Tauseef Nabi et al / International Journal of Biomedical and Advance Research 2015; 6(05): 418-421.

418

International Journal of Biomedical and Advance Research

ISSN: 2229-3809 (Online); 2455-0558 (Print)
Journal DOI: 10.7439/ijbar
CODEN: IJBABN Original Research Article

Assessment of cardiovascular fitness [VO2 max] among medical

students by Queens College step test

Tauseef Nabi*1 Nadeema Rafiq2 and Ouber Qayoom1

1Department of Medicine, MMIMSR, Mullana, Ambala, India.
2Department of Physiology, MMIMSR, Mullana, Ambala, India.

*Correspondence Info:
Dr. Tauseef Nabi
Department of Medicine,
MMIMSR, Mullana, Ambala, India.
E-mail: [email protected]

Abstract
Objective: Cardio respiratory fitness in terms of maximum oxygen uptake [VO2max] reflects physical fitness of a
person.VO2max is single best measure of cardio respiratory capacity and is considered as a bench mark to
quantify cardiovascular function capacity and aerobic fitness. The main aim of study was to assess and compare
the cardio respiratory fitness in terms of maximum aerobic capacity [VO 2max] among the young adult male and
female medical students of Maharishi Markandeshwar University [MMU], Mullana, Haryana.
Method: A total of fifty seven young adult male [n=30] and female [n=27] students, around age group of 18-24
years were recruited by simple random sampling from Maharishi Markandeshwar University, Haryana.VO 2max
was estimated indirectly by following the protocol of Queen’s College Step Test [QCT] method. QCT is the
simplest one to determine cardio respiratory fitness in terms of maximum oxygen uptake.
Result: In present study it was found that mean value of VO2max for males was [45.66+8.96] ml/kg/min and for
females it was [37.85+4.3] ml/kg/min. The mean value of VO2max was found significantly higher in male as
compared to female students [P value <0.0001].
Conclusion: From the study it was concluded that our subjects fitted in the category of fair on cardio respiratory
fitness scale, could be because of the decreased physical activity, unhealthy lifestyle behaviors as are established
during the years of gaining education, which may influence adult behavior and health status. Physical fitness
performance was better in male students than female students. Health promotion policies and physical activity
programs should be designed to improve cardio respiratory fitness.
Keywords: Cardio respiratory fitness, step test, VO2max
1. Introduction
Cardio respiratory fitness, also called or in milliliters /kg/min as relative VO2 max. The
cardiovascular fitness or maximal aerobic power, is VO2max can be estimated using maximal or sub
the overall capacity of the cardiovascular and maximal tests, by direct or indirect methods. The
respiratory systems and the ability to carry out most commonly used tests are walking/running tests
prolonged strenuous exercise. The maximal oxygen followed by cycling and step tests.[2] VO2 max is often
consumption [VO2max] attained during a graded estimated using prediction equations rather than
maximal exercise to voluntary exhaustion has long direct measurement as it is cost effective and
since been considered by the World Health relatively easier.
Organization as the single best indicator of cardio VO2 max is often used as marker of physical
respiratory fitness.[1] fitness and considered the best indicator of aerobic
VO2 max is the maximum amount of oxygen a fitness.[3] VO2 max estimation by step test is one such
person can intake and the value does not change test and is considered to be a practical field test for
despite an increase in workload over time period. assessing individual aerobic fitness.[4]
VO2 max is expressed as liters/min as an absolute value

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Tauseef Nabi et al / Assessment of cardiovascular fitness [VO2 max] among medical students by Queens College step test 419

Physical fitness is considered as the degree laboratory conditions in comfortable environment.

of ability to execute a physical task under various Before the test the subjects were instructed not to
ambient conditions. Fitness is generally considered to indulge in any activities. Subjects were also
have five components: aerobic capacity, muscle instructed not to have heavy meals/tea/coffee at least
strength, muscular endurance, flexibility, and body 2 hours before test. Detailed history was taken and
composition. Physical fitness is presently considered clinical examination was done. The Anthropometric
one of the most important health markers, as well as a data which included age, height, weight was noted
predictor of morbidity and mortality for and Body Mass Index [BMI] was calculated. Before
cardiovascular disease [CVD] and for all causes.[5] commencement of test the subjects were asked to
Hence, the present study emphasizes on rest, then all basal parameters like heart rate, blood
cardiovascular fitness in terms of maximum aerobic pressure and respiratory rate were measured.
capacity [VO2max] among the young adult male and Body Mass Index [BMI] was calculated as
female medical students of MMU [Maharishi Body weight in kilograms divided by square root of
Markandeshwar University], Haryana. There is need Body height in meter, using Quetelet index. Normal
for the students to measure and analyze their physical weight was defined as BMI 18.5 to ≤ 22.9, Under
fitness for their own benefit and improvement. For weight as BMI < 18.5, Overweight as BMI 23 to ≤
better productivity the students should be healthy and 24.9 and Obesity as BMI ≥ 25 kg/m2, as per revised
have good physical fitness. Medical students of today body type classification for Indian Population
are the physicians of tomorrow and a good physician recommended by Health ministry and Diabetes
must be physically fit and mentally alert. Foundation of India in 2008.[6][7][8]
VO2max was estimated indirectly by
2. Material and Methods following the protocol of Queen’s College Step Test
2.1 Study design: Cross-sectional Study [QCT] method.[6][8] The step test was performed
2.2 Source of data: Maharishi Markandeshwar using a tool of 16.25 inches height.Stepping was
University [MMU], Ambala. done for a total duration of 3 minutes at the rate of 24
The study was conducted in the department steps up per minute for males and 22 steps up per
of Physiology, Maharishi Markandeshwar Institute of minute for females which was set by a metronome.
Medical Sciences and Research, Mullana [Ambala]. After completion of exercise, the carotid pulse rate
2.3 Methodology was measured from the fifth to the twentieth second
2.3.1 Study subjects of recovery period. The 15 seconds pulse rate was
The subjects were healthy young male and female converted into beats per minute and following
medical students of MMU, aged 18–25 years, equation was used to predict VO2max .
2.3.2 Eligibility criteria For males:
The students were recruited based on following VO2max = 111.33 – [0.42 × pulse rate beats/min]
inclusion and exclusion criteria. For females:
2.3.3 Inclusion criteria VO2max= 65.81–[0.1847×pulse rate beats/min]
1. The study included apparently healthy male and [ml/kg/min]
female subjects between age group of 18-25 years.
2. Non-smokers and non-alcoholic subjects. 3. Results
2.3.4 Exclusion criteria The study was conducted on 57 healthy
1. Students on any medication. students [30 males and 27 females]. The mean age of
2. Student’s under-going regular physical training. males was 19.0 + 1.6 years and that of the females
3. Students with history of any acute or chronic was 18.5 + 1.5 years [p =0.27]. The mean BMI of
illness. males was 24.5+4.0Kg/m2 and females was
2.3.5 SAMPLING METHOD AND SAMPLE 23.31+4.9 Kg/m2 [p = 0.31] There was no statistically
SIZE: significant difference in the age and BMI of the two
Sampling method: Simple random sampling. sexes. Out of 57 students 22 [38.6%] were found
Sampling size: 57 subjects. obese, among them 12 were males and 10 were
2.4 Procedure females.
57 subjects, who fulfilled inclusion criteria, Mean value of VO2max for males was
were recruited for the study after obtaining their 45.66+8.9 ml/kg/min and for females it was 37.85
consent. Initial explanation about the aim and +4.3 ml/kg/min, which was found significantly
purpose of the study, test procedure, method of higher in males than in females [p<0.0001]. On
testing, instructions on how to perform test was comparison of our VO2max value with the standard
given. All the students were tested under similar VO2max classification, our subjects fitted in the
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Tauseef Nabi et al / Assessment of cardiovascular fitness [VO2 max] among medical students by Queens College step test 420

category of fair on cardio respiratory fitness scale. the level of physical fitness among medical college
Mean values of VO2max in non-obese students [42.2 + students of Maharishi Markandeshwar University,
7.9 ml/Kg/min] was slightly higher than in obese Haryana. The result of the present study showed that
[41.3 + 8.7 ml/Kg/min] but the difference was not mean value of VO2max for males was 45.66+8.96
statistically significant [p = 0.69] ml/kg/min and for females it was 37.85 +4.3
Higher values of VO2max was found in non- ml/kg/min, which was found significantly higher in
obese males [46.1+ 8.8ml/Kg/min] versus obese males than in females [p<0.0001]. On comparison of
males [44.7 + 9.6 ml/Kg/min] [p =0.68] and non- our VO2max value with the standard VO2max
obese females [38.16 + 3.9 ml/Kg/min] versus obese classification, our subjects fitted in the category of
females [37.12 + 5.6 ml/Kg/min] [p = 0.5853]. fair on cardio respiratory fitness scale.[11]
Table 1: Comparative study of some The reason for reduced VO2max in our
anthropometric parameters along with VO2max subjects could be because of the decreased physical
amongst the male and female medical students activity, unhealthy lifestyle behaviors as are
Male Female
Variables
[mean ± SD] [mean ± SD]
established during the years of gaining education,
Age [years] 19.0 + 1.6 18.5 + 1.5 which may influence adult behavior and health status.
Height [cm] 166.13+2.3 154.66+2.1 Cardio respiratory fitness has also shown a stronger
Weight [kg] 68.23+ 3.2 58.96+2.9 association with total adiposity, as measured by
BMI [kg/m2] 24.5+4.0 23.31+ 4.9
BMI.[12] Overweight and obesity in our subjects
VO2max [ml/kg/min] 45.66+8.9 37.85 +4.3
Table 2: Comparison of VO2max between various could also be the reason for reduced VO2max.
groups of obese with non-obese. The results of this study also suggest that
Obese Non obese female students have lower levels of aerobic fitness
[VO2max [VO2max compared with male students. Our findings are in
[ml/kg/min]] [ml/kg/min]] agreement with other studies that have examined
All subjects aerobic fitness levels in African-American adults.[13]
41.3 + 8.7 42.2 + 7.9
[Male+ Female] Aerobic capacity of male students was significantly
Male 44.7 + 9.6 46.1 + 8.8
higher compared to that of female participants. This
Female 37.12 + 5.6 38.16 + 3.9
has been confirmed by correlations between
considered variables in female and male participants
4. Discussion disregarding their physical activity levels.
The maximum oxygen uptake [VO2 max], an Studies have suggested that achieving 60
internationally accepted parameter to evaluate the min or more of moderate–vigorous physical activity
cardio respiratory fitness reflects the amount of daily is associated with a healthier cardio respiratory
oxygen utilized by working muscles during maximal fitness level in adolescents, independently of their
exercise. It is the best index of aerobic capacity and adiposity status.[14] Improvements in cardio
gold standard for cardio respiratory fitness. Thus respiratory fitness have positive effects on
measure of maximum oxygen consumption offer depression, anxiety, mood status and self-esteem, and
insight into ability of cardiovascular, respiratory and seem also to be associated with a higher academic
muscular system to deliver and utilize oxygen. performance. So, it is suggested that adequate
During exercise, up to a point the increase in oxygen physical activity programmers should be included in
consumption is proportionate to energy expended and the curriculum of educational institutes.
all the energy needs are met my aerobic process. So There are a few limitations to the study that
in a person, the more is the maximum oxygen need to be considered. First, the motivation of the
consumption capacity [VO2max], the more will be his/ subjects in performing the physical fitness tests, were
her aerobic capacity. VO2max is the measure of the uncontrollable. It might affect the results of the study.
functional limit of the cardio-respiratory system and Secondly, the performance of the subjects might
the single most valid index of maximal exercise affect due to their physical lifestyle and different
capacity.[9] physical characteristics.
Decrease in VO2 max is therefore an indicator
of reduced exercise capacity or tolerance. It is the
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