Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 316594

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : August | Volume : 16 | Issue : 8 | Page : CC12 - CC16 Full Version

Physical Fitness Index of Medical Students in Thrissur, Kerala, India: A Cross-sectional Study


Published: August 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/57596.16733
Arsha Krishnan, Gokul Suresh Revathy

1. Assistant Professor, Department of Physiology, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India. 2. Assistant Professor, Department of Physiology, Sree Narayana Institute of Medical Sciences, Ernakulam, Kerala, India.

Correspondence Address :
Dr. Arsha Krishnan,
Sreeragam, Panayil P.O, Pallickal North, Nooranad, Alappuzha-690504, Kerala, India.
E-mail: arshanikhil11@gmail.com

Abstract

Introduction: Physical activity forms an important component of a healthy lifestyle. Inadequate physical activity is a major risk factor for non communicable diseases. It is necessary to identify the status of physical fitness of medical students who are the future professionals of healthcare. There are various parameters available to assess the physical fitness of an individual. Modified Harvard step test is a tool used for assessing cardiopulmonary fitness, which is employed in this study.

Aim: To compare the physical fitness of medical students who were regular basketball players, with sedentary medical students, using cardiovascular parameters.

Materials and Methods: The cross-sectional study was conducted in the Department of Physiology, Government Medical College, Thrissur, Kerala, India, from April 2017 to April 2018. Total 60 medical students of both gender, in the age group 18-25 years, out of which 30 were athletes and 30 non athletes, were selected by simple random sampling. Physical fitness index was measured after the subjects performed modified Harvard step test. The duration of exercise and the recovery heart rates were considered. Statistical analysis was done using Chi-square test, correlation and regression tests, Independent t-test and Paired t-test, for which, p-value <0.05 was significant.

Results: The mean age of the athletes was 20.97±1.69 years and non athletes was 21.40±1.42 years. Lower Body Mass Index (BMI), resting pulse rate and after exercise recovery pulse rates were found in athletes which were statistically significant (p-value <0.05). The duration of exercise and Physical Fitness Index (PFI) were found to be higher in athletes than non athletes and was statistically significant (p-value <0.001). Physical fitness was thus found to be higher in athletes compared to non athletes.

Conclusion: The study indicated that students who had routine physical training had better fitness levels than sedentary students.

Keywords

Athletes, Modified harvard step test, Non athletes, Physical activity

Obesity is one of the major health concerns that is affecting people all over the world. World Health Organization (WHO), defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health” (1). With increasing obesity, there is an increase in cardiovascular diseases, diabetes mellitus and other non-communicable diseases. Our societies are undergoing transformations in various sectors like economy, nutrition and demography. Rapid adoption of urban lifestyle and increase in monthly household income has caused a shift to caloric beverages, egg, meat and other food items with high sugar, salt and fat. The busy schedule of urban working parents has led to the increased demand for ready to cook foods and fast foods which are increasingly replacing home-made food items. In addition, sedentary lifestyle and reduced physical activity are making children prone for obesity (1).

People have to be made aware of the health hazards associated with such lifestyle changes and encouraged to adopt healthy nutrition and exercise habits in order to shape a healthy society. Physical inactivity has been pointed out as the fourth leading risk factor for global mortality, associated with almost 3.2 million deaths globally (2). According to WHO, around 23% of adults aged 18 and over were found to be physically inactive as of 2010 (men 20% and women 27%) (3). Physical fitness is defined as “the ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy, to enjoy leisure time pursuits, and to meet unforeseen emergencies” (2). The overall level of physical fitness is determined by aerobic fitness (ability of the heart and lungs to deliver blood to muscles); muscular strength and endurance, (which measures the strength required to perform normal activities easily); Flexibility (the ability to mobilise joints through their proper range of motion) and Body composition (4). A holistic lifestyle encompassing all aspects of fitness is essential for leading a healthy life.

College is an important phase of a person’s life where academic, personal, social, physical and emotional aspects collide. In a stressful professional course such as medicine, it is all too common for students to skimp on healthy eating and exercise habits in pursuit of academics. The unhealthy habits picked during this time continue into their adult lives. It is important for medical students to have healthy habits as they are responsible for the future healthcare of the society, and should reflect what they preach. It is also seen that doctors are exposed to early risk factors of non communicable diseases (5). Generally, medical students know more about healthy lifestyle and dietary habits when compared to other professional courses (6). But whether this knowledge translates into practice in terms of maintaining good health remains to be seen (6). In this regard, there is a need to assess the physical fitness of our future doctors and to make them aware of adopting a healthy life style right from the beginning of their career.

Not many studies, which determine Physical Fitness Index (PFI) using modified Harvard step test in basketball players, are available in this part of the country (5),(7). So, the present study aimed to compare the physical fitness index of medical students, who were regular basketball players, with sedentary medical students.

Material and Methods

This cross-sectional study took place at Department of Physiology, Government Medical College, Thrissur, Kerala, India, from April 2017 to April 2018. Clearance was obtained from the Hospital Ethical Committee and informed written consent was obtained for all subjects included in the study.

Sample size calculation: The minimum sample size calculated was 60. Sample size was calculated using the formula:

(zα+zβ)2×2×(SD)2 / d2, where SD=SD1+SD2 / 2

zα=z value for α error (the probability of falsely rejecting a true null hypothesis)
zβ=z value for β error (the probability of failing to reject a false null hypothesis)
SD=Mean standard deviation between two groups
d=Difference in means of PFI in previous study (7).
Confidence level considered was 95%, ??is 5% with power of 100%, and the p-value <0.001 highly significant (8).

The students were grouped by simple random sampling methods:

Athletes (n=30): Medical students who palyed basketball regulary
Non athletes (n=30): Medical students who have sedentary lifestyle.

Inclusion criteria: The athletes were basketball players of age group 18-25 years from Government Medical College, Thrissur, being trained in basketball for at least 2 hours in the morning and evening, 5 days a week, for a minimum of 3 months. The non athletes were age and sex matched medical students from same college, who did not perform regular physical activity in the form of any exercise, and/or their structured physical activity was less than 20 minutes per day.

Exclusion criteria: Exclusion criteria included those with history of acute or chronic respiratory illness, cardiovascular illness or any other medical illness, those on medications, and those with history of smoking or tobacco abuse.

Procedure

Body Mass Index (BMI): After taking a detailed history and physical examination, height and weight measurements were taken using standard protocol and BMI was calculated (kg/m2).

Blood pressure: Blood pressure was recorded from the right upper limb in the sitting position, using standard mercury sphygmomanometer by palpatory and auscultatory methods.

Modified Harvard step test: All subjects were familiarised with modified Harvard step test. It is a test of aerobic fitness, developed by Brouha L et al., (1943) during World War II in the Harvard Fatigue Laboratories (9). Originally, the participants step up and down on a platform of step height 50.8 cm, at a rate of 30 steps per minute (once every two seconds) for 5 minutes, or until exhaustion (9). Exhaustion was defined as inability to maintain stepping rate for 15 seconds (9). It is valid and reliable (10). In this study, authors employed modified Harvard step test where step height was 33 cms for ease of performance from an Indian context (11). Resting pulse rate was procured by counting the radial artery pulse for one minute in sitting position after 5 minutes of rest. The subjects were made to do modified Harvard step test in a rhythmic manner for five minutes, or until exhaustion. Total duration of the exercise was measured as the time in seconds upto which each subject was able to perform the test. At one, three and five minutes after exercise, pulse rate was recorded.

Physical Fitness Index (PFI): PFI was calculated using the formula:

Physical Fitness Index = (Duration of exercise in seconds×100) ÷ (P1+P2+P3).

Where P1, P2 and P3 being pulse rates one minute, three minutes and five minutes after exercise respectively (12).

Based on the score, PFI was graded as (13):

• Excellent (>90),
• Good (80-89),
• High average (65-79),
• Low average (55-64), and
• Poor (<55)

Correlation of PFI with respect to height of individual was also done. Height is an important factor that influences athletic performance especially basketball (14). But some studies have shown that increase in subject’s height can make the step test comparatively easier to perform even if the person is not an athlete (7),(15). That is why in this study, authors have specifically tested for correlation of PFI with height.

Statistical Analysis

The data was entered into Microsoft Excel 13 and analysis of quantitative variables were done using mean, standard deviation and 95% confidence interval. Statistical analysis was done using Chi-square test, correlation test, Independent t-test, for which, p-value <0.05 was assigned significant.

Results

The mean age of athletes was 20.97±1.69 years and non athletes was 21.40±1.42 years (Table/Fig 1) which was comparable (p-value=0.43). The athlete group had more males than females, while the non-athlete group had more females (p-value=0.03) (Table/Fig 2). Mean values and standard deviation of the quantitative variables like height, weight, BMI, systolic and diastolic blood pressure of both the group has been given in (Table/Fig 3). The BMI of non athletes (22.67±3.37 kg/m2) was more than athletes (20.80±2.01 kg/m2) and statistically significant (p-value=0.01) (Table/Fig 3).

Resting and recovery pulse rates were lower for athletes, and statistically significant (p-value <0.05) as analysed by Independent t-test (Table/Fig 4). The mean duration of exercise was more for athletes (274.00 sec) when compared to non athletes (160.63 sec) and statistically significant (p-value<0.05) (Table/Fig 5). Physical fitness index was more in athletes (94.31-graded as excellent) than non athletes (47.87-graded poor) and was found to be statistically significant (Table/Fig 6). Correlation of PFI with respect to height of individual was also done and was positive and statistically significant (p-value <0.001) (Table/Fig 7).

Discussion

It is well known that physical fitness can be increased by participation in sports activities. The game of basketball requires good level of physical fitness and that too in various aspects like flexibility, neuromuscular efficiency, muscular strength and speed of movements. The extent of an individual’s ability to play basketball can be predicted by his/her cardiovascular capacity and physical characteristics. It is a multiple sprint game. Basketball requires strong agility, repetitive jump and land, and sudden change in direction. This involves optimum aerobic and anaerobic power (16).

This study population included 60 participants who were comparable in age. The participation of males in physical activity was found to be higher than females. This is similar to the one conducted by Bergier J et al., who found that males were more involved in sports than females (17). Physical activity among females was influenced by socio-ecological factors at the individual, family, educational and environmental levels (18).

In this study, the BMI of athletes was less than non athletes and it was statistically significant (p-value< 0.05). BMI is one of the most important determinants of obesity. Over-weight and obese individuals tend to have lower fitness levels compared to normal weight individuals as shown by the one conducted by Parmar D et al., (19). In this study, athletes were also taller compared to non athletes, which was statistically significant (p-value <0.05). It is to be noted that height is an important factor which significantly affects performance, especially basketball (14).

In the study, mean SBP and DBP values of both groups were within normal limits as per American Heart Association (AHA) guidelines (20). The results were comparable (p-value >0.05). A study conducted by Halder K et al., also showed that resting blood pressure holds no statistically significant difference between female athletes and non athletes (21).

In this study, the resting pulse rate of athletes, who were students who regularly played basketball, was lower compared to non athletic group and was statistically significant (p-value <0.05). A similar study by Koley S and Singh J also found resting pulse rate to be lower in athletes compared to non-athletes (22). A similar study by Martinelli F et al., suggests that the resting bradycardia observed in athletes could be due to the variability in intrinsic mechanisms acting on the sinus node and the variation in autonomic regulation of the heart (23). The reduced sympathetic activity or increased vagal tone can contribute in part to resting bradycardia in athletes (24). These are true for basketball players also. Once the subjects started the physical activity, which in this study was the modified Harvard step test, heart rate increased. The tachycardia at the beginning of exercise occurs during the initial 10 seconds of activity at all levels of exercise (24). This is due to the sudden reduction of vagal tone in the sinus node (24). The post exercise pulse rates for athletes showed a comparatively less increase compared to non athletes in this study. This may be due to the regular training sessions they carry out as a part of their athletic involvement. A study by Mikhahil CM et al., showed that the post exercise recovery of the heart rate for athletes was faster than the non athletes (25). The present study also presented similar findings. Body function during exercise are regulated by sympathetic nervous system, but a shift in the autonomic balance occurs after exercise, and the parasympathetic system returns the body to a resting state (26). A coordinated interaction of parasympathetic reactivation and sympathetic withdrawal results in post exercise heart rate recovery (26). Sympathetic system exerts its effect during exercise by increasing the heart rate via an epinephrine mediated stimulation of cardiac beta-1 receptors and during rest, parasympathetic system decreases the heart rate via muscarinic activation by acetylcholine through reactivation of the vagal nerve (27). The duration of heart rate recovery depends on intensity of exercise and cardiovascular fitness (28).

Physical fitness index is calculated based on the duration of exercise and recovery heart rate values. In this study, PFI was found to be higher in athletes than non athletes and this was statistically significant (p-value<0.05). Athletes are able to prolong the duration of their physical activity while having a faster pulse rate recovery. This translated to a higher PFI value for the athlete group in the present study. A similar study by Katralli J et al., also observed a higher PFI among Judo players compared to sedentary individuals (7). The height of subjects had a significantly positive correlation to the fitness score and also to the duration of exercise as shown by the study done by Sharma P et al., (15). They also suggested that shorter individuals undergo muscle fatigue faster, trying to do the step test, and this could be the reason for their lower PFI score rather than cardiorespiratory impairment (15). But further studies are required to verify this.

The efficiency of the heart, lungs and blood vessels in delivering oxygen to the working muscles for maintaining prolonged physical work is represented by cardiovascular fitness (29). Variables like resting heart rate, resting blood pressure, cardiac output, stroke volume, maximum oxygen consumption (VO2 max), endurance capacity, High Density Lipoprotein (HDL) cholesterol, body fat, glucose-stimulated insulin, and total cholesterol levels were the traditional indicators of cardiovascular fitness (29). It has been identified that heart rate recovery is a powerful and independent predictor of cardiovascular and all-cause mortality in healthy adults (30), in those with cardiovascular diseases (31) and diabetes (32). It has been described as an independent predictor of endothelial function, an important risk factor for cardiovascular disease, and is delayed due to autonomic dysfunction or imbalance (33). Heart rate recovery is an important parameter in calculating physical fitness index (12). The present study has been done with a view to compare the physical fitness index of medical students who played basketball with those who were sedentary.

An increase in cardiopulmonary fitness levels of medical students who practice regular athletic activity was objectively confirmed in this study.

Limitation(s)

Small sample size with only 30 subjects in each group and there was a disparity in number of males and females. Some of the factors that may have an impact on the result of this test like room temperature, noise level and humidity, the subject’s emotional state, the amount of sleep the subject had prior to testing, the subject’s caffeine intake, the subject’s prior knowledge/experience regarding the test and inappropriate warm up were not considered.

Conclusion

Physical fitness index was significantly higher in students who were regular basketball players than sedentary students. Regular physical training leads to various cardiopulmonary adaptations that can considerably increase the fitness levels of an individual. Medical students are inherently likely to skip on regular physical activity to find more time for academics and clinical duties. This could lead to a possible unhealthy lifestyle in their subsequent years. As torch-bearers of future healthcare of our society, they should be made aware and adequate measures ensured so as to lead an active and healthy life. Future research studies comparing PFI among different sports can be done in order to showcase the effects of various types of training on cardio-respiratory fitness of athletes.

References

1.
Chaturvedi S, Ramji S, Arora NK, Rewal S, Dasgupta R, Deshmukh V, et al. Time-constrained mother and expanding market: Emerging model of under-nutrition in India. BMC Public Health. 2016;16(1):632. [crossref] [PubMed]
2.
Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126-31.
3.
Mannu GS, Zaman MJS, Gupta A. Evidence of lifestyle modification in the management of hypercholesterolemia. Curr Cardiol Rev. 2013;9:02-14. [crossref] [PubMed]
4.
Sargent C, Gebreurs C, Mahony JO. A review of the physiological and psychological health and wellbeing of naval service personnel and the modalities used for monitoring. Mil Med Res. 2017;4:01 [crossref] [PubMed]
5.
Rao CR, Darshan B, Das N, Rajan V, Bhogun M, Gupta A. Practice of physical activity among future doctors: A cross sectional analysis. Int J Prev Med. 2012;3(5):365-69.
6.
Brehm BJ, Summer SS, Khoury JC, Filak AT, Lieberman MA, Heubi JE. Health status and lifestyle habits of US medical students: A longitudinal study. Ann Med Health Sci Res. 201;6(6):341-47. [crossref] [PubMed]
7.
Katralli J, Goudar SS, Itagi V. Physical fitness index of indian judo players assessed by harvard step test. IOSR J Sport Phys Educ. 2015;2(2):24-27.
8.
Machin D, Campbell MJ, Walters SJ. Medical statistics-A textbook for the health statistics. 4th edition, 2007;Chapter 6:89-94.
9.
Brouha L, Health CW, Graybiel A. Step test simple method of measuring physical fitness for hard muscular work in adult men. Rev Canadian Biol. 1943;2:86.
10.
Ismail WS. Evaluating the validity and reliability of Harvard step test to predict VO2 max in terms of the step height according to the knee joint angle. Journal of Applied Sports Science. 2011;1(2):126-32. [crossref]
11.
Parmar D, Modh N. Study of physical fitness index using modified harvard step test in relation with gender in physiotherapy students. IJSR. 2013;6:14.
12.
Pescatello LS, Arena R, Riebe D, Thompson PD. ACSM’s guidelines for exercise testing and prescription. 9th. Local Gov Stud. 2014;31(4):511-26.
13.
Eshita, Kaur L. Influence of height and weight on physical fitness index of amateur gymers of age 17 years. IRJET. 2018;5(6):3236-39.
14.
Norton K, Olds T; Australian Sports Commission. Anthropometrica: A textbook of body measurement for sports and health courses. 1996;11:413.
15.
Sharma P, Bhagat OL, Datta A, Sircar S. Fitness scores of Indians assessed by the Harvard step test. 2014;1(4):258-61. [crossref]
16.
Singh A, Deol NS. Study of physiological variables of basketball players at different levels of competitions. Int J Behav Soc Mov. 2012;1(3):177-85.
17.
Bergier J, Bergier B, Tsos A. Letter to the editor: Variations in physical activity of male and female students from different countries. Iran J Public Health. 2016;45(5):705-07. [crossref]
18.
Telford RM, Telford RD, Olive LS, Cochrane T, Davey R. Why are girls less physically active than boys? Findings from the LOOK longitudinal study. PLoS One. 2016;11(3):01-11. [crossref] [PubMed]
19.
Parmar D. Study of physical fitness index using modified harvard step test in relation with body mass index in physiotherapy students. IJRAMR. 2016;2(12):1075-77.
20.
Kaneko H, Yano Y, Itoh H, Morita K, Kiriyama H, Kamon T, et al. Association of blood pressure classification using the 2017 American College of Cardiology/ American Heart Association blood pressure guideline with risk of heart failure and atrial fibrillation. Circulation. 2021;143(23):2244-53. [crossref] [PubMed]
21.
Halder K. Physical and physiological comparison between indian female college basketball players and sedentary students. Adv Appl Physiol. 2016;1(2):18. [crossref]
22.
Koley S, Singh J, Sandhu JS. Anthropometric and physiological characteristics on Indian inter -University volleyball players. J Hum Sport Exerc. 2010;5(3):389-96. [crossref]
23.
Martinelli F, Chacon-Mikahil M, Martins L, Lima-Filho E, Golfetti R, Paschoal M, et al. HRV in athletes and nonathletes. Brazilian J Med Biol Res. 2005;38(4):639-47. [crossref] [PubMed]
24.
Dixon EM, Kamath MV, McCartney N, Fallen EL. Neural regulation of heart rate variability in endurance athletes and sedentary controls. Cardiovasc Res. 1992;26(7):713-19. [crossref] [PubMed]
25.
Mikhahil CM, Forti VAM, Catai AM, Szrajer JS, Golfetti R, Martins LEB, et al. Cardiorespiratory adaptations induced by aerobic training in middle-aged men: The importance of a decrease in sympathetic stimulation for the contribution of dynamic exercise tachycardia. Braz J Med Biol Res. 1998;31(315):705-12. [crossref] [PubMed]
26.
Michael S, Graham KS, Davis OAM GM. Cardiac autonomic responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals-A review. Front Physiol. 2017;8:301. [crossref] [PubMed]
27.
Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise: Measurements and implications for monitoring training status. Sports Med. 2008;38(8):633-46. [crossref] [PubMed]
28.
Dimpka U. Post-exercise heart rate recovery: An index of cardiovascular fitness. Journal of Exercise Physiology Online. 2009;12(1):10-22.
29.
Abelson PH. Physical fitness. Science. 1968;161(3848):1299. [crossref] [PubMed]
30.
Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med. 1999;341(18):1351-57. [crossref] [PubMed]
31.
Pitsavos CH, Chrysohoou C, Panagiotakos DB, Kokkinos P, Skoumas J, Papaioannou I, et al. Exercise capacity and heart rate recovery as predictors of coronary heart disease events, in patients with heterozygous Familial Hypercholesterolemia. Atherosclerosis. 2004;173(2):345-50. [crossref] [PubMed]
32.
Cheng YJ, Lauer MS, Earnest CP, Church TS, Kampert JB, Gibbons LW, et al. Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all-cause mortality in men with diabetes. Diabetes Care. 2003;26(7):2052-57. [crossref] [PubMed]
33.
Huang PH, Leu HB, Chen JW, Cheng CM, Huang CY, Tuan TC, et al. Usefulness of attenuated heart rate recovery immediately after exercise to predict endothelial dysfunction in patients with suspected coronary artery disease. Am J Cardiol. 2004;93(1):10-13. [crossref] [PubMed]

DOI and Others

DOI: 10.7860/JCDR/2022/57596.16733

Date of Submission: May 06, 2022
Date of Peer Review: Jun 03, 2022
Date of Acceptance: Jul 22, 2022
Date of Publishing: Aug 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 11, 2022
• Manual Googling: Jun 30, 2022
• iThenticate Software: Jul 20, 2022 (25%)

ETYMOLOGY: Author Origin

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com