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Yüksek Yoğunluklu Fonksiyonel Egzersizlerin Sirkadiyen Ritim ve Anaerobik Performans Parametreleri Üzerindeki Akut Etkisi

Yıl 2022, Cilt: 11 Sayı: 1, 279 - 286, 19.03.2022
https://doi.org/10.37989/gumussagbil.1049921

Öz

Kickboks, yüksek yoğunlukta ve kısa aralıklarla yapılan bir spordur. Yüksek yoğunluklu fonksiyonel antrenman, müsabakaya özel kickboksçuların antrenmanına katkıda bulunabilir. Bu çalışmanın amacı, yüksek yoğunluklu fonksiyonel egzersizlerin sirkadiyen ritim ve anaerobik performans parametreleri üzerindeki akut etkisini incelemektir. Araştırmaya 18-25 yaşları arasında gönüllü 15 erkek kick boks sporcusu (yaş, 20.67± 1.23 yıl; boy, 173.60± 3.18 cm; 69, 20±2.67 kg; VKİ 23.03±.49) katıldı. Araştırma protokolü günün farklı saatlerinde gerçekleştirilen multimodel HIFT egzersizlerinden oluşmaktadır. HIFT protokolünden sonra; gönüllülerden günün farklı saatlerinde (09.00; 13.00; 17.00) T-line çeviklik, dikey sıçrama, ortalama ve zirve güç verileri elde edildi. Dikey sıçrama [F(1,145)= 129.54 p=.000, kısmi eta kare:,902], zirve güç değerleri [F(1.275)= 122.89 p=.000, kısmi eta kare:,898], ortalama güç değerleri [F(1,139)= 124.23 p=.000, kısmi eta kare:,899], T-line çeviklik süreleri [F(1.925)= 39.227 p=.000, kısmi eta kare:,737] sabah, öğle ve akşam protokollerinde sonra uygulanan HIFT arasında istatistiksel olarak anlamlı fark bulundu (p< 0.05). Tüm parametreler için en iyi değerler akşam saatinde (05.00 pm) elde edildi. Akşam saatlerinde dikey sıçrama, ortalama güç, zirve güç ve T-line çevikliği üzerinde HIFT'in sabah ve öğleden sonra saatlerine göre daha iyi bir etkiye sahip olduğu belirlendi.

Kaynakça

  • 1. Ambroży, T, Rydzik, Ł, Obmiński, Z, Klimek, A.T, Serafin, N, Litwiniuk, A, Czaja R. and Czarny, W. (2021). “The Impact of Reduced Training Activity of Elite Kickboxers on Physical Fitness, Body Build, and Performance during Competitions.” International Journal of Environmental Research and Public Health, 18 (8), 4342.
  • 2. Barley, O. R, Chapman, D. W. and Abbiss, C. R. (2018). “Weight Loss Strategies in Combat Sports and Concerning Habits in Mixed Martial Arts.” International Journal Of Sports Physiology and Performance 13, (7), 933-939.
  • 3. Jackson, K, Edginton-Bigelow, K, Cooper, C. and Merriman, H. (2012). “A Group Kickboxing Program For Balance, Mobility, and Quality of Life in Individuals with Multiple Sclerosis: A Pilot Study.” Journal of Neurologic Physical Therapy, 36 (3), 131-137.
  • 4. Slimani, M, Chaabene, H, Miarka, B, Franchini, E, Chamari, K. and Cheour, F. (2017). “Kickboxing Review: Anthropometric, Psychophysiological and Activity Profiles and Injury Epidemiology.” Biology of Sport, 34 (2), 185.
  • 5. Buse, G. J. and Santana J. C. (2008). “Conditioning Strategies for Competitive Kickboxing.” Strength and Conditioning Journal, 30 (4), 42-48.
  • 6. Moreira, A, Arsati, F, de Oliveira Lima-Arsati, Y. B, Franchini, E. and De Araújo, V. C. (2010). “Effect of a Kickboxing Match on Salivary Cortisol and Immunoglobulin A.” Perceptual And Motor Skills, 111 (1), 158-166.
  • 7. Souissi, N, Gauthier, A, Sesboüé, B, Larue, J. and Davenne, D. (2004). “Circadian Rhythms in Two Types of Anaerobic Cycle Leg Exercise: Force-Velocity And 30-S Wingate Tests.” International Journal of Sports Medicine, 25 (01), 14-19.
  • 8. Atkinson, G. and Reilly, T. (1996). “Circadian Variation in Sports Performance.” Sports Medicine, 21 (4), 292-312.
  • 9. Kline, C. E, Durstine, J. L, Davis, J.M, Moore, T. A, Devlin, T.M, Zielinski, M. R. and Youngstedt, S. D. (2007). “Circadian Variation in Swim Performance.” Journal of Applied Physiology, 102 (2), 641-649.
  • 10. Sedliak, M, Finni, T, Peltonen, J. and Häkkinen, K. (2008). “Effect of Time-of-Day-Specific Strength Training on Maximum Strength And EMG Activity of The Leg Extensors İn Men.” Journal of Sports Sciences, 26 (10), 1005-1014.
  • 11. Decostre, V, Bianco, P, Lombardi, V. and Piazzesi, G. (2005). “Effect of Temperature on The Working Stroke of Muscle Myosin.” Proceedings of the National Academy of Sciences, 102 (39), 13927-13932.
  • 12. Moore, R. Y. and Danchenko, R. L. (2002). “Paraventricular–Subparaventricular Hypothalamic Lesions Selectively Affect Circadian Function.” Chronobiology International, 19 (2), 345-360.
  • 13. Davidson, A. J, Yamazaki, S. and Menaker, M. (2004). “SCN: Ringmaster of the Circadian Circus or Conductor of The Circadian Orchestra.” Molecular Clocks and Light Signalling, 110-125.
  • 14. Duffy, J. F. and Dijk, D. J. (2002). “Getting through to Circadian Oscillators: Why Use Constant Routines?.” Journal of Biological Rhythms, 17 (1), 4-13.
  • 15. Spengler, C. M. and Shea, S. A. (2000). “Endogenous Circadian Rhythm Of Pulmonary Function in Healthy Humans.” American Journal of Respiratory and Critical Care Medicine, 162 (3), 1038-1046.
  • 16. Boivin, D. B, Czeisler, C. A, Dijk, D. J, Duffy, J. F, Folkard, S, Minors, D. S, Totterdell P. and Waterhouse, J. M. (1997). “Complex İnteraction of The Sleep-Wake Cycle and Circadian Phase Modulates Mood in Healthy Subjects.” Archives of General Psychiatry, 54 (2), 145-152.
  • 17. Wright Jr, K. P, Hull, J. T. and Czeisler, C. A. (2002). “Relationship between Alertness, Performance, and Body Temperature in Humans.” American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 283 (6), R1370-R1377.
  • 18. Brandenburg, J. P. (2006). “Duration of Stretch Does Not Influence The Degree of Force Loss Following Static Stretching.” Journal of Sports Medicine and Physical Fitness, 46 (4), 526.
  • 19. Feito, Y, Hoffstetter, W, Serafini, P. and Mangine, G. (2018). “Changes in Body Composition, Bone Metabolism, Strength, and Skill-Specific Performance Resulting from 16-weeks of HIFT.” PLoS One, 13 (6), e0198324.
  • 20. Feito, Y, Heinrich, K. M, Butcher, S. J. and Poston, W. S. C. (2018). “High-Intensity Functional Training (HIFT): Definition and Research Implications For Improved Fitness.” Sports, 6 (3), 76.
  • 21. Murawska-Cialowicz, E, Wojna, J. and Zuwala-Jagiello, J. (2015). “Crossfit Training Changes Brain-Derived Neurotrophic Factor and İrisin Levels At Rest, after Wingate And Progressive Tests, and Improves Aerobic Capacity and Body Composition of Young Physically Active Men and Women.” J Physiol Pharmacol, 66 (6), 811-821.
  • 22. Heinrich, K. M, Spencer, V, Fehl, N. and Carlos Poston, W. S. (2012). “Mission Essential Fitness: Comparison of Functional Circuit Training To Traditional Army Physical Training For Active Duty Military.” Military Medicine, 177 (10), 1125-1130.
  • 23. Faul, F, Erdfelder, E, Lang, A. G. and Buchner, A. (2007). “G* Power 3: A Flexible Statistical Power Analysis Program For The Social, Behavioral, and Biomedical Sciences.” Behavior Research Methods, 39 (2), 175-191.
  • 24. Reilly, T, Atkinson, G, Edwards, B, Waterhouse, J, Farrelly, K. and Fairhurst, E. (2007). “Diurnal Variation in Temperature, Mental and Physical Performance, and Tasks Specifically Related To Football (Soccer).” Chronobiology International, 24 (3), 507-519.
  • 25. Riebe, D, Ehrman, J.K, Liguori, G, Magal, M. and American College of Sports Medicine (Eds). (2018). “ACSM's guidelines for exercise testing and prescription.” Wolters Kluwer.
  • 26. Pauole, K, Madole, K, Garhammer, J, Lacourse, M. and Rozenek, R. (2000). “Reliability and Validity of The T-Test As A Measure Of Agility, Leg Power, and Leg Speed in College-Aged Men and Women.” The Journal of Strength and Conditioning Research, 14 (4), 443-450.
  • 27. Fox E. (1998). “The Physiological Basis of Physical Education and Athletics.” 4th edition, Saunders College Publishing, Philadelphia.
  • 28. Ben-Zeev, T, Hirsh, T, Weiss, I, Gornstein, M. and Okun, E. (2020). “The Effects of High-İntensity Functional Training (HIFT) on Spatial Learning, Visual Pattern Separation and Attention Span in Adolescents.” Frontiers in Behavioral Neuroscience, 14, 165.
  • 29. Karvonen, M.J. (1957). “The Effects of Training on Heart Rate: A Longitudinal Study.” Annales Medicinae Experimentalis Et Biologiae Fenniae, 35, 307-315.
  • 30. Brisebois, M. F, Rigby, B. R. and Nichols, D. L. (2018). “Physiological and Fitness Adaptations after Eight Weeks Of High-İntensity Functional Training in Physically İnactive Adults.” Sports, 6 (4), 146.
  • 31. Crawford, D. A, Drake, N. B, Carper, M. J, DeBlauw, J. and Heinrich, K. M. (2018). “Are Changes in Physical Work Capacity Induced By High-İntensity Functional Training Related To Changes in Associated Physiologic Measures?.” Sports, 6 (2), 26.
  • 32. Sobrero, G, Arnett, S, Schafer, M, Stone, W, Tolbert, T. A. and Salyer-Funk. (2017). “A Comparison of High Intensity Functional Training And Circuit Training on Health and Performance Variables in Women: A Pilot Study.” Women in Sport and Physical Activity Journal, 25 (1), 1-10.
  • 33. López-Samanes, Á, Moreno-Pérez, D, Maté-Muñoz, J. L, Domínguez, R, Pallarés, J.G, Mora-Rodriguez, R. and Ortega, J.F. (2017). “Circadian Rhythm Effect on Physical Tennis Performance in Trained Male Players.” Journal of Sports Sciences, 35 (21), 2121-2128.

The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters

Yıl 2022, Cilt: 11 Sayı: 1, 279 - 286, 19.03.2022
https://doi.org/10.37989/gumussagbil.1049921

Öz

Kickboxing is a sport that involves high intensity and short intervals. High intensity functional training can contribute to training kickboxers specific to the competition. The purpose of this study is to examine the acute effect of high-intensity functional exercises on circadian rhythm and anaerobic performance parameters. The study consisted of 15 volunteer male kickboxers (age, 20.67± 1.23 years; height, 173.60± 3.18 cm; 69, 20±2.67 kg; BMI 23.03±.49) between the ages of 18-25. The research protocol consisted of multimodal HIFT exercises performed at different times of the day. After HIFT protocol; T-line agility, vertical jump, average and peak power data were obtained from the volunteers at different times of day (09.00 am; 01.00 pm; 05.00 pm). There was find statistically significant difference between vertical jump [F(1,145)= 129.54 p=.000, partial eta square:,902], peak power values [F(1,275)= 122.89 p=.000, partial eta square:,898], average power values [F(1,139)= 124.23 p=.000, partial eta square:,899], T-line agility times [F(1,925)= 39,227 p=.000, partial eta square:,737] after HIFT in the morning, afternoon and evening protocols (p< 0.05). The best scores were obtained in the evening (05.00 pm) values for all parameters. It was determined that HIFT had better effect on vertical jump, average power, peak power and T-line agility in the evening than morning and afternoon hours.

Kaynakça

  • 1. Ambroży, T, Rydzik, Ł, Obmiński, Z, Klimek, A.T, Serafin, N, Litwiniuk, A, Czaja R. and Czarny, W. (2021). “The Impact of Reduced Training Activity of Elite Kickboxers on Physical Fitness, Body Build, and Performance during Competitions.” International Journal of Environmental Research and Public Health, 18 (8), 4342.
  • 2. Barley, O. R, Chapman, D. W. and Abbiss, C. R. (2018). “Weight Loss Strategies in Combat Sports and Concerning Habits in Mixed Martial Arts.” International Journal Of Sports Physiology and Performance 13, (7), 933-939.
  • 3. Jackson, K, Edginton-Bigelow, K, Cooper, C. and Merriman, H. (2012). “A Group Kickboxing Program For Balance, Mobility, and Quality of Life in Individuals with Multiple Sclerosis: A Pilot Study.” Journal of Neurologic Physical Therapy, 36 (3), 131-137.
  • 4. Slimani, M, Chaabene, H, Miarka, B, Franchini, E, Chamari, K. and Cheour, F. (2017). “Kickboxing Review: Anthropometric, Psychophysiological and Activity Profiles and Injury Epidemiology.” Biology of Sport, 34 (2), 185.
  • 5. Buse, G. J. and Santana J. C. (2008). “Conditioning Strategies for Competitive Kickboxing.” Strength and Conditioning Journal, 30 (4), 42-48.
  • 6. Moreira, A, Arsati, F, de Oliveira Lima-Arsati, Y. B, Franchini, E. and De Araújo, V. C. (2010). “Effect of a Kickboxing Match on Salivary Cortisol and Immunoglobulin A.” Perceptual And Motor Skills, 111 (1), 158-166.
  • 7. Souissi, N, Gauthier, A, Sesboüé, B, Larue, J. and Davenne, D. (2004). “Circadian Rhythms in Two Types of Anaerobic Cycle Leg Exercise: Force-Velocity And 30-S Wingate Tests.” International Journal of Sports Medicine, 25 (01), 14-19.
  • 8. Atkinson, G. and Reilly, T. (1996). “Circadian Variation in Sports Performance.” Sports Medicine, 21 (4), 292-312.
  • 9. Kline, C. E, Durstine, J. L, Davis, J.M, Moore, T. A, Devlin, T.M, Zielinski, M. R. and Youngstedt, S. D. (2007). “Circadian Variation in Swim Performance.” Journal of Applied Physiology, 102 (2), 641-649.
  • 10. Sedliak, M, Finni, T, Peltonen, J. and Häkkinen, K. (2008). “Effect of Time-of-Day-Specific Strength Training on Maximum Strength And EMG Activity of The Leg Extensors İn Men.” Journal of Sports Sciences, 26 (10), 1005-1014.
  • 11. Decostre, V, Bianco, P, Lombardi, V. and Piazzesi, G. (2005). “Effect of Temperature on The Working Stroke of Muscle Myosin.” Proceedings of the National Academy of Sciences, 102 (39), 13927-13932.
  • 12. Moore, R. Y. and Danchenko, R. L. (2002). “Paraventricular–Subparaventricular Hypothalamic Lesions Selectively Affect Circadian Function.” Chronobiology International, 19 (2), 345-360.
  • 13. Davidson, A. J, Yamazaki, S. and Menaker, M. (2004). “SCN: Ringmaster of the Circadian Circus or Conductor of The Circadian Orchestra.” Molecular Clocks and Light Signalling, 110-125.
  • 14. Duffy, J. F. and Dijk, D. J. (2002). “Getting through to Circadian Oscillators: Why Use Constant Routines?.” Journal of Biological Rhythms, 17 (1), 4-13.
  • 15. Spengler, C. M. and Shea, S. A. (2000). “Endogenous Circadian Rhythm Of Pulmonary Function in Healthy Humans.” American Journal of Respiratory and Critical Care Medicine, 162 (3), 1038-1046.
  • 16. Boivin, D. B, Czeisler, C. A, Dijk, D. J, Duffy, J. F, Folkard, S, Minors, D. S, Totterdell P. and Waterhouse, J. M. (1997). “Complex İnteraction of The Sleep-Wake Cycle and Circadian Phase Modulates Mood in Healthy Subjects.” Archives of General Psychiatry, 54 (2), 145-152.
  • 17. Wright Jr, K. P, Hull, J. T. and Czeisler, C. A. (2002). “Relationship between Alertness, Performance, and Body Temperature in Humans.” American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 283 (6), R1370-R1377.
  • 18. Brandenburg, J. P. (2006). “Duration of Stretch Does Not Influence The Degree of Force Loss Following Static Stretching.” Journal of Sports Medicine and Physical Fitness, 46 (4), 526.
  • 19. Feito, Y, Hoffstetter, W, Serafini, P. and Mangine, G. (2018). “Changes in Body Composition, Bone Metabolism, Strength, and Skill-Specific Performance Resulting from 16-weeks of HIFT.” PLoS One, 13 (6), e0198324.
  • 20. Feito, Y, Heinrich, K. M, Butcher, S. J. and Poston, W. S. C. (2018). “High-Intensity Functional Training (HIFT): Definition and Research Implications For Improved Fitness.” Sports, 6 (3), 76.
  • 21. Murawska-Cialowicz, E, Wojna, J. and Zuwala-Jagiello, J. (2015). “Crossfit Training Changes Brain-Derived Neurotrophic Factor and İrisin Levels At Rest, after Wingate And Progressive Tests, and Improves Aerobic Capacity and Body Composition of Young Physically Active Men and Women.” J Physiol Pharmacol, 66 (6), 811-821.
  • 22. Heinrich, K. M, Spencer, V, Fehl, N. and Carlos Poston, W. S. (2012). “Mission Essential Fitness: Comparison of Functional Circuit Training To Traditional Army Physical Training For Active Duty Military.” Military Medicine, 177 (10), 1125-1130.
  • 23. Faul, F, Erdfelder, E, Lang, A. G. and Buchner, A. (2007). “G* Power 3: A Flexible Statistical Power Analysis Program For The Social, Behavioral, and Biomedical Sciences.” Behavior Research Methods, 39 (2), 175-191.
  • 24. Reilly, T, Atkinson, G, Edwards, B, Waterhouse, J, Farrelly, K. and Fairhurst, E. (2007). “Diurnal Variation in Temperature, Mental and Physical Performance, and Tasks Specifically Related To Football (Soccer).” Chronobiology International, 24 (3), 507-519.
  • 25. Riebe, D, Ehrman, J.K, Liguori, G, Magal, M. and American College of Sports Medicine (Eds). (2018). “ACSM's guidelines for exercise testing and prescription.” Wolters Kluwer.
  • 26. Pauole, K, Madole, K, Garhammer, J, Lacourse, M. and Rozenek, R. (2000). “Reliability and Validity of The T-Test As A Measure Of Agility, Leg Power, and Leg Speed in College-Aged Men and Women.” The Journal of Strength and Conditioning Research, 14 (4), 443-450.
  • 27. Fox E. (1998). “The Physiological Basis of Physical Education and Athletics.” 4th edition, Saunders College Publishing, Philadelphia.
  • 28. Ben-Zeev, T, Hirsh, T, Weiss, I, Gornstein, M. and Okun, E. (2020). “The Effects of High-İntensity Functional Training (HIFT) on Spatial Learning, Visual Pattern Separation and Attention Span in Adolescents.” Frontiers in Behavioral Neuroscience, 14, 165.
  • 29. Karvonen, M.J. (1957). “The Effects of Training on Heart Rate: A Longitudinal Study.” Annales Medicinae Experimentalis Et Biologiae Fenniae, 35, 307-315.
  • 30. Brisebois, M. F, Rigby, B. R. and Nichols, D. L. (2018). “Physiological and Fitness Adaptations after Eight Weeks Of High-İntensity Functional Training in Physically İnactive Adults.” Sports, 6 (4), 146.
  • 31. Crawford, D. A, Drake, N. B, Carper, M. J, DeBlauw, J. and Heinrich, K. M. (2018). “Are Changes in Physical Work Capacity Induced By High-İntensity Functional Training Related To Changes in Associated Physiologic Measures?.” Sports, 6 (2), 26.
  • 32. Sobrero, G, Arnett, S, Schafer, M, Stone, W, Tolbert, T. A. and Salyer-Funk. (2017). “A Comparison of High Intensity Functional Training And Circuit Training on Health and Performance Variables in Women: A Pilot Study.” Women in Sport and Physical Activity Journal, 25 (1), 1-10.
  • 33. López-Samanes, Á, Moreno-Pérez, D, Maté-Muñoz, J. L, Domínguez, R, Pallarés, J.G, Mora-Rodriguez, R. and Ortega, J.F. (2017). “Circadian Rhythm Effect on Physical Tennis Performance in Trained Male Players.” Journal of Sports Sciences, 35 (21), 2121-2128.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Özgür Eken 0000-0002-5488-3158

Ramazan Bayer 0000-0002-2161-5886

Serdar Bayrakdaroğlu 0000-0002-2166-6675

Yayımlanma Tarihi 19 Mart 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 11 Sayı: 1

Kaynak Göster

APA Eken, Ö., Bayer, R., & Bayrakdaroğlu, S. (2022). The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 11(1), 279-286. https://doi.org/10.37989/gumussagbil.1049921
AMA Eken Ö, Bayer R, Bayrakdaroğlu S. The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. Mart 2022;11(1):279-286. doi:10.37989/gumussagbil.1049921
Chicago Eken, Özgür, Ramazan Bayer, ve Serdar Bayrakdaroğlu. “The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11, sy. 1 (Mart 2022): 279-86. https://doi.org/10.37989/gumussagbil.1049921.
EndNote Eken Ö, Bayer R, Bayrakdaroğlu S (01 Mart 2022) The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11 1 279–286.
IEEE Ö. Eken, R. Bayer, ve S. Bayrakdaroğlu, “The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters”, Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 11, sy. 1, ss. 279–286, 2022, doi: 10.37989/gumussagbil.1049921.
ISNAD Eken, Özgür vd. “The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11/1 (Mart 2022), 279-286. https://doi.org/10.37989/gumussagbil.1049921.
JAMA Eken Ö, Bayer R, Bayrakdaroğlu S. The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2022;11:279–286.
MLA Eken, Özgür vd. “The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 11, sy. 1, 2022, ss. 279-86, doi:10.37989/gumussagbil.1049921.
Vancouver Eken Ö, Bayer R, Bayrakdaroğlu S. The Acute Effect of High-Intensity Functional Exercises on Circadian Rhythm and Anaerobic Performance Parameters. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2022;11(1):279-86.