Meral KÜÇÜK YETGİN

Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi

Obez bireyin egzersiz öncesi klinik değerlendirmeler sonrasında, obezite derecesine ve eşlik eden hastalıklarına göre; türü, sıklığı, süresi ve şiddeti bireysel olarak reçetelendirilmiş bir egzersiz programı, obezitenin tedavisi ve prognozu açısından çok önemlidir. Amerikan College of Sports Medicine (ACSM), obez bir bireyin haftanın 5 günü 30 dakika/gün ile başlayıp 60 dakika/güne artan (toplam; 250 -300 dk/hafta), orta şiddette [maksimum oksijen tüketimi (VO2 maks.)’ın %40-60’ı veya maksimum kalp hızının %50-70’i olacak şekilde] aerobik egzersiz yapmasını önermektedir. Aerobik egzersiz programına eklenmiş direnç ve esneklik egzersizleri ile kombine edilmiş modeller ve interval egzersizler, kasları koruma ve yağ oksidasyonuna destek olmak bakımından etkili tedaviyi destekler. Orta şiddette direnç egzersizleri, haftada 2-3 kere, 2-4 set, 8-12 tekrar olacak şekilde aerobik egzersize eklenmelidir. 2-4 tekrarlı 10-30 saniyelik statik germe egzersizleri de her bir egzersiz seansında bulunmalıdır. Minimal kilo kaybı, 3-6 ay içerisinde vücut ağırlığının %3-%10’u (haftada 0,5 kg-1,0 kg) arasında olmalıdır. Günde 100-250 kcal, haftada toplam 1000 kcal enerji harcaması sağlayan egzersizler ile başlanmalı, ilerleyen dönemlerde her seansta 300-400 kalori enerji harcaması hedeflenmelidir. Egzersiz modeli, obez bireyin fiziksel ve fonksiyonel gelişimine göre egzersizin sıklığı, süresi ve şiddeti değiştirilerek takip edilmelidir. Düzenli egzersiz yapmak iştah kontrolü ve kilo verme sürecinde psikolojik bakış açısını da desteklemektedir.

Anahtar Kelimeler:

Egzersiz Modelleri, Obezite, Egzersiz Reçetesi

Pre-Exercise Assessment of the Obese Individual and Exercise Prescription

According to the degree of obesity and comorbidities; type, frequency, duration and intensity of an individually prescribed exercise program is very important for the treatment and prognosis of obesity. Prior history of orthopedic injuries should be assessed to reduce risk of injury. According to American College of Sports Medicine (ACSM), an obese individual has moderate to vigorous aerobic exercise (40-60% of VO2 max or 50-70% of maximum heart rate), 30 min/day to total 150 min/week, increasing to 60 min/day to total 250-300 min /week, 5 days a week recommended. Interval exercises and combined model with resistance and flexibility exercises added to the aerobic exercise program support effective treatment to protect muscles and provide fat oxidation. Muscle strengthening should be moderate to vigorous intensity; 2-4 sets of 8-12 repetitions, 2-3 day/week; static stretch 10-30 s; 2-4 repetitions of each exercise. Target a minimal reduction in body weight of at least 3%–10% over 3-6 monthly 100-250 kcal per day and 1000 kcal energy per week should be started with exercises, and in the following periods, it should be aimed to spend 300-400 calories in each session. The exercise model should be followed by changing the frequency, duration and intensity of the exercise according to the physical and functional development of the obese individual. Regular exercise also supports the psychological perspective in the process of appetite control and weight loss.

Keywords:

Obesity, Exercise Models, Exercise Prescription,

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