestyle changes within the target population. • Applies health promotion strategies. e. APA Style and Organization – 10 points/10% • TurnItIn is used prior to submitting paper for grading. • Revisions are made based on TurnItIn originality report. • References are submitted with assignment. • Uses appropriate APA format (6th ed.) and is free of errors. • Grammar and mechanics are free of errors. • NR222 African American Men and Strokes Discussion

Paper is 3-4 pages, excluding title and reference pages. • Information is organized around required components and flows in a logical sequence. 2 NR222 Health Promotion Project Guidelines V3.docx Revised: 05/2019 21 Grading Rubric NR222 Health and Wellness Required Uniform Assignment: Health Promotion Project Guidelines Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment. Assignment Section and Required Criteria (Points possible/% of total points available) Introduction and Conclusion (15 points/15%) Required criteria 1. Introduction establishes the purpose of the paper and describes why topic is important to health promotion in the target population in your area. 2. Introduction stimulates the reader’s interest. 3. Conclusion includes the main ideas from the body of the paper. 4. Conclusion includes the major support points from the body of the paper. Relate Topic to Target Population (25 points/25%) Required criteria 1. Describes the topic and target cultural population. 2. Includes statistics to support significance of the topic. 3. Explains how the project relates to the selected Healthy People 2020 topic area. 4. Applies health promotion concepts. Summary of Articles (25 points/25%) Required criteria 1. A minimum of three (3) scholarly articles, from the last 5 years, are used as sources. 2. Articles meet criteria of being from scholarly journals and include health promotion and wellness content. 3. At least one article is related to the chosen cultural NR222 Health Promotion Project Guidelines V3.docx Highest Level of Performance High Level of Performance 15 points 13 points 12 points Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes 1 or fewer requirements for section. 25 points 20 points 15 points 10 points Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no less than 2 requirements for section. Includes 1 or fewer requirements for section. 25 points 23 points 21 points 10 points Includes no fewer than 6 requirements for section. Includes no fewer than 5 requirements for section. Includes no fewer than 4 requirements for section. Revised: 05/2019 Satisfactory Level of Performance Unsatisfactory Level of Performance Section not present in paper 8 points 0 points Includes 1-3 requirements for section. No requirements for this section presented. 0 points No requirements for this section presented. 0 points No requirements for this section presented. 31 NR222 Health and Wellness Required Uniform Assignment: Health Promotion Project Guidelines group. 4. Summaries all key points and findings from the articles. 5. Includes statistics to support significance of the topic. 6. Discusses how information from the articles is used in the Health Promotion Project, including specific examples. Health Promotion Discussion (25 points/25%) Required criteria 1. Describes approaches to educate the target population about the topic. 2. The approaches are appropriate for the cultural target population. 3. Identifies specific ways to promote lifestyle changes within the target population. 4. Applies health promotion strategies. APA Style and Organization (10 points/10%) Required criteri …