Turkiye Klinikleri Journal of Sports Sciences

.: REVIEW
Core Stabilizasyonunda Diyafram Nefesinin Önemi ve İlerleme Stratejileri
Importance of Diaphragm Breathing in Core Stabilization and Progression Strategies
Kaan Gürbey AKTÜREa, Çiğdem BULGANa, Mustafa Arslan BAŞARb, Sedat ODABAŞIb
aİstanbul Sağlık Bilimleri Üniversitesi Yaşam Bilimleri Fakültesi, Egzersiz ve Spor Bilimleri Bölümü, İstanbul, TÜRKİYE
bHaliç Üniversitesi Beden Eğitimi ve Spor Yüksekokulu, Antrenörlük Bölümü, İstanbul, TÜRKİYE
Turkiye Klinikleri J Sports Sci. 2020;12(2):212-21
doi: 10.5336/sportsci.2019-73079
Article Language: TR
Full Text
ÖZET
Diyaframın core bölgesi stabilitesindeki önemi; birleşik atletik faaliyetlerde, kuvvet ve hareketi optimum şekilde üretmek, aktarmak ve kontrol etmek için, gövdenin pelvis üzerindeki konumunu ve hareketini kontrol etme yeteneğidir. Bu çalışmanın amacı, core bölgesi stabilitesinde diyafram nefesinin öneminin anlatılması ve iyileştirme stratejilerinin belirlenmesidir. Panjabi'ye göre, bu bütünlüğü koruyabilmek için, santral sinir sistemi (kontrol), iskelet sistemi (pasif) ve kas sistemi (aktif) birlikte çalışır. Bu sistemlerin bir bileşenindeki fonksiyon bozukluğunun; diğer sistemlerin bunu telafi etmesine, bir veya birden fazla sistemin uzun vadeli adaptasyonuna ve sistemlerin bileşenlerinin zarar görmesine neden olabileceği düşünülmektedir. Bu nedenle, aslında omurganın stabilitesinin sadece kas kuvvetine değil, santral sinir sistemine uygun duyu girdisine bağlı olduğu anlaşılmıştır. Diyaframın eşzamanlı stabilizasyonda ve solunum sisteminde rolü olması nedeniyle değerlendirme; sırtüstü, yüzüstü, oturarak ve ayakta durmayı içermelidir. Değerlendirme sonucunda, diyafram nefesinin öğrenilmesi sağlanmalı ve doğru nefes tekniği etkin bir şekilde sahada uygulanacak hareket modellerine adapte edilmelidir. Eğer doğru bir diyafram kullanımı sağlanamıyor ise performans sırasında, göğüsten alınan nefes nedeni ile daha fazla oksijen alma ihtiyacı hissedilecek; bu da çok daha sık nefes alışverişine ve sporcunun normalden daha önce yorulmasına sebep olabilecektir. Kuvvet ve kondisyon antrenörleri, daha iyi solunum alışkanlıklarının, core stabilizasyonunu olumlu olarak etkileyebileceği ve sporcunun genel kondisyon seviyesini iyileştirebileceği için sporcuların solunum modellerini değerlendirmeyi ve yeniden eğitmeyi düşünmelidir.

Anahtar Kelimeler: Diyafram; core stabilizasyonu; nefes
ABSTRACT
The importance of the diaphragm in the stability of the core region is the ability to control the position and movement of the trunk on the pelvis in optimal athletic activities to optimally produce, transmit and control force and movement. The aim of this study is to explain the importance of diaphragm breathing in core region stability and to determine improvement strategies. According to Panjabi, the central nervous system (control), the skeletal system (passive) and the muscular system (active) work together to maintain this integrity. It is also contemplated that dysfunction in one component of these systems may cause other systems to compensate for this, long-term adaptation of one or more systems, and damage to the components of the systems. Thus, it has been found that the stability of the spine depends not only on muscle strength but also on sensory input to the central nervous system. Because the diaphragm has a role in simultaneous stabilization and respiratory system, the assessment should include supine, prone, sitting and standing. As a result of the evaluation, the diaphragm breath should be learned and this should be adapted effectively to the movement patterns to be applied in the field. If proper diaphragm use cannot be achieved, there will be a need for more oxygen to breathe from the chest during performance, which will cause more frequent breathing and may cause the athlete to get tired earlier than usual. Strength and conditioning coaches should consider evaluating and retraining their breathing patterns for athletes, as better breathing habits can positively affect core stabilization and ultimately improve the athlete's overall fitness level.

Keywords: Diaphragm; core stabilization; breathing
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