{"id":1277,"date":"2020-05-28T07:00:00","date_gmt":"2020-05-28T04:00:00","guid":{"rendered":"http:\/\/acilbulten.net\/?p=1277"},"modified":"2021-11-10T22:38:16","modified_gmt":"2021-11-10T19:38:16","slug":"gunde-10-000-adim-efsanesi","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2020\/05\/28\/gunde-10-000-adim-efsanesi\/","title":{"rendered":"G\u00fcnde 10.000 Ad\u0131m Efsanesi"},"content":{"rendered":"\n

Bu bir efsane olabilir ger\u00e7ekten.<\/em><\/h2>\n\n\n\n

Yazar: Murat \u00c7etin<\/em><\/strong> @drmuratcetin<\/span><\/a><\/em><\/strong><\/p>\n\n\n\n

\"murat<\/figure><\/div>\n\n\n\n

2016 y\u0131l\u0131ndan beri Trakya\u2019ya yolu d\u00fc\u015fm\u00fc\u015f, o zamandan beri Tekirda\u011f Devlet Hastanesi\u2019nde Acil T\u0131p Uzman\u0131 olarak g\u00f6rev yapmaktad\u0131r.  Dokuz Eyl\u00fcl Acil T\u0131p ihtisasl\u0131 olup T\u00fcrkiye Acil T\u0131p Derne\u011fi Y\u00f6netim Kurulu \u00fcyeli\u011fi ve Acil T\u0131p Asistan Birli\u011fi ba\u015fkanl\u0131k g\u00f6revleri yapm\u0131\u015ft\u0131r. 2018-2019 aras\u0131 d\u00f6nemde TATD Geriatrik Acil T\u0131p \u00e7al\u0131\u015fma grubuna ba\u015fkanl\u0131\u011f\u0131 g\u00f6revini y\u00fcr\u00fctm\u00fc\u015ft\u00fcr. 2016-2019 aras\u0131 y\u0131llar\u0131 aras\u0131nda da ACEP Uluslararas\u0131 Well-Being Komitesinin bir \u00fcyesidir. \u0130lgi alanlar\u0131 travma, havayolu, uluslararas\u0131 Acil T\u0131p olup, Acil Serviste tak\u0131m olmaya inanan, kahvesiz duramayan, Twitter\u2019da online bir #FOAMed takip\u00e7isi ve kritik hasta y\u00f6netimini seven bir Acil T\u0131p g\u00f6n\u00fcll\u00fcs\u00fcd\u00fcr. Derin ve Nil\u2019in babas\u0131d\u0131r.<\/p>\n\n\n\n

Art\u0131k daha kaliteli ve daha uzun ya\u015fama fikri insanlar\u0131n gelecek planlar\u0131 i\u00e7inde yer al\u0131yor. \u0130\u015fte ve trafikte ge\u00e7irilen uzun s\u00fcreler, ailemiz ve arkada\u015flar\u0131m\u0131zla daha az zaman ge\u00e7irmemize neden olmakta. Bu telafi edilemeyecek zamanlar\u0131 hep \u201cileride\u201d daha \u00e7ok zaman\u0131m\u0131z olaca\u011f\u0131 y\u00f6n\u00fcnde avuntularla ge\u00e7i\u015ftiriyoruz. Emeklilik g\u00fcnlerimizde tad\u0131n\u0131 \u00e7\u0131karabilece\u011fimiz zamanlar i\u00e7in de sa\u011fl\u0131kl\u0131 bir \u201colgunluk\u201d d\u00f6nemimiz olmas\u0131 gerekiyor. \u0130\u015fte bu sa\u011fl\u0131kl\u0131 hale kavu\u015fman\u0131n en \u00f6nemli yollar\u0131 (\u015fu an bildi\u011fimiz kadar\u0131yla) fiziksel aktivite ve sa\u011fl\u0131kl\u0131 beslenme.<\/p>\n\n\n\n

D\u00fcnyan\u0131n d\u00f6rt bir yan\u0131nda hepimiz fiziksel aktivitelerimizi tipik olarak frekans, s\u00fcre ve yo\u011funluk parametreleri cinsinden \u00f6l\u00e7ebiliyoruz. A\u015f\u0131r\u0131 derecede kaybedilen zamana odaklanmay\u0131 s\u00fcrd\u00fcr\u00fcrken, \u201cbaz\u0131 fiziksel aktivitelerin hi\u00e7 olmamas\u0131ndan daha iyi oldu\u011funu\u201d kabul eden mevcut kan\u0131ta dayal\u0131 halk sa\u011fl\u0131\u011f\u0131 k\u0131lavuz ilkeleriyle uyumlu olmas\u0131 gerekti\u011fi anlam\u0131na geliyor. Sosyal medyan\u0131n da ya\u015fam\u0131m\u0131z\u0131n i\u00e7inde oldu\u011fu bu g\u00fcnlerde imrenilecek hayatlar\u0131 g\u00f6zlemliyoruz ve Wellness\u2019a (iyilik hali) biraz daha \u00f6nem veriyoruz. Basit fiziksel aktivitelerden \u201cy\u00fcr\u00fcy\u00fc\u015f\u201d ise hepimiz i\u00e7in uygulamas\u0131 en kolay olan\u0131d\u0131. <\/p>\n\n\n\n

\"10000<\/figure><\/div>\n\n\n\n

Peki nas\u0131l y\u00fcr\u00fcmeliyiz? Ka\u00e7 ad\u0131m atmal\u0131y\u0131z? Acil serviste bug\u00fcn \u00e7ok y\u00fcr\u00fcd\u00fcm, ka\u00e7 ad\u0131m att\u0131m acaba? sorular\u0131 geliyor akl\u0131m\u0131za do\u011fal olarak\u2026<\/p>\n\n\n\n\n\n\n\n

10.000 Say\u0131s\u0131 Nereden \u00c7\u0131km\u0131\u015f?<\/strong> <\/p>\n\n\n\n

Bir\u00e7ok ki\u015fi, ya\u015f\u0131na veya formuna bak\u0131lmaks\u0131z\u0131n kendi h\u0131zlar\u0131nda y\u00fcr\u00fcyebilir ve bu fiziksel aktivite bi\u00e7imini kendine g\u00f6re geni\u015fletebilir. Giyilebilir teknolojiler veya ak\u0131ll\u0131 telefonlar ile \u201cg\u00fcnl\u00fck ad\u0131mlar\u201d kolayca anla\u015f\u0131labilir ve \u00f6l\u00e7\u00fclebilir. Ancak bir\u00e7ok insan i\u00e7in, her g\u00fcn 10.000 ad\u0131m atma fikri korkutucu gelebiliyor ve bu onlar\u0131n daha fazla y\u00fcr\u00fcmelerini engelleyebiliyor. Benim i\u00e7in de b\u00f6yle san\u0131r\u0131m. Bir g\u00fcnde hi\u00e7 10.000 ad\u0131m att\u0131\u011f\u0131m\u0131 sanm\u0131yorum. <\/p>\n\n\n\n

\"tokyo<\/figure><\/div>\n\n\n\n

Hi\u00e7 d\u00fc\u015f\u00fcnd\u00fcn\u00fcz m\u00fc? Acil serviste bir n\u00f6bette ortalama ka\u00e7 ad\u0131m at\u0131yoruz acaba? 10.000 ad\u0131m atarsam hayat\u0131m de\u011fi\u015fir mi?<\/em><\/strong><\/p>\n\n\n\n

Asl\u0131nda 1 g\u00fcnde 10.000 ad\u0131m fikri, 1964 y\u0131l\u0131nda Japonya\u2019da Tokyo olimpiyatlar\u0131nda ortaya \u00e7\u0131km\u0131\u015f. <\/p>\n\n\n\n

\"manpo<\/figure><\/div>\n\n\n\n

O y\u0131llarda Japonya\u2019da \u201cmanpokei<\/em>\u201d<\/strong> ad\u0131nda bir ad\u0131msayar \u00fcreticisi varm\u0131\u015f. Manpokei di\u011fer dillere \u201c10 bin ad\u0131m metre<\/em>\u201d<\/strong> olarak \u00e7evrilmi\u015f. Burada 10.000 say\u0131s\u0131n\u0131n sa\u011fl\u0131kl\u0131 egzersiz i\u00e7in alt\u0131n say\u0131 oldu\u011fundan de\u011fil, tamamen Japon k\u00fclt\u00fcr\u00fcnde y\u00fcksek ve yuvarlak bir say\u0131 oldu\u011fu i\u00e7in se\u00e7ildi\u011fi d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015f. T\u00fcm ya\u015f gruplar\u0131 i\u00e7in bu de\u011ferler uygun olmayacakt\u0131r. Osteoartriti olan, operasyon \u00f6yk\u00fcs\u00fc olan hastalar\u0131n g\u00fcnde 10.000 say\u0131s\u0131na ula\u015fmas\u0131 \u00e7ok da kolay olmayacakt\u0131r. Bu gruptaki ki\u015filer i\u00e7in ba\u015fka fiziksel aktivite imkanlar\u0131 oldu\u011funu da unutmamam\u0131z gerekir.<\/p>\n\n\n\n\n\n\n\n

Ara\u015ft\u0131rmalardan Ne \u00d6\u011frendik?<\/strong><\/p>\n\n\n\n

\"10000<\/figure><\/div>\n\n\n\n

Genel olarak \u00e7al\u0131\u015fmalar bir ad\u0131m hedefi belirleme ve bir ad\u0131m g\u00fcnl\u00fc\u011f\u00fc kullanman\u0131n fiziksel aktiviteyi artt\u0131rmada temel motivasyon fakt\u00f6rleri olabilece\u011fini g\u00f6steriyor.<\/em><\/strong> 10.000 ad\u0131ml\u0131k hedef veya alternatif ki\u015fiselle\u015ftirilmi\u015f ad\u0131m hedefi olsun, hedef atanm\u0131\u015f olan ad\u0131msayar kullan\u0131c\u0131lar\u0131, temel hedeflere g\u00f6re fiziksel etkinliklerini \u00f6nemli \u00f6l\u00e7\u00fcde artt\u0131r\u0131rken, hedef belirlenmemi\u015f ad\u0131msayar kullan\u0131c\u0131lar\u0131n\u0131n fiziksel aktivite d\u00fczeylerinde anlaml\u0131 bir de\u011fi\u015fim g\u00f6zlenmemi\u015ftir.<\/p>\n\n\n\n

Amerikan Tabipler Birli\u011fi Dergisi\u2019nde (JAMA)<\/em><\/strong> yay\u0131nlanan bir g\u00f6zlemsel \u00e7al\u0131\u015fmada ya\u015f\u0131tlar\u0131ndan daha fazla y\u00fcr\u00fcyen ya\u015fl\u0131 kad\u0131nlarda \u00f6l\u00fcm oranlar\u0131 daha d\u00fc\u015f\u00fck bulunmu\u015fken daha uzun bir ya\u015fam i\u00e7in g\u00fcnl\u00fck 4.400 ad\u0131mdan az<\/u><\/em><\/strong> ad\u0131m\u0131n yeterli oldu\u011fu g\u00f6sterilmi\u015ftir. \u00d6l\u00fcm riski ad\u0131m say\u0131s\u0131 artt\u0131k\u00e7a azalmakla beraber g\u00fcnde 7.500 ad\u0131m\u0131n \u00fczerinde<\/u><\/em><\/strong> y\u00fcr\u00fcnmesinin ki\u015fiye ya\u015famsal a\u00e7\u0131dan ekstra bir faydas\u0131 olmad\u0131\u011f\u0131 ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Ayr\u0131ca h\u0131zl\u0131 veya yava\u015f y\u00fcr\u00fcmenin \u00f6l\u00fcm riski \u00fczerine bir etkisi olmad\u0131\u011f\u0131 net bir \u015fekilde g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Bu ara\u015ft\u0131rma g\u00f6zleme dayal\u0131 oldu\u011fu i\u00e7in sadece birlikteli\u011fi g\u00f6steriyor, dolay\u0131s\u0131yla bu sonu\u00e7lardan daha fazla ad\u0131m atman\u0131n m\u0131 \u00f6l\u00fcm riskini azaltt\u0131\u011f\u0131 yoksa sa\u011fl\u0131klar\u0131 yerinde olanlar\u0131n m\u0131 daha fazla y\u00fcr\u00fcd\u00fcklerini s\u00f6ylemek m\u00fcmk\u00fcn de\u011fil.<\/p>\n\n\n\n

Ba\u015fka bir \u00e7al\u0131\u015fmada ad\u0131m sayar kullan\u0131m\u0131n\u0131n, g\u00fcnl\u00fck at\u0131lan ad\u0131m say\u0131s\u0131nda art\u0131\u015fa neden oldu\u011fu ve bu durumun ki\u015filerin sistolik kan bas\u0131nc\u0131nda yakla\u015f\u0131k 4 mmHg d\u00fc\u015f\u00fc\u015fe neden oldu\u011fu tespit edilmi\u015f. Fiziksel aktivitenin kan bas\u0131nc\u0131 \u00fczerindeki etkilerinin yay\u0131nlanm\u0131\u015f di\u011fer meta-analizleriyle tutarl\u0131 oldu\u011fu g\u00f6r\u00fclm\u00fc\u015f. Biliyoruz ki sistolik kan bas\u0131nc\u0131ndaki 2 mmHg\u2019l\u0131k d\u00fc\u015f\u00fc\u015f, inme nedenli \u00f6l\u00fcm oran\u0131nda %7-10 azalma ile ili\u015fkilidir. Orta ya\u015f pop\u00fclasyonunda damar hastal\u0131klar\u0131na ba\u011fl\u0131 \u00f6l\u00fcm oranlar\u0131n\u0131n azalt\u0131lmas\u0131 i\u00e7in ad\u0131m sayar kullan\u0131m\u0131n\u0131n kan bas\u0131nc\u0131 \u00fczerindeki etkilerinin gelecekteki \u00e7al\u0131\u015fmalarda incelenmesi \u00f6nemli sonu\u00e7lar\u0131n ortaya \u00e7\u0131kmas\u0131na neden olabilir.<\/p>\n\n\n\n

International Journal of Exercise Science\u2019da 2017 Ocak ay\u0131nda yay\u0131nlanan ba\u015fka bir \u00e7al\u0131\u015fma sonu\u00e7lar\u0131 ise bele tak\u0131lan ad\u0131m sayarlar\u0131n, bile\u011fe tak\u0131lan ad\u0131m sayarlara g\u00f6re daha tutarl\u0131 sonu\u00e7lar verdi\u011fini, ancak sat\u0131lan \u00fcr\u00fcnlerin fiyatlar\u0131 artt\u0131k\u00e7a tutarl\u0131l\u0131klar\u0131n\u0131n zay\u0131flad\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir. Bu \u00e7al\u0131\u015fma neticesinde, elinizdeki ad\u0131m sayar\u0131 takip edebilirsiniz ancak ona her zaman g\u00fcvenmeyin \u015feklinde bir sonu\u00e7 ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Davran\u0131\u015f de\u011fi\u015ftirme programlar\u0131nda ad\u0131m sayarlar\u0131n kullan\u0131m\u0131, fiziksel aktiviteyi yakla\u015f\u0131k 2.000 ile 2.500 ad\u0131m\/g\u00fcn aras\u0131nda art\u0131rd\u0131\u011f\u0131 ve bu art\u0131\u015f seviyesinin, kilo kayb\u0131 ve tansiyondaki d\u00fc\u015f\u00fc\u015fle ili\u015fkili oldu\u011fu g\u00f6sterilmi\u015ftir.<\/p>\n\n\n\n

\"10000<\/figure><\/div>\n\n\n\n

Bir ad\u0131m hedefi ve \u00f6zellikle 10.000 ad\u0131m\/g\u00fcn hedefini kullanan \u00e7al\u0131\u015fmalara g\u00f6re; fiziksel aktivitedeki art\u0131\u015fta, g\u00fcnl\u00fck belirli bir ad\u0131m hedefinin en b\u00fcy\u00fck etken oldu\u011funu g\u00f6steriyor. Ancak daha \u00f6nce belirtildi\u011fi gibi, az say\u0131da \u00e7al\u0131\u015fma alternatif hedefleri 10.000 ad\u0131m\/g\u00fcn olarak de\u011ferlendirmi\u015ftir ve bug\u00fcne kadar yap\u0131lan hi\u00e7bir \u00e7al\u0131\u015fma, g\u00fcnl\u00fck farkl\u0131 say\u0131da ad\u0131m hedeflerinin doz-yan\u0131t etkilerini sistematik olarak de\u011ferlendirmemi\u015ftir.<\/p>\n\n\n\n

Sa\u011fl\u0131kl\u0131 bir ya\u015fam i\u00e7in<\/em><\/strong> Ya\u015fam Tarz\u0131 De\u011fi\u015fikli\u011fi \u015eart!<\/em><\/strong><\/p>\n\n\n\n

\u015eu anda mevcut kan\u0131tlara dayanarak, sa\u011fl\u0131kl\u0131 yeti\u015fkinlerde ad\u0131m sayarlar ile belirlenen fiziksel aktiviteyi s\u0131n\u0131fland\u0131rmak i\u00e7in a\u015fa\u011f\u0131daki \u00f6n endekslerin kullan\u0131lmas\u0131n\u0131 \u00f6neriyoruz:<\/p>\n\n\n\n