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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><span style=3D'color:#0070C0'>EGZERS&#304;Z&#304;N YA&#286;LANMAYA
ETK&#304;S&#304; NED&#304;R<o:p></o:p></span></b></p>

<p style=3D'text-align:justify'><span style=3D'mso-spacerun:yes'>&nbsp;</sp=
an><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp; </span>Egzersiz
program&#305;n&#305;n yo&#287;unlu&#287;u ve s&uuml;resi, <span class=3DSpe=
llE>lipoproteinlerdeki</span>
de&#287;i&#351;ikli&#287;i etkileyen etkenlerden biridir. D&uuml;zenli egze=
rsiz
yapmayan ki&#351;ilerde maksimum kalp h&#305;z&#305;n&#305;n % 60&#8242;&#3=
05;
ile s&uuml;rd&uuml;r&uuml;len alt&#305; ayl&#305;k bir egzersiz
program&#305;ndan sonra, Ya&#287; ve <span class=3DSpellE>lipoprotein</span=
> <span
class=3DGramE>konsantrasyonlar&#305;nda</span> bir de&#287;i&#351;iklik
olmamakta; maksimum kalp h&#305;z&#305;n&#305;n % 80-90&#8242;&#305; ile
yap&#305;lan egzersiz program&#305; sonunda ise &#8220;Y&uuml;ksek
yo&#287;unluklu <span class=3DSpellE>Lipoprotein</span>-Kolesterol (HDL-C)&=
#8221;
de artma ve <span class=3DSpellE>trigliseridlerde</span> bir azalma
olmaktad&#305;r.</p>

<p style=3D'text-align:justify'>Egzersizin <span class=3DSpellE>lipoprotein=
ler</span>
&uuml;zerine etkisi &ccedil;e&#351;itli mekanizmalar ile
a&ccedil;&#305;klanmaktad&#305;r.</p>

<p style=3D'text-align:justify;text-indent:35.4pt'>Egzersiz yapanlarda, <sp=
an
class=3DSpellE>trigliseridden</span> zengin <span class=3DSpellE>lipoprotei=
nleri</span>
par&ccedil;alayan <span class=3DSpellE>lipoprotein</span> <span class=3DSpe=
llE>lipaz</span>
gibi ya&#287; par&ccedil;alayan enzim d&uuml;zeylerinin y&uuml;ksek olu&#35=
1;u
bu ili&#351;kiyi <span class=3DGramE>a&ccedil;&#305;klayabilir.<span
class=3DSpellE>Lipoprotein</span></span> <span class=3DSpellE>lipaz</span>
d&uuml;zeyi ve <span class=3DSpellE>trigliserid</span> konsantrasyonu
aras&#305;nda negatif ve yine bu enzimle HDL-C aras&#305;nda pozitif bir
ili&#351;ki vard&#305;r. Egzersizle hem iskelet kas&#305; hem de ya&#287;
dokusunda <span class=3DSpellE>lipoprotein</span> <span class=3DSpellE>lipa=
z</span>
aktivitesinde art&#305;&#351; olur. Bunun sonucu olarak &ccedil;ok
d&uuml;&#351;&uuml;k yo&#287;unluklu <span class=3DSpellE>lipoprotein</span=
> <span
class=3DGramE>konsantrasyonunda</span> azalma ve HDL konsantrasyonunda bir
art&#305;&#351; olur. Bu iki de&#287;i&#351;iklik, tipik olarak fiziksel
aktivitesi y&uuml;ksek ki&#351;ilerde g&ouml;r&uuml;l&uuml;r.</p>

<p style=3D'text-align:justify;text-indent:35.4pt'>Ya&#287; dokusu doku LPL
aktivitesi kad&#305;nlarda erkeklerden daha y&uuml;ksektir. Kad&#305;nlarda=
ki
ya&#287; ve <span class=3DSpellE>lipoproteinlerle</span> ilgili risk
fakt&ouml;rlerinin daha d&uuml;&#351;&uuml;k olu&#351;u, LPL aktivitesinin
artm&#305;&#351; olu&#351;una ve &ouml;strojenlerin HDL-C d&uuml;zeyini
artt&#305;r&#305;c&#305; etkisine <span class=3DGramE>ba&#287;lan&#305;r.Eg=
zersiz</span>
Program&#305; Haz&#305;rlanmas&#305; Egzersizin yo&#287;unlu&#287;una, maks=
imum
kalp h&#305;z&#305;na g&ouml;re karar verilir. Maksimum kalp h&#305;z&#305;=
 ve
egzersiz kalp h&#305;z&#305;n&#305;n belirlenmesi, egzersiz
ba&#351;lang&#305;&ccedil; d&uuml;zeyinin saptanmas&#305;nda gereklidir.
Maksimum kalp h&#305;z&#305;, &#8220;220-ya&#351;&#8221; form&uuml;l&uuml;y=
le
hesaplan&#305;r.</p>

<p style=3D'text-align:justify;text-indent:35.4pt'>Egzersiz kalp h&#305;z&#=
305;
ya da hedeflenen kalp h&#305;z&#305;: Maksimum kalp h&#305;z&#305;n&#305;n %
60-90&#8242;&#305; hedeflenir. <span class=3DSpellE>Asemptomatik</span>
eri&#351;kin i&ccedil;in % 70-85, kardiyak sorunu olan hastalar i&ccedil;in=
 %
50-60&#8242;&#305; ile ba&#351;lanabilir. Egzersiz s&uuml;resi, k&#305;smen
yo&#287;unlu&#287;una ba&#287;l&#305;d&#305;r. Egzersiz ne kadar yo&#287;un=
sa,
s&uuml;renin o kadar k&#305;sa olmas&#305; gerekir; yo&#287;unluk
azald&#305;k&ccedil;a s&uuml;re uzar. 30 dakikadan uzun olan egzersizlerde =
kas
iskelet <span class=3DGramE>komplikasyonlar&#305;</span> artar. Egzersizin
s&#305;kl&#305;&#287;&#305; ki&#351;inin ya&#351;&#305;na ve sa&#287;l&#305=
;k
durumuna g&ouml;re de&#287;i&#351;ir. En uygunu haftada 3-4 kezdir. Egzersi=
z,
2-3 haftada bir yeniden de&#287;erlendirilip yo&#287;unlu&#287;u
artt&#305;r&#305;lmazsa, etkisiz olur. Egzersiz Program&#305;: 3 d&ouml;nem=
den
olu&#351;mal&#305;d&#305;r.<br>
1. Is&#305;nma D&ouml;nemi&middot; Ki&#351;inin kendini psikolojik ve
fizyolojik olarak aktiviteye haz&#305;rlamas&#305;n&#305; sa&#287;lar, ekle=
m ve
kaslarda sakatlanma olas&#305;l&#305;&#287;&#305;n&#305; azalt&#305;r.
Ama&ccedil;; performans&#305; artt&#305;rmak, sakatlanma
olas&#305;l&#305;&#287;&#305;n&#305; azaltmak, <span class=3DSpellE>iskemik=
</span>
<span class=3DGramE>komplikasyonlar&#305;n</span> ve aritmilerin
g&ouml;r&uuml;lmesini &ouml;nlemek ya da azaltmakt&#305;r. Bu do&#287;rultu=
da
&#305;s&#305;nma periyodu basamakl&#305; olmal&#305;, kas ve v&uuml;cutta
yorgunluk yaratmadan ve enerji depolar&#305;n&#305; azaltmadan y&uuml;ksele=
cek
d&uuml;zeyde olmal&#305;d&#305;r.</p>

<p style=3D'text-align:justify'>2. Egzersiz D&ouml;nemi: Egzersiz
program&#305;n&#305;n <span class=3DGramE>kondisyon</span>
k&#305;sm&#305;d&#305;r. Aerobik egzersizler; b&uuml;y&uuml;k kas
gruplar&#305;n&#305;n uzun d&ouml;nemler halinde, oksijen ta&#351;&#305;ma
sistemini zora sokmayan, <span class=3DSpellE>submaksimal</span>, ritmik,
yineleyici, dinamik egzersizlerdir. Ki&#351;inin dayanabilme
s&#305;n&#305;rlar&#305; i&ccedil;inde olmal&#305;d&#305;r. Egzersiz testin=
deki
yo&#287;unluk ve kalp h&#305;z&#305;n&#305;n &uuml;zerine
&ccedil;&#305;k&#305;lmamal&#305;d&#305;r. Kondisyon olu&#351;mas&#305;
i&ccedil;in e&#351;ik d&uuml;zeyin &uuml;zerinde ve klinik belirtilerin
g&ouml;r&uuml;ld&uuml;&#287;&uuml; d&uuml;zeyin alt&#305;nda egzersiz
yap&#305;lmal&#305;d&#305;r.</p>

<p style=3D'text-align:justify'>3. So&#287;utma D&ouml;nemi: Egzersizden so=
nra bu
d&ouml;nem gereklidir. Bu devrenin amac&#305;; kan&#305;n kalp ve beyne
d&ouml;n&uuml;&#351;&uuml;n&uuml; artt&#305;rarak
bayg&#305;nl&#305;&#287;&#305;, kan&#305;n kol ve bacaklarda g&ouml;llenmes=
ini,
aritmi ve di&#287;er <span class=3DSpellE>kardiyovask&uuml;ller</span> <span
class=3DGramE>komplikasyonlar&#305;</span> &ouml;nlemektir.</p>

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