MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Medical and Health Science Journal Available at http://journal2.unusa.ac.id/index.php/MHSJ; DOI: 10.33086/mhsj.v6i2.3213 pISSN 2549-7588. eISSN 2549-7596 ORIGINAL ARTICLE Assessment of Cardiovascular Fitness Among Young Sedentary Adults Using 1600 M Walking Test Aftab Begum1, Lakshmi T2, Syed Sadat Ali3* 1Associate Professor, Department of Physiology, Basaveshwara Medical College, Chitradurga, Karnataka, India 2Assistant Professor. Department of Physiology, Mandya Institute of Medical Sciences, Mandya, Karnataka, India. 3Associate Professor, Department of Physiology, Sri Siddhartha Institute of Medical Sciences, T-Begur, Nelamangala, Bengaluru Rural, Karnataka, India ARTICLE INFO Article history: Received : July 18, 2022 Received in revised form : August 02, 2022 Accepted : August 11, 2022 Keywords: Cardiorespiratory fitness, Physical activity, 1600 M walk. Noncommunicable diseases, Assessment. *) Corresponding author: drsadatali@gmail.com ABSTRACT Background: Cardiorespiratory endurance refers to the ability of the heart and lungs to deliver oxygen to working muscles during continuous physical activity, which is an important indicator of physical health. Physical activity is a complex multidimensional behaviour that is difficult to assess in free- living populations and for which a gold standard measurement does not exist. Thereby, we assessed cardiovascular fitness among young sedentary adults using 1600 M walking test. Methods: The study participants were assessed for Pulse rate, Respiratory rate, Blood pressure and oxygen saturation at rest followed by 1st, 2nd, 3rd and after 5 minutes after 1600 M walking test. Results: There were no significant changes in pulse rate, respiratory rate, blood pressure; both systolic and diastolic blood pressure, and oxygen saturation across both the genders after performing 1600 M walk at 1st 2nd and 5th minutes except significant changes for respiratory rate (P=0.03) & systolic blood pressure (P =0.02). Conclusion: There is no single gold standard for estimating the cardiac endurance and fitness. It has to be assessed for Vo2 along with basic parameters and need to be repeated to validate the outcome and reduce the bias in case of aerobic exercises. Medical and Health Science Journal http://journal2.unusa.ac.id/index.php/MHSJ Begum et al MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Page 2 of 6 Introduction Human evolution has been dependent on a physically active lifestyle supplemented with nutritional fortification.1 A physically active lifestyle is 1 of the 7 goals listed for ideal cardiovascular health in the 2020 American Heart Association impact goals. 2 Physical activity is a complex multidimensional behaviour that is difficult to assess in free-living populations and for which a gold standard measurement does not exist. [3,4] The 4 dimensions of physical activity include (1) mode or type of activity, (2) frequency of performing activity, (3) duration of performing activity, and (4) intensity of performing activity.2 Cardiorespiratory endurance is an important aspect of health that affects a person's physical and mental activity. This is indicated by the absolute intensity determined by external work, while the relative intensity is determined relative to the individual's cardiorespiratory fitness level (V̇o2max). 5 Walking, for instance, is often described as a moderate-intensity physical activity; however, the actual intensity for an individual may vary. Measures of physical activity derived from heart rate monitoring are typically time spent in physical activities at different intensity levels (eg, moderate and vigorous intensity). [2] Living environments in developed countries are characterized by low daily energy expenditure and an abundant and inexpensive calorie-dense food supply, making positive energy balance common. [1] Numerous investigators have confirmed the strong link between physical activity and health in a variety of populations. [4] There are major challenges to disentangling the complex multifactorial etiology of physical activity, adiposity and health outcomes. 1 Lack of physical activity can have adverse effects and is often associated with chronic diseases, including heart disease, type 2 diabetes mellitus, hypertension, obesity, osteoporosis, depression, and breast and colorectal cancer.6,7 As such, a variety of methods have been used to assess physical activity and these measurements have a broad range of accuracy, reproducibility, and feasibility. [4] So, in this study we have used 1600 M walking test along with Vo2 Max, Heart Rate and Respiratory rate to assess the cardiovascular endurance among the sedentary adults and compared it across the gender. We hypothesise that these above parameters collectively can be used to determine the cardiovascular endurance and validate the fitness of the individual. Materials & Methods: A Cross sectional study was conducted under the auspices of department of physiology among 188 male and 212 female study participants. Institutional ethical committee clearance & a written informed consent from the study participants were obtained. The heart rate and blood pressure among the study participants were measured in seated position at rest before sending them for 1600 M walking test. This was followed by continuous heart rate monitoring and recording of blood pressure for every three minutes during the test. By using oximeter, “Pulse rate, Respiratory rate, systolic & diastolic blood pressure along with oxygen saturations were measured and recorded in the 1st, 3rd & 5th minutes after the test and before the test in both the genders”. Statistical Analysis The data was evaluated with the IBM SPSS Statistics 16.0 to compare the outcomes across the two groups. Two sample t test and confidence interval of 95% is used. P<0.05 is considered as statistically significant and P<0.01 is considered as highly statistically significant. Results: A total of 400 study participants among which 188 were male and 212 were female participants. All the participants have been measured for their anthropometric indices. They were checked for the basic parameters like Pulse rate, Respiratory rate, Blood pressure and oxygen saturation at rest. These study participants were informed to complete the 1600 M walking test. Following the walking test reading with regard to pulse rate, respiratory rate, systolic and diastolic blood pressure and oxygen saturation were recorded immediately after the walk followed after 1st, 2nd, 3rd and after 5 minutes. Begum et al MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Page 3 of 6 Table 1: Cardiovascular endurance across pulse rate at rest, immediately after exercise, 1,2, 3 and 5 minutes Variable Mean Std. Dev. 95% Conf. Interval t P Pulse rate_At 84.3883 10.03061 82.94513 85.83146 -1.4377 0.1513 85.78302 9.365162 84.51509 87.05094 Pulse rate_ Ime 109.4628 12.58569 107.652 111.2735 -1.0946 0.2743 110.9198 13.87856 109.0408 112.7988 Pulse rate_ 1 104.4043 11.81436 102.7045 106.1041 0.5234 0.6010 103.7406 13.35883 101.9319 105.5492 Pulse rate_ 2 98.87234 9.948245 97.44102 100.3037 0.1695 0.8655 98.69811 10.53153 97.27228 100.124 Pulse rate_ 3 91.78723 9.972017 90.3525 93.22197 -0.3797 0.7044 92.17453 10.3632 90.77148 93.57758 Pulse rate_ 5 90.61702 8.705652 89.36449 91.86956 0.8696 0.1643 90.46698 9.467522 89.1852 91.74876 Table 2: Cardiovascular endurance across Respiratory rate at rest, immediately after exercise, 1,2, 3 and 5 minutes Variable Mean Std. Dev. 95% Conf. Interval t P Respiratory rate _At 15.21277 3.274835 14.7416 15.68394 -1.2112 0.2265 15.84906 6.508897 14.96783 16.73028 Respiratory rate _ Ime 25.46277 5.364141 24.69099 26.23454 0.2352 0.8142 25.34906 4.291604 24.76803 25.93009 Respiratory rate _ 1 22.90426 3.572231 22.3903 23.41821 -1.1786 0.2393 23.65566 8.067213 22.56346 24.74786 Respiratory rate _ 2 19.54787 2.135227 19.24066 19.85508 -1.8918 0.0592 19.98585 2.456211 19.65331 20.31839 Respiratory rate _ 3 17.68617 1.921569 17.4097 17.96264 -2.1344 0.0334* 19.11321 8.985845 17.89664 20.32978 Respiratory rate _ 5 16.6117 1.675004 16.37071 16.8527 -1.1734 0.2414 17.23585 7.119897 16.2719 18.19979 Table 3: Cardiovascular endurance across Blood Pressure at 1,2, 3 and 5 minutes using 1600-meter walking test Variable Mean Std. Dev. 95% Conf. Interval t P SBP _ Atr 112.9787 10.82083 111.4219 114.5356 0.6163 0.5381 Begum et al MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Page 4 of 6 112.3443 9.76692 111.022 113.6667 DBP _ Atr 79.11702 2.674324 78.73225 79.50179 -0.3465 0.7292 79.31132 7.263964 78.32787 80.29477 SBP _ Ime 127.617 13.63709 125.655 129.5791 0.2948 0.7683 127.2217 13.15467 125.4407 129.0027 DBP _ Ime 73.51064 13.17853 71.61456 75.40672 -0.3056 0.7600 73.90566 12.65138 72.19282 75.6185 SBP _ 1min 123.9149 10.11343 122.4598 125.37 1.9099 0.0569 121.8868 11.01298 120.3958 123.3778 DBP _ 1min 74.86702 9.238861 73.53777 76.19627 0.0286 0.9772 74.83962 9.828999 73.5089 76.17035 SBP _ 2min 120.0532 11.52942 118.3944 121.712 1.7543 0.0802 117.9953 11.86715 116.3886 119.6019 DBP _ 2min 72.2766 7.8378 71.14892 73.40427 0.0559 0.9554 72.23113 8.35744 71.09964 73.36262 SBP _ 3min 116.2394 8.294779 115.0459 117.4328 2.3278 0.0204* 114.0896 9.965651 112.7404 115.4388 DBP _ 3min 73.79787 5.062349 73.06952 74.52622 0.4123 0.6803 73.56132 6.256827 72.71423 74.40842 SBP _ 5min 109.5798 10.61575 108.0524 111.1071 1.1748 0.2408 108.4009 9.454034 107.121 109.6809 DBP _ 5min 68.29787 8.289327 67.10524 69.49051 -0.8726 0.3834 69.0566 9.011662 67.83654 70.27667 Table 4: Cardiovascular endurance across Oxygen saturation at rest, immediately after exercise, 1,2, 3 and 5 minutes Variable Mean Std. Dev. 95% Conf. Interval t P O2 Sat._At 96.68085 .9888444 96.53858 96.82312 -0.0299 0.9762 96.68396 1.083757 96.53724 96.83069 O2 Sat._ Ime 95.42021 2.405212 95.07416 95.76627 -0.8332 0.4053 95.62736 2.547707 95.28243 95.97229 O2 Sat._ 1 94.48404 3.890859 93.92424 95.04384 -1.5315 0.1264 95 2.813306 94.61911 95.38089 O2 Sat._ 2 95.85106 1.634896 95.61584 96.08629 -0.9908 0.3224 95.97642 .7995321 95.86817 96.08466 O2 Sat._ 3 95.54255 1.510497 95.32523 95.75988 -0.2952 0.7680 95.58491 1.358616 95.40097 95.76885 O2 Sat._ 5 96.27128 1.314593 96.08214 96.46042 1.0330 0.3023 96.13679 1.286151 95.96266 96.31092 Begum et al MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Page 5 of 6 Among these study participants, there were no significant changes in pulse rate, respiratory rate, blood pressure; both systolic and diastolic blood pressure, and oxygen saturation across both the genders after performing 1600 M walk at 1st 2nd and 5th minutes except significant changes for respiratory rate (P=0.03) & systolic blood pressure (P =0.02), both, after 3 minutes were found. (Table 2 & 3) Discussion: Physical activity (PA) is one of the most important contributors to maintaining optimal health, and considerable evidence suggests that sufficient PA has the potential to prevent numerous diseases and provide health benefits to people of all ages.8 This study provides evidence that there is no single gold standard test for assessing the cardiovascular endurance and fitness of any individual. High level of cardiorespiratory fitness in childhood could be a protective factor of cardiovascular disease in adulthood.9 Fitness education and student fitness assessments offer students an opportunity to assess, track, and improve their fitness level. The effects of cardiovascular risk factors on health may partly be mediated through physical fitness level but the level of cardiorespiratory fitness is highly associated with the performance of other health- related fitness parameters in young people and in adults.10,11 In this study we could find that there were no significant changes in any of the parameters tested; Pulse rate, Respiratory rate, Blood pressure and Oxygen saturation except at one point for Respiratory rate & Blood pressure indicating that the assessment should include more than one tests which will increase the validity and these tests should be assessed repeatedly to overcome the confounding variables and bias. The findings of this study did not correlate with other study showing significant changes which would be due to the increase in the number of assessments.11 It is well known that individuals with regular physical activity have a lower risk of developing cardiovascular diseases, hypertension, type 2 diabetes, obesity and other chronic diseases. Therefore, performing regular cardiorespiratory exercise improves exercise capability which in turn increase cardiorespiratory fitness and results in short and long-term benefits on overall health.12 Thereby, consideration of study participants pertaining to the duration of exercise will help in eliciting their cardiovascular endurance using 1600 M walking test. In this study we could not find any significant change in oxygen saturation across the gender. This finding was correlated with other studies done irrespective of their gender and ethnicities.5 Limitations of the study 1. The study has not included other variables affecting the cardiovascular endurance; Lifestyle and nutrition which may act as confounding variables in bringing up the expected change among the study participants. 2. The expected change in cardiovascular endurance has been studied with only one test;1600 M walk. This either, if, done repeatedly and done along with other tests may show better results and outcome among the study participants. Conclusion: The treatment of noncommunicable diseases (NCD), like coronary heart disease or type 2 diabetes mellitus, causes rising costs for the health system. Physical activity is supposed to reduce the risk for these diseases. [13] There is no single gold standard for estimating the cardiac endurance and fitness. It has to be assessed for Vo2 along with basic parameters and need to be repeated to validate the outcome and reduce the bias in case of aerobic exercises. Acknowlegment The financing is obtained independently Conflicts of Interest There are no conflicts of interest declared by the author. Begum et al MEDICAL AND HEALTH SCIENCE JOURNAL 2022 AUGUST VOL.6 (02) Page 6 of 6 References: 1. Michael J. LaMonte and Steven N. Blair. Physical activity, cardiorespiratory fitness, and adiposity: contributions to disease risk, Current Opinion in Clinical Nutrition and Metabolic Care 2006, 9:540–546. 2. Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund ULF, Freedson PS, Gary RA, RN, et. al, Guide to the Assessment of Physical Activity: Clinical and Research Applications, Circulation, 2013;128:2259- 2279. 3. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288:1723–1727 4. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. 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