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Pre-Exercise Assessment of the Obese Individual and Exercise Prescription

Yıl 2019, Cilt: 3 Sayı: 3, 115 - 122, 31.12.2019

Meral Küçük Yetgin

Öz

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. 

Anahtar Kelimeler

Obesity Exercise Models Exercise Prescription

Kaynakça

  • 1. Akkurt S. Obezite ve egzersiz tedavisi. Spor Hekimliği Dergisi. 2012;47(4):123-130.
  • 2. Akova B, Şekir U, Keleş B, Gür H. Metabolik Sendrom, Obezite, Diyabet, Hipertansiyon, Dislipidemi ve Egzersiz. Yağmur Tanıtım, Bursa, 2011.
  • 3. Bloom OJ, Fields KB, McGrath TM, Draper TR. Exercise prescription and physiology. Netter’s Sports Medicine. 2018;17:117-123.
  • 4. ACSM’s Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia (PA): Wolters Kluwer; 2018.
  • 5. Özkan A, Köklü Y, Kayıhan G, Alemdaroğlu U, Ersöz G. Obezitenin önlenmesi ve tedavisinde fiziksel aktivite ve egzersizin rolü. Uluslararası Hakemli Akademik Spor ve Sağlık ve Tıp Bilimleri Dergisi. 2013;3(7):48-63.
  • 6. Hagströmer M, Oja P, Sjöström M. The International Physical Activity Questionnaire (IPAQ): A study of concurrent and construct validity. Public Health Nutr. 2006;9(6):755-762.
  • 7. National Clinical Guideline Centre (NCGC). Obesity: Identification, assessment and management of overweight and obesity in children, young people and adults, clinical guideline. (2014). (Accessed October 10, 2019, at https://www.ncbi.nlm. nih.gov/books/NBK264165/pdf/Bookshelf_NBK264165.pdf ).
  • 8. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Michos ED. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376-1414.
  • 9. Thompson W, Gordon N, Pescatello LS. ACSM’s Guidelines for Exercise Testing and Prescription. 8th ed. Baltimore, MD: Lippincott Williams& Wilkins; 2009.
  • 10. Fletcher, GF, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson, Williams MA. Exercise standards for testing and training: A scientific statement from the American Heart Association. Circulation. 2013;128:873-934.
  • 11. Ehrman KJ, Gordon MP, Visich SP, Keteyian ST. Clinical Exercise Physiology. Human Kinetics, USA, 2003. 12. de Souto Barreto P. Exercise for multimorbid patients in primary care: One prescription for all? Sports Med. 2017;47(11):2143-2153.
  • 13. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey P C, Tate DF. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079.
  • 14. Sigal RJ, Kenny GP, David H, Wasserman DH, Castaneda- Sceppa C, White RD, Carmen MD, Russell D. Physical activity/ exercise and type 2 diabetes. A consensus statement from the american diabetes association. Diabetes Care. 2006;29:1433- 1438.
  • 15. Al-Mallah MH, Keteyian SJ, Brawner CA, Whelton S, Blaha MJ. Rationale and design of the Henry Ford Exercise Testing Project (the FIT Project). Clin Cardiol. 2014;37(8):456-461.
  • 16. Çeçen S, Bulur Ş. Egzersiz reçetesi düzenlemenin genel prensipleri. The Journal of Turkish Family Physician. 2015;6(1):40-46.
  • 17. Santangelo KS, Radakovich LB, Fouts J, Foster MT. Pathophysiology of obesity on knee joint homeostasis: Contributions of the infrapatellar fat pad. Horm Mol Biol Clin Investig. 2016;26(2):97-108.
  • 18. Tudor-Locke C, Washington TL, Hart TL. Expected values for steps/day in special populations. Prev Med. 2011;49(1):3-11.
  • 19. Can S. Sedanter davranış, adım sayısı ve sağlık. Spor Hekimliği Dergisi. 2019;54(1):71-82.
  • 20. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the US bone and joint initiative. Semin Arthritis Rheum. 2014;43(6):701-712.
  • 21. Whelton SP, Narla V, Blaha MJ, Nasir K, Blumenthal RS, Jenny NS, Al-Mallah MH, Michos ED. Association between resting heart rate and ınflammatory biomarkers (High-Sensitivity C-Reactive Protein, Interleukin-6, and Fibrinogen) (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2014;113(4):644-649.
  • 22. Ardıç F. Egzersiz reçetesi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2014;60 (2):1-8
  • 23. Ardıç F. Egzersizin sağlık yararları. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 2014:60:9-14.
  • 24. Çelik C, Yalbuzdağ ŞA. Obesity and exercise. Journal of Clinical and Analytical Medicine. 2014;5(143):244-7.
  • 25. Mead WF, Hartwig R. Fitness evaluation and exercise prescription. J Fam Pract. 1981;13(7):1039-1050.
  • 26. Morrison CA. Using the exercise test to create the exercise prescription. Prim Care. 2001;28(1):137-58.
  • 27. Foster C, Porcari JP, Anderson J, Paulson M, Smaczny D, Webber H, Udermann B. The talk test as a marker of exercise training intensity. J Cardiopulm Rehabil Prev. 2008;28(1):24- 30.
  • 28. Liao CD, Tsauo JY, Lin LF, Huang SW, Ku JW, Chou LC, Liou TH. Effects of elastic resistance exercise on body composition and physical capacity in older women with sarcopenic obesity: A CONSORT-compliant prospective randomized controlled trial. Medicine. 2017;96(23):e7115.
  • 29. Donnelly JE, Jakicic JM, Pronk NP, Smith BK, Kirk EP, Jacobsen DJ, Washburn R. Is resistance exercise effective for weight management? Evidenced Based Preventive Medicine. 2004;1:21–29.
  • 30. Rayes ABR, de Lira CAB, Viana RB, Benedito-Silva AA, Vancini RL, Mascarin N, Andrade MS. The effects of pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: A clinical trial. Peer J. 2019;7:e6022.
  • 31. Donges CE, Duffield R. Effects of resistance or aerobic exercise training on total and regional body composition in sedentary overweight middle-aged adults. Appl Physiol Nutr Metab. 2012;37:499-509.
  • 32. Jakicic JM, Otto AD. Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr. 2005;82(1):226-229.
  • 33. Goldfield GS, Kenny GP, Alberga AS, Tulloch HE, Doucette S, Cameron JD, Sigal RJ. Effects of aerobic or resistance training or both on health-related quality of life in youth with obesity: The hearty trial. Appl Physiol Nutr Metab. 2016;42(4):361-370.
  • 34. Akdagcık IU. Indirect research of weight of one repetation maximum in Bench Press technique. Journal of Human Sciences. 2014;11(1):177-191.
  • 35. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  • 36. Gibala MJ, Little JP, MacDonald MJ, Hawley JA. Physiological adaptations to low‐volume, high‐intensity interval training in health and disease. J Physiol. 2012;590(5):1077-1084.
  • 37. Jung ME, Bourne JE, Beauchamp MR, Little JP. High-intensity interval training as an efficacious alternative to moderate- intensity continuous training for adults with prediabetes. J Diabetes Res. 2015;2015:191595.
  • 38. Smith-Ryan AE, Trexler ET, Wingfield HL, Blue MN. Effects of high-intensity interval training on cardiometabolic risk factors in overweight/obese women. J Sports Sci. 2016;34(21):2038- 2046.
  • 39. Özata M. Endokrinoloji, Metobalizma ve Diyabet, İstanbul Tıp Kitabevi. İstanbul. 2011.
  • 40. Pearson ES, Hall CR. Examining body image and its relationship to exercise motivation: An 18-week cardiovascular program for female initiates with overweight and obesity. Baltic Journal of Health and Physical Activity. 2013;5(2):121-131.

Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi

Yıl 2019, Cilt: 3 Sayı: 3, 115 - 122, 31.12.2019

Meral Küçük Yetgin

Öz

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

Kaynakça

  • 1. Akkurt S. Obezite ve egzersiz tedavisi. Spor Hekimliği Dergisi. 2012;47(4):123-130.
  • 2. Akova B, Şekir U, Keleş B, Gür H. Metabolik Sendrom, Obezite, Diyabet, Hipertansiyon, Dislipidemi ve Egzersiz. Yağmur Tanıtım, Bursa, 2011.
  • 3. Bloom OJ, Fields KB, McGrath TM, Draper TR. Exercise prescription and physiology. Netter’s Sports Medicine. 2018;17:117-123.
  • 4. ACSM’s Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia (PA): Wolters Kluwer; 2018.
  • 5. Özkan A, Köklü Y, Kayıhan G, Alemdaroğlu U, Ersöz G. Obezitenin önlenmesi ve tedavisinde fiziksel aktivite ve egzersizin rolü. Uluslararası Hakemli Akademik Spor ve Sağlık ve Tıp Bilimleri Dergisi. 2013;3(7):48-63.
  • 6. Hagströmer M, Oja P, Sjöström M. The International Physical Activity Questionnaire (IPAQ): A study of concurrent and construct validity. Public Health Nutr. 2006;9(6):755-762.
  • 7. National Clinical Guideline Centre (NCGC). Obesity: Identification, assessment and management of overweight and obesity in children, young people and adults, clinical guideline. (2014). (Accessed October 10, 2019, at https://www.ncbi.nlm. nih.gov/books/NBK264165/pdf/Bookshelf_NBK264165.pdf ).
  • 8. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Michos ED. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74(10):1376-1414.
  • 9. Thompson W, Gordon N, Pescatello LS. ACSM’s Guidelines for Exercise Testing and Prescription. 8th ed. Baltimore, MD: Lippincott Williams& Wilkins; 2009.
  • 10. Fletcher, GF, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson, Williams MA. Exercise standards for testing and training: A scientific statement from the American Heart Association. Circulation. 2013;128:873-934.
  • 11. Ehrman KJ, Gordon MP, Visich SP, Keteyian ST. Clinical Exercise Physiology. Human Kinetics, USA, 2003. 12. de Souto Barreto P. Exercise for multimorbid patients in primary care: One prescription for all? Sports Med. 2017;47(11):2143-2153.
  • 13. Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey P C, Tate DF. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079.
  • 14. Sigal RJ, Kenny GP, David H, Wasserman DH, Castaneda- Sceppa C, White RD, Carmen MD, Russell D. Physical activity/ exercise and type 2 diabetes. A consensus statement from the american diabetes association. Diabetes Care. 2006;29:1433- 1438.
  • 15. Al-Mallah MH, Keteyian SJ, Brawner CA, Whelton S, Blaha MJ. Rationale and design of the Henry Ford Exercise Testing Project (the FIT Project). Clin Cardiol. 2014;37(8):456-461.
  • 16. Çeçen S, Bulur Ş. Egzersiz reçetesi düzenlemenin genel prensipleri. The Journal of Turkish Family Physician. 2015;6(1):40-46.
  • 17. Santangelo KS, Radakovich LB, Fouts J, Foster MT. Pathophysiology of obesity on knee joint homeostasis: Contributions of the infrapatellar fat pad. Horm Mol Biol Clin Investig. 2016;26(2):97-108.
  • 18. Tudor-Locke C, Washington TL, Hart TL. Expected values for steps/day in special populations. Prev Med. 2011;49(1):3-11.
  • 19. Can S. Sedanter davranış, adım sayısı ve sağlık. Spor Hekimliği Dergisi. 2019;54(1):71-82.
  • 20. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the US bone and joint initiative. Semin Arthritis Rheum. 2014;43(6):701-712.
  • 21. Whelton SP, Narla V, Blaha MJ, Nasir K, Blumenthal RS, Jenny NS, Al-Mallah MH, Michos ED. Association between resting heart rate and ınflammatory biomarkers (High-Sensitivity C-Reactive Protein, Interleukin-6, and Fibrinogen) (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2014;113(4):644-649.
  • 22. Ardıç F. Egzersiz reçetesi. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2014;60 (2):1-8
  • 23. Ardıç F. Egzersizin sağlık yararları. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 2014:60:9-14.
  • 24. Çelik C, Yalbuzdağ ŞA. Obesity and exercise. Journal of Clinical and Analytical Medicine. 2014;5(143):244-7.
  • 25. Mead WF, Hartwig R. Fitness evaluation and exercise prescription. J Fam Pract. 1981;13(7):1039-1050.
  • 26. Morrison CA. Using the exercise test to create the exercise prescription. Prim Care. 2001;28(1):137-58.
  • 27. Foster C, Porcari JP, Anderson J, Paulson M, Smaczny D, Webber H, Udermann B. The talk test as a marker of exercise training intensity. J Cardiopulm Rehabil Prev. 2008;28(1):24- 30.
  • 28. Liao CD, Tsauo JY, Lin LF, Huang SW, Ku JW, Chou LC, Liou TH. Effects of elastic resistance exercise on body composition and physical capacity in older women with sarcopenic obesity: A CONSORT-compliant prospective randomized controlled trial. Medicine. 2017;96(23):e7115.
  • 29. Donnelly JE, Jakicic JM, Pronk NP, Smith BK, Kirk EP, Jacobsen DJ, Washburn R. Is resistance exercise effective for weight management? Evidenced Based Preventive Medicine. 2004;1:21–29.
  • 30. Rayes ABR, de Lira CAB, Viana RB, Benedito-Silva AA, Vancini RL, Mascarin N, Andrade MS. The effects of pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: A clinical trial. Peer J. 2019;7:e6022.
  • 31. Donges CE, Duffield R. Effects of resistance or aerobic exercise training on total and regional body composition in sedentary overweight middle-aged adults. Appl Physiol Nutr Metab. 2012;37:499-509.
  • 32. Jakicic JM, Otto AD. Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr. 2005;82(1):226-229.
  • 33. Goldfield GS, Kenny GP, Alberga AS, Tulloch HE, Doucette S, Cameron JD, Sigal RJ. Effects of aerobic or resistance training or both on health-related quality of life in youth with obesity: The hearty trial. Appl Physiol Nutr Metab. 2016;42(4):361-370.
  • 34. Akdagcık IU. Indirect research of weight of one repetation maximum in Bench Press technique. Journal of Human Sciences. 2014;11(1):177-191.
  • 35. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  • 36. Gibala MJ, Little JP, MacDonald MJ, Hawley JA. Physiological adaptations to low‐volume, high‐intensity interval training in health and disease. J Physiol. 2012;590(5):1077-1084.
  • 37. Jung ME, Bourne JE, Beauchamp MR, Little JP. High-intensity interval training as an efficacious alternative to moderate- intensity continuous training for adults with prediabetes. J Diabetes Res. 2015;2015:191595.
  • 38. Smith-Ryan AE, Trexler ET, Wingfield HL, Blue MN. Effects of high-intensity interval training on cardiometabolic risk factors in overweight/obese women. J Sports Sci. 2016;34(21):2038- 2046.
  • 39. Özata M. Endokrinoloji, Metobalizma ve Diyabet, İstanbul Tıp Kitabevi. İstanbul. 2011.
  • 40. Pearson ES, Hall CR. Examining body image and its relationship to exercise motivation: An 18-week cardiovascular program for female initiates with overweight and obesity. Baltic Journal of Health and Physical Activity. 2013;5(2):121-131.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Meral Küçük Yetgin 0000-0002-4916-5661

Yayımlanma Tarihi 31 Aralık 2019
Kabul Tarihi 30 Aralık 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 3

Kaynak Göster

APA Küçük Yetgin, M. (2019). Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi. Türkiye Diyabet Ve Obezite Dergisi, 3(3), 115-122.
AMA Küçük Yetgin M. Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi. Turk J Diab Obes. Aralık 2019;3(3):115-122.
Chicago Küçük Yetgin, Meral. “Obez Bireyin Egzersiz Öncesi Değerlendirilmesi Ve Egzersiz Reçetelendirilmesi”. Türkiye Diyabet Ve Obezite Dergisi 3, sy. 3 (Aralık 2019): 115-22.
EndNote Küçük Yetgin M (01 Aralık 2019) Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi. Türkiye Diyabet ve Obezite Dergisi 3 3 115–122.
IEEE M. Küçük Yetgin, “Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi”, Turk J Diab Obes, c. 3, sy. 3, ss. 115–122, 2019.
ISNAD Küçük Yetgin, Meral. “Obez Bireyin Egzersiz Öncesi Değerlendirilmesi Ve Egzersiz Reçetelendirilmesi”. Türkiye Diyabet ve Obezite Dergisi 3/3 (Aralık 2019), 115-122.
JAMA Küçük Yetgin M. Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi. Turk J Diab Obes. 2019;3:115–122.
MLA Küçük Yetgin, Meral. “Obez Bireyin Egzersiz Öncesi Değerlendirilmesi Ve Egzersiz Reçetelendirilmesi”. Türkiye Diyabet Ve Obezite Dergisi, c. 3, sy. 3, 2019, ss. 115-22.
Vancouver Küçük Yetgin M. Obez Bireyin Egzersiz Öncesi Değerlendirilmesi ve Egzersiz Reçetelendirilmesi. Turk J Diab Obes. 2019;3(3):115-22.

Zonguldak Bülent Ecevit Üniversitesi Obezite ve Diyabet Uygulama ve Araştırma Merkezi’nin bilimsel yayım organıdır.

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