Vol 6 No 1 full text edit final.indd

Althea Medical Journal. 2019;6(1)

24 AMJ March 2019

Cardiorespiratory Endurance among End Year Student of Faculty of
Pharmacy in Jatinangor, Bandung

Hemavahthy Mani,1 Tri Damiati Pandji,2 Putri Teesa3
1Faculty of Medicine Universitas Padjadjaran, Indonesia, 2Department of Physical Medicine and
Rehabilitation Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital,

Bandung, Indonesia, 3Department of Biomedical Sciences Faculty of Medicine
Universitas Padjadjaran, Indonesia

Correspondence: Putri Teesa, dr., M.Kes., AIFO, Department of Biomedical Sciences, Faculty of Medicine, Universitas
Padjadjaran, Jalan Raya Bandung-Sumedang KM 21, Indonesia, Email: putritessa@gmail.com

Introduction

Physical fitness is an important health marker
that relates to the ability of a person to perform
physical activity.1 Components of physical
fitness such as cardiorespiratory endurance
are essential for total fitness of the body and
mind.2 Cardiorespiratory endurance is the
body’s ability to supply the needed oxygen to
large working muscles for an extended period
of time.3 The degree of cardiorespiratory
endurance shows how the heart and lungs
respond to movement.4 There are three things
that can affect a person’s cardiorespiratory
endurance. These are how often they exercise,
how intensely they exercise, and how long
each workout lasts.5 The maximal oxygen
consumption (VO2 max) is quantified in
L min-1 or ml kg-1 min-1 as a measure of

cardiorespiratory endurance.1,6
According to previous studies, about

40% to 50% of higher institute students
are physically inactive.7 There have been
consistent declines in cardiorespiratory
endurance fitness performance across all
studied Asian nations over the past 10–15
years.8 Several countries, including Indonesia,
have approximately 60–85% of adults that
perform less physical activity to maintain
their physical fitness.9 As higher institute
students move toward their senior year, they
significantly have a more sedentary lifestyle.10

The sedentary lifestyle may replace physical
activity, promoting an energy imbalance, and
subsequently, an increased risk for obesity
with low cardiorespiratory endurance.11
Generally, fresh graduates of higher-learning
institutions are physically less active and
weigh more compared to their freshman

AMJ. 2019;6(1):24–9

Abstract

Background: Physical fitness indicates the ability of an individual to perform daily physical activities
with ease. The major component of physical fitness is the cardiorespiratory endurance, which is assessed
through maximal oxygen consumption (VO2 max). A decrease in cardiorespiratory endurance can be
associated with a sedentary lifestyle. This study was conducted to determine the cardiorespiratory
endurance among young adults in Jatinangor, Bandung.
Methods: This cross-sectional study had used total sampling method, conducted among end year
student of Faculty of Pharmacy, Universitas Padjadjaran from October–November 2013. The inclusion
criteria wasall end year students who had no health-related problems and the students had to agree
to participate in the study. After obtaining written informed consent from the participants, Astrand-
Rhyming Step Test was performed to measure the level of VO2max.
Results: In total, 32 students were included of whom 14 students (43.7%) had an average level of VO2
max and 9 (28.2%) had just below average level. Chi-square test results showed that there was no
significant relationship (p>0.05) between VO2 max level and gender, BMI level, and smoking habit, but
showed a significant relationship (p< 0.05) with exercising habit.
Conclusions: The majority of the participants had an average level of VO2 max. A significant relationship
between the level of VO2 max and exercising habit, suggesting a regular exercise for a better lifestyle.

Keywords: Cardiorespiratory endurance, pharmacy students, VO2 max

Althea Medical Journal. 2019;6(1)

year.10 Therefore, this study was conducted to
determine the cardiorespiratory endurance
of end year students from Universitas
Padjadjaran, Jatinangor.

Methods

This study was a cross sectional study
performed among all end year students in the
Faculty of Pharmacy, Universitas Padjadjaran,
Jatinangor, conducted from October–
November 2013 after the ethical clearance
was given After considering the inclusion
and exclusion criteria, 32 students were
recruited. The inclusion criteria were all end
year students , and the exclusion criteria were
students who had health-related problems
according to a physical activity readiness
questionnaire. The students must agree to
participate in this study.

After filled in questions regarding
their health background, students were
weighed using a weighing scale with
precisely measurement to the nearest 0.1 kg.
Furthermore, height was measured using a
stadiometer, precise to the nearest centimeter.
Using those values, body mass index (BMI)
was calculated as weight in kilograms divided
by the square of height in meters.12 Resting
pulse rate was measured for 15 seconds and
multiplied by 4 to calculate the pulse rate in

beats per minute. Resting blood pressure
of the participants was measured using
sphygmomanometer and stethoscope with
them while resting in sitting position. Then,
the participants performed Astrand-Rhyming
Step Test; as for the male participants step up
and down on a 40-centimeter bench and for
female participants on a 33 cm bench both, for
5 minutes at the rate of 90 steps per minute.
According to the metronome rhythm, the
participant’s right leg had to be on the bench
at the first sound followed by the left leg at
the second sound. During the third sound, the
right leg had to be down on the floor followed
by the left leg at the fourth sound. Throughout
this procedure, the participant’s posture
had to be upright. Heart rate was measured
from exactly 15–30 seconds following the
completion of the test. Recovery heart rate
was measured each minute for five minutes
and blood pressure was measured again at the
end after completion of the test.

The VO2 max of the participants were
calculated using the Astrand-Rhyming
Nomogram.13 Data were collected and analyzed
to seek any significance relationship (p<0.05)
between level of VO2max and gender, level
of BMI, smoking and exercising habit, using
the Windows Statistical Product and Service
Solutions 17.0 and Microsoft Excel program.
The results were presented in tables for better
view.

Table 1 Characteristic of end Year Students from Faculty of Pharmacy Jatinangor, Bandung
Frequency (n) Percentage (%)

Gender

Female 18 56.25
Male 14 43.75
BMI (kg/m2)
Underweight 2 6.25
Normal 24 75
Overweight 4 12.5
Obese 2 6.25
Smoking habit
No 26 81.25
Yes 6 18.75
Exercise regularly
No 12 37.5
Yes 20 62.5

Putri Teesa et al.: Cardiorespiratory Endurance among End Year Student of Faculty of Pharmacy in Jatinangor,
Bandung

Althea Medical Journal. 2019;6(1)

26 AMJ March 2019

Results

Based on the data obtained, the 32 participants
in this study had an age range of 21–27 years
old and the majority were female. Most of the
participants had normal BMI. Majority of the
participants did not smokeand more than half
of them exercised regularly (Table 1).

Most of the participants had an average
level of VO2 max (43.7%) and just below the

average (28.2%) (Table 2). Both male and
female participants belong to the average
category of VO2 max (Table 3). Based on
chi-square analysis, there was no significant
relationship between gender and level of
VO2max (X2 = 5.70; df = 4; p = 0.22).

Of all the levels of VO2 max, a high number
of participants have normal BMI (Table 4). No
significant relationship between level of BMI
and level of VO2 max (X2 = 14.58; df = 12; p =

Table 2 Classification of Level of VO2 max among end Year Students from Faculty of
Pharmacy, Jatinangor, Bandung

VO2 max Frequency (n) Percentage (%)

Very High 4 12.5

High 4 12.5
Average 14 43.7
Below Average 9 28.2
Very Low 1 3.1

Table 3 Classification of Level of VO2 max among end year students from Faculty of
Pharmacy, Jatinangor, Bandung based on Gender

VO2 max

Gender
Total

(n)Female Male

(n) (N)
Very High 4 0 4
High 3 1 4
Average 7 7 14
Below Average 4 5 9
Low 0 1 1
Total 18 14 32

Table 4 Classification of Level of VO2 max among end year students from Faculty of
Pharmacy, Jatinangor, Bandung based on BMI

VO2 max

BMI (kg/m2)
Total

(n)Underweight Normal Overweight Obese

n N N n
Very High - 4 - - 4
High 1 3 - - 4
Average 1 12 1 - 14
Below Average - 4 3 2 9
Low - 1 - - 1
Total 2 24 4 2 32

Althea Medical Journal. 2019;6(1)

27Putri Teesa et al.: Cardiorespiratory Endurance among End Year Student of Faculty of Pharmacy in Jatinangor,
Bandung

0.27). Most of the participants with no smoking
habit had an average and just below average
levels of VO2 max (Table 5). The chi-square
test did not show any significant differences
between smoking habit and level of VO2max
(X2 = 6.26; df = 4; p = 0.18).

Most of the participants that exercise
regularly had an average level of VO2 max.
Very high and high level of VO2 max could
only be seen in participants that had the habit
of exercising regularly, albeit there was one
participant that exercised regularly but had a
low level of VO2 max. Below average VO2 max
could only be seen in participants that did not
exercise regularly (Table 6). Statistically, there
was a significant relationship between habit of
exercising and level of VO2 max (X2 = 21.94; df
= 4; p = 0.00).

Discussion

The data were collected to measure the level
of cardiorespiratory endurance as expressed
in VO2 max values, and to stratify according
to gender, BMI, smoking habit and habit of

exercising regularly. Result shows that most
of the end year students have an average
level and just below the average level of VO2
max, despite that the end year students were
involved in fewer physical activities, since they
were more preoccupied with assignments and
other academic work compared to their junior
peers.

In terms of gender, female participants have
a generally higher VO2 max. Females have 20
percent lower VO2 max than males, however,
many female athletes have higher VO2 max
values than most male.14 Interestingly, our
study result showed that no significant
relationship between gender, level of BMI,
smoking habit and level of VO2 max. In our
study, female participants engage themselves
in exercise more often than male participants.
Besides engaging in regular exercise, the female
participants also filled their leisure time with
dancing as well, which in itself is a vigorous
physical activity as well. Furthermore, most of
the female participants walk to campus every
day unlike most of the male participants who
ride motorbikes to campus. Unfortunately,

Table 5 Classification of Level of VO2 max based on Smoking Habit

VO2 max

Smoke
Total

(n)No Yes

n n
Very High 4 - 4
High 4 - 4
Average 11 3 14
Below Average 7 2 9
Low - 1 1
Total 26 6 32

Table 6 Classification of Level of VO2 max based on the Habit of Exercising

VO2 max

Regular Exercise
Total

(n)No Yes

n n
Very High - 4 4
High - 4 4
Average 3 11 14
Below Average 9 - 9
Low - 1 1
Total 12 20 32

Althea Medical Journal. 2019;6(1)

28 AMJ March 2019

there were no further inquiries made about
this activity, but it has been observed during
the study.

In accordance with our study, BMI may
not be associated with cardiorespiratory
fitness.15 On the other hand, lower waist
circumference may be correlated with better
cardiorespiratory fitness.15 This result agrees
with the findings of other studies in which
waist circumference was a superior predictor
for cardiovascular disease and cancer
risk.16,17 Unfortunately, in our study, the waist
circumference is not measured, that limits our
analysis. Other previous studies have found
that level of VO2 max is most affected in heavy
smokers group.18,19 Interestingly, our finding
has unexpected result; there is no significant
relationship between smoking habit and level
of VO2 max. A possible explanation for this
might be that the smoking participants in this
study are light or moderate/regular smokers,
defined as 1-10 pack-y (packs•day * year(s)
smoking) or 11-20 pack-y, respectively.

A significant relationship confirmed in our
study is that the exercising habit and the level
of VO2 max. It has been suggested that doing
exercise regularly improves cardiorespiratory
endurance. Exercise has significant
improvement in VO2 max.20 Regular exercise
done by healthy sedentary and active adults
show an improvement of their VO2 max.21

This study was limited by the absence of
daily physical activity and waist circumference
data. Information about the number of
cigarette’s packs and smoking duration of
smoker’s participants were also not obtained,
that makes further analysis about the
relationship of the gender, body composition,
and the smoking habit is lacking.

To conclude, our findings indicate that
in order to have a better level of VO2 max,
participants must engage themselves in
regular exercise. Here we suggest for at least
three times in a week with each session being
more than 60 minutes. Future research needs
to examine more closely the relationship
between VO2 max level and known factors
affecting the VO2 max level increase.

References

1. Ortega FB, Ruiz JR, Castillo MJ, Sjostrom
M. Physical fitness in childhood and
adolescence: a powerful marker of health.
Int J Obes (Lond). 2008;32(1):1–11.

2. Eurenius E, Stenström CH. Physical
activity, physical fitness, and general
health perception among individuals with

rheumatoid arthritis. Arthritis Rheum.
2005;53(1):48–55.

3. Dutt S. Health related physical fitness
of boys aged 8 to 18 years. Journal of
Exercise Science and Physiotherapy.
2005;1(1&2):12–22.

4. Hoeger WWK, Hoeger SA. Lifetime physical
fitness and wellness. 10th ed. Belmont:
Yolanda Cossio; 2009.

5. García-Artero E, Ortega FB, Ruiz JR, Mesa
JL, Delgado M, González-Gross M, et al.
Lipid and metabolic profiles in adolescents
are affected more by physical fitness than
physical activity (AVENA Study). Rev Esp
Cardiol. 2007;60(06):581–8.

6. Tarnus E, Catan A, Verkindt C, Bourdon
E. Evaluation of maximal O2 uptake with
undergraduate students at the University
of La Reunion. Adv Physiol Educ.
2011;35(1):76–81.

7. Keating XD, Guan J, Piñero JC, Bridges
DM. A meta-analysis of college students’
physical activity behaviors. J Am Coll
Health. 2005;54(2):116–25.

8. Macfarlane D, Tomkinson GR. Evolution
and variability in fitness test performance
of Asian children and adolescents. Med
Sport Sci. 2007;50(1):143–67.

9. Rismayanthi C. Tes kebugaran jantung
paru dengan metode Rockport bagi
karyawan Dinas Kesehatan Propinsi DIY.
2012 [cited 2013 March 23]; Available
from: http://staff.uny.ac.id/sites/default/
files/pengabdian/cerika-rismayanthi-
sor/tes-kebugaran-dinkes-2012-metode-
rockport.pdf.

10. Indiana University. College days --
more sedentary days. Science Daily.
2010 [cited 2013 March 5]; Available
from: http://www.sciencedaily.com/
releases/2010/11/101110073332.htm.

11. Collins AE, Pakiz B, Rock CL. Factors
associated with obesity in Indonesian
adolescents. Int J Pediatr Obes.
2008;3(1):58–64.

12. Tate DF, Jackvony EH, Wing RR. Effects
of internet behavioral counseling on
weight loss in adults at risk for type
2 diabetes: a randomized trial. JAMA.
2003;289(14):1833–6.

13. Sawada SS, Lee IM, Muto T, Matuszaki K,
Blair SN. Cardiorespiratory fitness and the
incidence of type 2 diabetes prospective
study of Japanese men. Diabetes Care.
2003;26(10):2918–22.

14. Quinn E. VO2 max measures aerobic
fitness and maximal oxygen uptake. 2011
[cited 2013 March 14]; Available from:

Althea Medical Journal. 2019;6(1)

http://sportsmedicine.about.com/od/
anatomyandphysiology/a/VO2_max.htm.

15. Pojskic H, Eslami B. Relationship
between obesity, physical activity,
and cardiorespiratory fitness levels
in children and adolescents in Bosnia
and Herzegovina: an analysis of gender
differences. Front Physiol. 2018; 9:1734.

16. Sawa SC, Tornaritis M, Sawa ME, Kourides
Y, Panagi A, Silikiotou N, et al. Waist
circumference and waist-to-height ratio
are better predictors of cardiovascular
disease risk factors in children than body
mass index. Int J Obes Relat Metab Disord.
2000; 24(11):1453–8.

17. Barberio AM, Alareeki A, Viner B, Pader
J, Vena JE, Arora P, et al. Central body
fatness is a stronger predictor of cancer
risk than overall body size. Nat Commun.
2019;10(1):383.

18. Wier LT, Suminski RR, Poston WS, Randles
AM, Arenare B, Jackson AS, et al. The effect

of habitual smoking on VO2max. 2008
[cited 2019 March 09]; Available from:
https://ntrs.nasa.gov/archive/nasa/casi.
ntrs.nasa.gov/20080014280.pdf

19. Suminski RR, Wier LT, Poston W, Arenare
B, Randles A, Jackson AS. The effect of
habitual smoking on measured and
predicted VO2(max). J Phys Act Health.
2009;6(5):667–73.

20. Naves JPA, Viana RB, Rebelo ACS, de Lira
CAB, Pimentel GD, Lobo PCB, et al. Effects of
High-Intensity Interval Training vs. Sprint
Interval Training on Anthropometric
Measures and Cardiorespiratory Fitness
in Healthy Young Women. Front Physiol.
2018; 9:1738.

21. Sloth M, Sloth D, Overgaard K, Dalgas
U. Effects of sprint interval training on
VO2max and aerobic exercise performance:
A systematic review and meta-analysis.
Scand J Med Sci Sports. 2013; 23(6):e341–
52.

Putri Teesa et al.: Cardiorespiratory Endurance among End Year Student of Faculty of Pharmacy in Jatinangor,
Bandung