Medicine and Health Sciences Commons^™

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

Healthier Together: A Holistic Office Protocol Addressing The Chronic Nature Of Children And Adolescents With Adhd, Kimberly Olmos

Evidence-Based Practice Project Reports

Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent, chronic condition with symptoms that include inattention, hyperactivity, and impulsivity. ADHD affects six million children in the United States (Tran et al., 2021). The purpose of this evidence-based practice project was to implement a holistic office protocol that addressed the chronicity and future health outcomes of children and adolescents, ages 2-17 years with ADHD through stimulant or non-stimulant medication prescriptions, behavioral therapy referrals, and education surrounding diet, and exercise. A comprehensive, systematic literature search yielded 16 articles to determine best practice when treating children and adolescents with ADHD in primary or …

Standing Posterior Trunk Rotation With Adaptive Proprioceptive Toss, Jennifer Elvir

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a remarkably individualized disease. Nearly every person’s trajectory is unique. One person may experience tremor at an early stage of the disease, while another may experience tremor at a later stage or even not at all. For all PD patients, for certain can expect increasing difficulty as the disease progresses. Parkinson’s disease is responsible for the loss of dopamine which displays itself most notably through motor and cognitive symptom disruption. Although Parkinson’s is a chronic and progressive condition that is irremediable, significant strides have been facilitated to help control and manage the trajectory of the disease. …

A Multimodal Intervention Treatment Plan For Adults With Generalized Anxiety Disorder In Primary Care, Morgan Cullings

Evidence-Based Practice Project Reports

Generalized anxiety disorder (GAD) is a debilitating psychological condition that affects 3.1% of the American population and is one of the leading causes of disability (Anxiety and Depression Association of America, 2022; Baxter, 2014). The purpose of this evidence-based practice project was to implement a multimodal intervention to decrease GAD symptoms in adults in the primary care setting. The PICOT question that guided this project was: In adults, over the age of 18, who have been diagnosed with generalized anxiety disorder (GAD), does the combination of digital cognitive behavioral therapy (CBT) through a smartphone application, lifestyle modification education, and pharmacotherapy …

A Multimodal Smartphone Application Intervention To Achieve Target Weight Goals In Overweight Adult Diabetics, Michael Thomas Schwuchow

Evidence-Based Practice Project Reports

Obesity is the leading risk factor for developing type 2 diabetes mellitus (American Diabetes Association, 2022). Diabetes mellitus (DM) and obesity put individuals at higher risk for developing heart disease, stroke, and hypertension, therefore, it is essential to properly manage both conditions. The purpose of this project is to determine if the implementation of an evidence-based weight loss intervention, MyFitnessPal© will result in reduction in body mass index (BMI) and lower hemoglobin A1c (HbA1c) levels in overweight adults with DM. A comprehensive literature search of six databases, hand searching, and citation chasing yielded 13 pieces of moderate to high quality …

Systematic Review Of The Effect Of Exercise On The Reduction Of Myocardial Remodeling Following A Myocardial Infarction Compared To A Sedentary Approach, Vladislav Gladis

Theses and Graduate Projects

Background: Cardiovascular disease is one of the leading causes of morbidity and mortality in humans worldwide. Ventricular remodeling following a myocardial infarction leads to detrimental outcomes due to cardiovascular death and ventricular dysfunction. Exercise training is an adjunct strategy to reduce the myocardial remodeling process.

Purpose: The paper seeks to answer the following PICO question: P: Population with post- infarct myocardial-remodeling I: Exercise following a myocardial infarction C: Sedentary approach O: Prevention of deleterious myocardial remodeling post-MI

Methods: A comprehensive literature review was done using PubMed and Science Direct with articles published in 2019 or after. The search was conducted …

Metabolic Foundations Of Exercise-Induced Cardiac Growth., Kyle Fulghum

Electronic Theses and Dissertations

Regular aerobic exercise promotes physiological cardiac growth, which is an adaptive response thought to enable the heart to meet higher physical demands. Cardiac growth involves coordination of catabolic and anabolic activities to support ATP generation, macromolecule biosynthesis, and myocyte hypertrophy. Although previous studies suggest that exercise-induced reductions in cardiac glycolysis are critical for physiological myocyte hypertrophy, it remains unclear how exercise influences the many interlinked pathways of metabolism that support adaptive remodeling of the heart. In this thesis project, we tested the general hypothesis that aerobic exercise promotes physiological cardiac growth by coordinating myocardial metabolism to promote glucose-supported anabolic pathway …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson

Evidence-Based Practice Project Reports

Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Changes In Physical Activity And Relationships To Submaximal Exercise Capacity And Cardiac Function During Breast Cancer Therapy, Moriah P. Bellissimo

Theses and Dissertations

Background: Breast cancer (BC) survivors are at high risk for heart failure due to curative cancer therapies. In non-cancer populations, physical activity is a first line treatment for preventing cardiovascular disease. This study examined whether more physical activity was associated with better submaximal exercise capacity and cardiac function during the first three months of cancer therapy.

Methods: Participants included 223 women with stage I-III BC before therapy and after three months of undergoing treatment and 126 controls. Leisure time physical activity was reported using the Godin Sheppard leisure time exercise questionnaire. Cardiac function was assessed by cardiac magnetic resonance, and …

Can Exercise Be An Alternative Treatment Option For Depression, Walker Rogers

Theses and Graduate Projects

As most people know, exercise has always been beneficial for our overall health. No matter which exercise program it is, they all provide some sort of benefit. A growing problem has been depression as more and more people are being diagnosed. Since normally, most people would be prescribed SSRIs, I wanted to find out if there were alternative options. I sought to determine if exercise can be an alternative treatment option for depression. A comprehensive literature review was conducted using the websites PubMed, NCBI, Science Direct, & Academic Search Premier and using the search terms depression, anxiety, exercise, yoga, resistance …

Lowering Depression Symptoms In Adults: Exploring Nonpharmacologic/Non-Talk Therapy Based Approaches, Alyssa A. Raiolo

Theses and Graduate Projects

Background: Depression has a high prevalence, affecting more than 300 million people worldwide.1 Antidepressants and talk therapy are the current mainstays for treatment. Given the high prevalence of depression, there is value in the research regarding further treatment options.

Purpose: A literature review of studies exploring additional treatment modalities to lower depression symptoms in adults.

Methods: A comprehensive literature review was conducted using with the search terms <(adults) AND (depression, low mood, mental health) AND (pharmacologic, SSRI, SNRI) OR ( physical activity, fitness, exercise), OR (time outdoors, UV exposure, phototherapy) OR (non-talk therapy)>. Inclusion criteria were studies that were published from 2015 to the present. Exclusion criteria were studies not in English.

Conclusions: Aside from the currently recommended approaches to treating …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

What Is The Effect Of Physical Activity On The Reduction Of Macrovascular Complications In Patients Diagnosed With Type 2 Diabetes Mellitus?, Rachael M. Gordon

Theses and Graduate Projects

The increasing prevalence and healthcare burden of type 2 diabetes is a worldwide concern. It is the seventh leading cause of mortality and a significant cause of morbidity. While both the macrovascular and microvascular complications of diabetes can have a profound impact on overall health and quality of life, cardiovascular events are the leading cause of mortality in patients with type 2 diabetes. Adults with diabetes have a two to four-fold increased risk of cerebrovascular events and myocardial infarctions. Oral medications combat insulin resistance and aid in the control of hemoglobin A1c, blood pressure, and cholesterol, therefore, contributing to a …

The Impacts Of Aging, Sedentarism, And Exercise On Neurotrophic Factor Expression And Innervation In The Heart And The Effects Of Treatment With Α-Cgrp On Heart Function, Gabriel Almeida Alves

Dissertations

Neurotrophic factors (NFs) are important molecules responsible for development, differentiation, regeneration, and maintenance of new and mature neurons. Neurotrophic factors act as neurocytokines and may assist with the regulation of axonal and dendritic arrangements and synaptic plasticity between neurons themselves or with other non-neural target tissues. In this study, we analyze the levels of two NFs: glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). Cardiomyocytes produce these neurotrophic factors which assist with the innervation pattern of the heart. The heart is innervated by the two branches of the autonomic nervous system; namely the sympathetic nervous system and …

The Study Of High Intensity Interval Training's Effect On Enjoyment, Keali Mari

Theses/Capstones/Creative Projects

This study assessed participant’s level of enjoyment in high-intensity training over moderate intensity-training. High intensity interval training is defined as short bouts of exercise performed at a near-maximal effort with rest periods or light activity in between. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery. This type of exercise has sparked the interest of many active people due to its decreased time commitment and the benefits it elicits. The results of this study show that high intensity interval training induces a higher enjoyment rate pre- …

Perceived Impact Of Non-Contact Boxing On Daily Life And Occupational Participation At Home Among Individuals With Parkinson's Disease, Kristen E. Bignal

Student Capstone Papers

The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific …

Effect Of Lifestyle Modifications On Blood Pressure And Bmi In Overweight Or Obese Adults With Primary Hypertension, Mariska Vandenbergh

Evidence-Based Practice Project Reports

Hypertension (HTN) and obesity contribute to poor cardiovascular outcomes which can be managed with diet and exercise lifestyle changes. In addition, self-awareness (SA) of eating patterns can be a useful tool to promote adherence to lifestyle changes. The purpose of this project was to determine the effect of lifestyle education, the DASH diet, and tools to increase SA for adult clinic patients who were overweight with hypertension. The REAP and PIH tools were utilized to increase patients’ SA of their diagnosis and current dietary habits. A literature search over five databases was conducted and analyzed thoroughly. National guidelines strongly recommend …

The Implementation Of Exercise For Chronic Kidney Disease And Dialysis Patients, Syed Ahmad Rizvi

Honors College Theses

While commonly known to be the organ that helps with urine production within the human body, the kidney plays one of the most crucial roles in maintaining homeostasis. When establishing all of the roles the kidney has on keeping humans healthy, there is the question of how does the body cope when a patient is diagnosed with kidney failure. One of the more common treatment options that allows the body to continue to function without a kidney is by beginning a patient on a form of dialysis. However, as with any treatment, there will always be a list of side …

Exercise And Nutrition Induced Weight Loss For Prostate Cancer Patients, Rebekah Louise Wilson

Theses: Doctorates and Masters

This thesis encompasses six main chapters - two reviews and four experimental chapters, in addition to a general introduction and discussion.

Review 1 (Chapter 2) is a discussion of the negative impact of obesity on prostate cancer prognosis and common prostate cancer treatments.

Review 2 (Chapter 3) is an evaluation of the current literature examining prostate cancer patients receiving androgen deprivation therapy (ADT) and how exercise and nutrition interventions can be used to induce fat loss, while preserving or improving lean mass.

Study 1 (Chapter 4) is an examination of the efficacy of a weight loss program in altering body …

Examining The Relationship Of Exercise And Sleep In Students Across Multiple Academic Disciplines, Taylor Zewe

Honors Projects

Students in college learn the importance of balancing their academic studies with their sleep and exercise habits. The amount of sleep and exercise a student recieves has been examined in previous research studies. In these studies it was found that exercise had a postive affect on the amount of sleep received. However, there is little research on the affect academic discipline has on sleep habits and/or exercise habits of students in college. The purpose of this study is to examine the sleep and exercise habits among students in multiple academic majors at Bowling Green State University.

Development And Cross-Validation Of A Cadence-Based Metabolic Equation For Walking, Christopher C. Moore

Masters Theses

The ACSM Metabolic Equation is a widely recognized equation for predicting metabolic intensity from walking speed. However, an equation that uses an observable metric (i.e., cadence [steps/min]), accounts for individual characteristics, and is validated across walking conditions may enable more accessible and accurate predictions of walking intensity. PURPOSE: To develop metabolic equations that predict metabolic intensity (oxygen consumption; mL/kg/min) from cadence using a large treadmill walking dataset (Study One) and cross-validate these equations during overground unconstrained and cadence-constrained walking conditions (Study Two). METHODS: In Study One, 193 adults (21-81 years) completed treadmill walking bouts while oxygen consumption was measured with …

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

Spinal Cord Injury Induced Cardiac Decline And The Limitations Of Exercise., Kathryn Michele Deveau

Electronic Theses and Dissertations

There is a general consensus that the level and the severity of spinal cord injury (SCI) impacts chronic cardiac abnormalities such that high thoracic and cervical SCI are the most severely affected. Furthermore, the extreme degree of immobility/inactivity experienced by the persons with SCI has implications on cardiac decline. Yet it has been difficult to separate the relative contributions of the decentralized autonomic nervous system (ANS) and the immediate and profound inactivity to chronic cardiac abnormalities. As such, this body of work sought to characterize a contusion SCI that results in persistent CV dysfunction. Echocardiography, Dobutamine stress echocardiography and pressure …

A Comparison Of Changes In Women's Cardiovascular Fitness And Body Composition After Performance In Zumba, Tabata, And Cycling, Kristi N. Kester

Williams Honors College, Honors Research Projects

Aerobic group exercise is important to prevent against cardiovascular, pulmonary, and metabolic diseases. Regular exercise can help to reduce the risk of these diseases and premature death. Group exercise classes have shown to be effective in reducing weight, blood pressure, and body composition Further research is necessary to evaluate the effectiveness of these aerobic group exercise classes to one another. PURPOSE: To evaluate and compare the potential health benefits that may occur for women who participate in regular group exercise classes at the Kohl Family YMCA. METHODS: A surrey and body measurements were taken of females enrolled an eight-week aerobic …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

The Effect Of A Multiple Modality Mind-Motor Exercise Intervention On Single And Dual-Task Gait, Balance, And Executive Function, In Community Dwelling Older Adults With A Subjective Cognitive Complaint: A Randomized Controlled Trial., John P. Bocti

Electronic Thesis and Dissertation Repository

Cognitive decline disorders are becoming increasingly prevalent, with older adults at increased risk. Combined exercise has been recently explored as an intervention to help to prevent the decline, however cognitive activation in combination with physical activity has yet to be explored. Therefore, the purpose of the study is to determine the effects of multiple modality exercise programs in combination with a mind-motor task and their effects on mobility and cognitive variables. A total of (n=89) older adults (55+ yrs), with subjective cognitive complaints participated in a multiple modality exercise class, three days a week over six months, with the intervention …

The Relationship Among School Playground Design And Conditions And Physical Activity Levels In Children, Ipuna Estavillo Black

UNLV Theses, Dissertations, Professional Papers, and Capstones

Almost 20% of children aged 6 to 11 years are obese in the United States, tripling over the last ten years. The rise in childhood obesity challenges nurses in their efforts to improve community health and sustainability. A decrease in physical activity (PA) levels has been associated with an increase in obesity. Schools have been identified as a primary setting to provide children adequate amounts of daily PA, and nurses working in the area of child health promotion can work with schools to provide opportunities for children to increase PA levels. The playground is one environment where children can increase …

Physical Activity And Exercise During Adolescence And Young Adulthood Can Act As Preventative Measures Against The Development Of Osteoporosis In Elderly People, Christine C. Center

Honors College Theses

Osteoporosis, “the silent killer,” is responsible for 8.9 million annual fractures. Although not bound to these factors, osteoporosis typically targets females that are post-menopausal and have a family history of the disease. Osteoporosis is caused by a decrease in bone mass density. Physical activity and exercise and often spoken about when the topic of osteoporosis is discussed because of the impact they have on maintaining bone mass density in an effort to delay osteoporosis. This paper first provides an overview of osteoporosis, explanation of methods of diagnosing osteoporosis, risk factors, complications and treatment for osteoporosis. Topics covered include, bone mass …