ASSESSING
THE
CARDIOVASCULAR
FITNESS
OF
HEALTHY
YOUNG
INDIVIDUALS USING HARVARD STEP TEST
Submitted by:
VIRALI BHANSALI
(Enrolment no. : 12SPTPT11006)
AND
ZAINAB BHARMAL
(Enrolment no. : 12SPTPT11007)
6th semester, JULY-2015
Guided by:
Dr. NIVEDITA CHOPRA (MSPT)
Lecturer, SOPT, RKU
I
CERTIFICATE
This is to certify that the project work entitled “Assessing the cardiovascular fitness
of healthy young individuals through Harvard Step Test” has been undertaken and
written under my supervision and it describes the original research work carried out by
Ms. VIrali Bhansali and Ms. Zainab Bharmal registered at RK University in 6th
semester Bachelors of Physiotherapy.
Signature of Guide:
Name: Dr. Nivedita Chopra
Degree: MSPT
Designation: Lecturer
II
DECLARATION
We hereby certify that we are the authors of this project work. We certify to the best of
our knowledge, our project does not infringe upon anyone’s copyright nor violate any
proprietary rights and that any ideas, techniques, quotations, or any other material from
the work of other people included in our project published or otherwise, are fully
acknowledged in accordance with the standard referencing practices. We declare that
this is a true copy of our project, including any final revisions, as approved by our
project review committee.
Signature of candidate:
Signature of candidate:
Virali Bhansali
Zainab Bharmal
Enrolment no.: 12SPTPT11006
Enrolment no.: 12SPTPT11007
Date: 1st June 2015
Date: 1st June 2015
Place: Rajkot
Place: Rajkot
III
ACKNOWLEGEMENT
First and foremost we would like to thank our parents who are my living Gods for
their valuable support and encouragement, blessing and love which has always been a source of
inspiration and strength in accomplishing this academic task.
Our heartfelt gratitude to almighty God who has guided me this far and to whom goes all
the honor and glory for the successful completion of this study.
We wish to express our regards to our Director Dr. Priyanshu V. Rathod School of
Physiotherapy, R.K.University for his whole hearted guidance and meticulous suggestions in the
completion of this work and for all the facilities and support extended to us during this study.
We are extremely. thankful to him for constant encouragement and inspiration during the
course of this study.
With due respect, we would like to express our sincere thanks to our guide Dr. Nivedita
Chopra , lecturer of School of Physiotherapy, R.K.University, for her judicious information,
expert suggestions, valuable guidance, continuous support, incessant reassurance during every
stage of this work and interest shown in this dissertation without which this work would not have
been possible.
We would like to extend my heartfelt thanks to other lecturers of R.K University and Dr.
Vaibhavi Ved , Dr. Shweta Rakholiya for their valuable guidance, constant help and support
throughout this study.
IV
We shall fail our duties if we don’t acknowledge my Colleagues and Friends for their
suggestions and criticism while assisting us in this study.
Last but not the least we would like to thanks all the Individuals in my study without whom this
task would not have been possible.
Our sincere thanks to all the contributors whose names we might have missed but who
truly deserve our gratitude.
We would like to thank once again to all who have helped me all the while.
Signature:
Signature:
Name: Virali Bhansali
Name: Zainab Bharmal
V
LIST OF ABBREVIATIONS
1. HR: Heart rate
2. VO2MAX: Maximum volume of oxygen
3. HST: Harvard step test
4. HR MAX : heart rate maximum
5. BMI: body mass index
6. te: time of exhaustion.
7. PFI: physical fitness Index
8. PAR-Q: Physical Activity Readiness Questionnaire
VI
ABSTRACT
BACKGROUND: Cardiovascular fitness is a health related component of physical
fitness that relates to the ability of the circulatory and respiratory systems to supply
oxygen during sustained physical activity.
This study is required to assess the cardiovascular fitness of young individuals and to
decide the level from which the cardiovascular fitness training must be started. It is also
required to know the possibilities of prevalence of cardiovascular diseases in future.
AIM: To judge the level of cardiovascular fitness of young individuals of age 18 to 25 years.
METHODOLOGY: Study design: observational study. Sample size: 50 subjects,
Sampling: convenient sampling method, Study setting: RK University campus, Rajkot
Inclusive criteria: Young individuals with normal BMI Exclusive Criteria: Individuals
with no respiratory infections, cardiovascular problems, endocrine problems and
obesity. Procedure : the written consent was taken and vitals were taken and physical
fitness index had been measured through Harvard’s step test (step height was 46 cm
and individual will perform step up down at speed of 30 steps per min until not able to
maintain speeds for 15 seconds) post heart rate was taken to judge the fitness index.
RESULTS: The average fitness index for the above study is = 38.98 that is POOR rating.
Which includes 92% of population.
CONCLUSION: Present study indicates that the average mean of the cardiovascular
fitness of young healthy individuals is Poor and has decreased cardio-respiratory
endurance.
KEY WORDS: heart rate, cardiovascular fitness , Harvard step up test.
VII
TABLE OF CONTENTS
Sr. No.
TITLE
Page No.
1.
INTRODUCTION
1-5
2.
NEED OF STUDY
7-8
3.
AIMS & OBJECTIVES
9-10
4.
REVIEW OF LITERATURE
11-12
5.
METHODOLOGY
13-20
6.
RESULTS
21-22
7.
DISCUSSION
23-27
8.
CONCLUSION
28-29
9.
SUMMARY
30-32
10.
BIBLIOGRAPHY
33-35
11.
ANNEXURES
36-41
VIII
LIST OF GRAPHS
SR.NO
GRAPHS
GRAPHS
PageNO.
SHOWINGTHE DISTRIBUTION OF THE
28
INDIVIDUALS
1.
ACCORDING
TO
THE
CARDIOVASCULAR FITNESS (6.1)
IX
LIST OF FIGURES
SR. NO.
FIGURES
1.1
SYSTEMIC AND PULMONARY CIRCULATION
PAGE NO.
4
5.1
MATERIALS USED FOR STUDY
18-19
5.2
METHOD
21-26
X
INTRODUCTION
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
INTRODUCTION
Physical fitness is a general state of health and well-being and, more specifically, the
ability to perform aspects of sports or occupations. Physical fitness is generally
achieved through correct nutrition, exercise, hygiene and rest. It is a set of attributes or
characteristics seen in people and which relate to the ability to perform a given set of
physical activities.
Before the industrial revolution, fitness was the capacity to carry out the day’s activities
without undue fatigue. However with automation and changes in lifestyles physical
fitness is now considered a measure of the body’s ability to function efficiently and
effectively in work and leisure activities, to be healthy, to resist hypokinetic diseases,
and to meet emergency situations.
Over the past two decades cardiovascular fitness, i.e. the efficiency of the
cardiovascular systems, has been the subject of a very large number of studies
involving endurance-trained athletes. In contrast, it is only recently that the
cardiovascular fitness of the general adult population has received much attention. This
is due to the fact that diseases of the respiratory and cardiovascular systems have
become a major cause of adult deaths in Western nations1.
There are various components of fitness. They are as follows:HEALTH RELATED FITNESS
Body Composition
A health-related component of physical fitness that relates to the relative amounts of
muscle, fat, bone and other vital parts of the body.
Cardiovascular Fitness
2
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
A health-related component of physical fitness that relates to ability of the circulatory
and respiratory systems to supply oxygen during sustained physical activity.
Flexibility
A health-related component of physical fitness that relates to the range of motion
available at a joint.
Muscular Endurance
A health-related component of physical fitness that relates to the muscle's ability to
continue to perform without fatigue.
Strength
A health-related component of physical fitness that relates to the ability of the muscle to
exert force.
SKILL RELATED FITNESS
Agility
A skill-related component of physical fitness that relates to the ability to rapidly change
the position of the entire body in space with speed and accuracy.
Balance
A skill-related component of physical fitness that relates to the maintenance of
equilibrium while stationary or moving.
Coordination
A skill-related component of physical fitness that relates to the ability to use the senses,
such as sight and hearing, together with body parts in performing motor tasks smoothly
and accurately.
3
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
Power
A skill-related component of physical fitness that relates to the ability to the rate at which
one can perform work.
Speed
A skill-related component of physical fitness that relates to the ability to perform a
movement within a short period of time.
Reaction Time
A skill-related component of physical fitness that relates to the time elapsed between
stimulation and the beginning of the reaction to it.
Cardiovascular fitness is also referred to as cardiovascular endurance, aerobic fitness
and cardio respiratory fitness. A Max V•O2 test in the laboratory setting is considered to
be the best measure of cardiovascular fitness. Commonly administered field tests
include the mile run, the 12 minute run, the 1 mile run, the mile walk, the Harvard’s step
up test , multiple step test, and treadmill tests etc2
Normal anatomy of the cardiovascular and pulmonary system and relation to body
Main functions of this system is to provide O2 as a energy source and nutrients and to
remove the waste metabolites from the tissue.2
Cardiovascular fitness of individual is very important as it decides the quality of life an
individual will spend and it will ultimately outcome as mortality and morbidity of
individuals. As it supplies nutrients oxygen and basic needs of the entire body any
dysfunction of the cardio respiratory system will lead to the impairment of various
bodily tissue and systems.
4
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
Figure 1.1
5
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
The Harvard Step Test was developed by Brouha et al. (1943) in the Harvard Fatigue
Laboratories during WWII. Some sources suggest a 40 cm high bench, which is not the
standard and original bench height. Since the original description of this test, there have
been variations in the test procedure such as reducing the bench height for female
persons in some research studies. The height of the step can be modified to suit
different personal training clients. A 50cm high step is very high for 'non-athletic' clients
so a step height of 25-30cm can be used. If the height is modified you must record the
exact height and ensure that this exact height is used in subsequent tests to ensure the
test results are valid. Also, if the step height is altered the comparative data in the table
above cannot be used.14
Reliability of Harvard step test
Reliability would depend upon how strictly the test is conducted and the individual’s
level of motivation in performing the test.
The HST is a convenient and widely used method for evaluating cardiopulmonary
functions. The HRV represents the change in heart rate in response to the physiological
states
Validity of Harvard step test
There are published tables to relate results to a potential level of fitness and the
correlation is high.The step height influences the result of physical fitness.3
Commonly other administered field tests include the mile run, the 12 minute run, bruce
protocol, balke protocol, naugtons protocol, the 1 mile run, the mile walk, the Harvard’s
step up test , multiple step test, and treadmill tests etc2
HST has been chosen in the study as its submaximal testing and without much
instruments required along with easy understanding of individual about the test with
less time required to assess the cardiovascular fitness as compared to other tests.
6
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
NEED OF THE STUDY
7
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
NEED OF THE STUDY
1. To assess the cardiovascular fitness of young individuals.
2. To decide the level from which the cardiovascular fitness training must be started
in today’s sedentary lifestyles of maximum individuals.
3. To know the prevalence of early cardiovascular diseases in future
8
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
AIM AND OBJECTIVES
9
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
AIM & OBJECTIVES
AIMS
1. To judge the level of cardiovascular fitness of young individuals ageing from 18 to 25
years.
OBJECTIVES
1. To assess the resting heart rate and the post exercise heart rate of the individuals
using Harvard step test.
2. To assess the BMI of the young individuals.
3. To assess the cardiovascular endurance of individuals aging from 18 to 25 years.
10
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
REVIEW OF LITERATURE
11
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
REVIEW OF LITERATURE
1. Prasenjit (2012) et al suggested that in last few decades there have been an alarming
trend was observed not only among young individuals but also in every person’s
regarding gym-practice as most used fitness media. Thus, that study had been
undertaken to evaluate whether regular gym going modulates physical and
physiological fitness or not. The investigation was conducted in randomly selected male
regular gym goers (mean age22.0) and non - gym - goers college students (mean age
21.3) of Kolkata. A significant difference (p _ 0.05) in blood pressure, PFI, energy
expenditure and motor unit recruitment was found in gym goers. Hence, this study infers
a definite positive influence of regular gym going over physical fitness and muscle mass
(strength) and also an influence over cardiovascular fitness .Thus suggesting of the
decreased cardio vascular fitness in young individuals due to sedentary lifestyle. 9
2. Jyoti P Khodnapur et al(July-Dec. 2012) In this study the mean PFI (%) for Group I
has been significantly higher as compared to Group II, indicating that students of
residential (trained) school have had higher physical fitness than that of students of nonresidential (untrained) school. This may be due to regular physical exercise and training
of residential school children.7
3.Chatterjee et al(2001) also has reported higher PFI score among trained (athletics)
than those untrained (nonathletic) comprising of female subjects only in cardio vascular
fitness. This also supports the study that the individual who has sedentary life style has
12
low cardio-respiratory fitness.
4. Rhyming modified the Harvard step up test(1993), selecting a 40 cm step for men
and 33 cm for women and rate of 22.5 steps per minute these changes allowed for a
working duration of 5 minutes at sub maximal response .However, procedure to assess
the cardiovascular fitness in healthy young individuals through Harvard step test
necessitated the use of pulse extrapolation for the prediction of work aerobic capacity.
Thus this study suggests that the Harvard step test uses the submaximal testing of
individuals and changing the height of the tools can vary the results. To assess the
11
cardiovascular fitness in healthy young individuals through Harvard step test.
5. J.watkins et al (1984) suggested that Harvard step test has been widely used to
assess the cardio-respiratory fitness of individuals; Harvard step up test depends upon
3
the performance based on heart rate during recovery.
12
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
METHODOLOGY
13
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
METHODOLOGY
Study design: observational study cross sectional study.
Study Setting: OPD, School of Physiotherapy, RK University campus.
Sampling Technique: convenient sampling .
Study Population: 17 to 22 years of age group.
Study Sample: 50 individuals.
Study Duration: Total Study duration - 3 weeks.
14
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
CRITERIA FOR SELECTION
INCLUSION CRITERIA

Young individuals with normal BMI.

Individuals which have cleared PAR Questionnaire.

Individuals with 17-22 years of age.
EXCLUSION CRITERIA
 Individuals with recent respiratory infections cardiovascular problems
 Individuals who are obese
 Individuals with musculoskeletal conditions of lower extrimity .
15
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
MATERIALS USED IN THE STUDY
1. Step (46 cm height)
2. Stop watch
3. Music to control speed
4. Stadiometer
5. Weighing machine
6. Sphygmomanometer
7. Stethoscope
8. Pen
9. Paper
Figure 5.1.3
Figure 5.1.1
Figure 5.1.2
16
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
Figure 5.1.5
Figure 5.1.4
Figure 5.1.6
Figure 5.1.7
17
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
METHOD
Harvard step up test can be used for both men and women of various ages and relies
on the linear relationship between heart rate and VO2 to predict maxVO2. The test has
been used as part of exercise testing for more than 50 years.
Present study was conducted on 50 subjects in the age group of 18-24 years, of the R.K
University of Rajkot city. Height, weight and body mass index (BMI) were measured.
Students with BMI less than 18.5 (underweight) and more than
25 (obese) were excluded from the study. Students suffering from any physical or
medical abnormality were also excluded from the study. Similarly students involved in
any kind of physical training were also excluded. Informed consent was taken from
all the students. They were explained with the whole test to be performed.
Pre HR and blood pressure of the subject was measured and the subject was asked to
perform the step up test according to the beeps of the music. subjects was asked to
climb the step on one beep and to descend on the next.
Time for which the subject can perform the test was noted. The time, at which the
subject feels that he cannot perform the test any more was taken into consideration.
This time is known as the Time of exhaustion.
After the completion of the test the immediate post HR of the subject was noted.
Then subsequent three post HRs were measured:
1. From 1 min to 1.5 min
2. From 2 min to 2.5 min
3. From 3 min to 3.5 min
Now the measured data of time of exhaustion (te)and the post heart rates was applied to
the following formula for measuring the Physical Fitness Index
18
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
FITNESS INDEX
=
duration of exercise in sec x 100/ 2 x (sum of pulse counts during recovery)
The result obtained was analyzed according to the comparative data table given in
annexure 3.
The cardiovascular fitness of all the individuals was measured accordingly and was then
statistically analyzed with the help of mean.
Figure 5.2.1
19
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
Figure:5.2.2
20
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
RESULTS
21
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
RESULTS
Data analysis of 50 individuals had been carried out as per the procedure.
The results were calculated on the basis of fitness index obtained through it. The mean
was calculated for the obtained data and the , Results of the study revealed that the
majority of individuals of age 17 to 23 having sedentary lifestyle has low cardiovascular
endurance.
The average fitness index of the data obtained is 38.98 (poor). Which include 92% of
poplation as shown below in graph.
22
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
DISCUSSION
23
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
DISCUSSION
The results of the present study reveals that the cardio vascular fitness of young
individuals from 17 to 23 years of age is poor. They have low cardiovascular endurance
and hence fitness.
Several studies have established that physical fitness is necessary to carry out daily
task. The effect of regular exercise is known to have beneficial effect on health.
Importance of physical fitness has been mentioned in the history of mankind including
Vedas. Yet, physiology of exercise is a recent advancement and is an open field for
research. 7
Physical fitness refers to the ability of an individual to perform physical activity. This is
normally slightly different from health related physical fitness that includes components
of physical fitness that are associated with some aspect of good health and or disease
prevention. This attribute of being physically fit to maintain good health is exceedingly
important not only to maintain good health throughout the life of the individual but also
to increase longevity of the individual. This becomes critical in the modern world where
automation coupled with a sedentary life style and with a western diet has drastically
reduced the “good health” of an individual at all ages. This is reflected in the increasing
incidences of obesity, cardiovascular diseases, diabetes mellitus & various cancers.
These diseases account for the bulk of the deaths from all causes & are the leading
causes of death in the developed world.4
This has not spared even the developing world including India. It is predicted that by the
year 2025, developing countries will contribute more than half the burden of diabetes in
the world and that India will have the largest number of diabetic patients (approximately
57 million.5 This would account for the highest number of diabetic patients in any single
country & India would be known as the diabetes capital of the world. Obesity, a feature
of diabetes and cardiovascular disease is a major complication that is increasingly
becoming a feature of even the young population leading to morbidity & even mortality.
24
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
It is therefore important to overcome or reduce the cost of this epidemic that is
assuming threatening proportions. A very simple and inexpensive alternative would be
to get the population into moderate patterns of regular activity. An essential tool in this
would be to investigate the ability of the population to carry out physical activity that
leads to health related fitness. An ideal age group would be the young individuals as
this would allow greater interventions in this age group. This would in the long run lead
to a greater reduction in the health budget as also greater reductions in morbidities and
mortalities 5. This study was a pilot study carried out to analyze the physical fitness in
the student population of a medical college. From this analysis It can be concluded that
this student population shows the necessary physical fitness and satisfies the minimum
requirement in the overall physical fitness regime.
10
This is important, because it has been observed that behavioral changes like becoming
physically active act to delay all cause of mortality and extend life 6.Similar observations
have been found with other studies which show that death rates of the least fit group
were more than 3 times that of the fittest group8. The most interesting finding of this
study was that the greatest health benefit occurred in the group rated just above the
most sedentary group. To move from the most sedentary to the next fit group requires
only moderate intensity exercise such as walking briskly for about 30 minutes several
times a week. To assess the cardiovascular fitness in healthy young individuals through
Harvard step test
J.watkins et al(1984) suggested that Harvard step test has been widely used to assess
the 1cardio-respiratory fitness of individuals; Harvard step up test depends upon the
performance based on heart rate during recovery.3
Prasenjit et al(2012) suggested that in last few decades there have been an alarming
trend was observed not only among young individuals but also in every person’s
regarding gym-practice as most used fitness media. Thus, the present study has been
undertaken to evaluate whether regular gym going modulates physical and
physiological fitness or not. The investigation was conducted in randomly selected male
regular gym goers (mean age22.0) and non - gym - goer college students (mean age
25
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
21.3) of Kolkata. A significant difference (p _ 0.05) in blood pressure, PFI, energy
expenditure and motor unit recruitment was found in gym goers. Hence, this study infers
a definite positive influence of regular gym going over physical fitness and muscle mass
(strength) and also an influence over cardiovascular fitness .Thus suggesting of the
decreased cardio vascular fitness in young individuals due to sedentary lifestyle.
9
Jyoti P Khodnapur’s(2012) study’s results were similar to the results of the present
study conducted i.e. decreased cardio vascular fitness of individuals with decreased
physical activity. In her study the mean PFI (%) for Group I has been significantly higher
as compared to Group II, indicating that students of residential (trained) school have
had higher physical fitness than that of students of non-residential (untrained) school.
may be due to regular physical exercise and training of residential school children. 7
Chatterjee et(2001) al also has reported higher PFI score among trained (athletics) than
those untrained (nonathletic) comprising of female subjects only in cardio vascular
fitness. This also supports the study that the individual who has sedentary life style has
low cardio-respiratory fitness. 12
Rhyming modified the Harvard step up test (1993), selecting a 40 cm step for men and
33 cm for women and rate of 22.5 steps per minute these changes allowed for a
working duration of 5 minutes at sub maximal response .However, procedure To assess
the cardiovascular fitness in healthy young individuals through Harvard step test
necessitated the use of pulse extrapolation for the prediction of work aerobic capacity.
Thus this study suggests that the Harvard step test uses the submaximal testing of
individuals and changing the height of the tools can vary the results. To assess the
cardiovascular fitness in healthy young individuals through Harvard step test
11 , 13
26
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
LIMITATIONS OF THE STUDY
 Change in the step height and health of individuals and height of
individuals may change the test results.
 It does not focus on the functional activity of the individuals.
 It’s a submaximal testing.
FURTHER RECOMMENDATIONS

Longitudinal studies must be conducted for prevalence of cardiovascular
diseases after giving cardiovascular fitness training to the young
individuals.

To assess the cardiovascular fitness in healthy young individuals through
Harvard step test

It can be accompanied by adding the changes in other vitals and can be
done with inclusion of various age groups.
27
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
CONCLUSION
28
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
CONCLUSION
Present study indicates that the average mean of the cardiovascular fitness of young
healthy individuals is Poor and they have decreased cardio-respiratory endurance. This
shows that the cardio respiratory training and physical activity must be encouraged and
implemented as soon as possible in the today’s young individuals / generation.
Sedentary lifestyle of young individuals has to be modified.
Some exercises of sub-maximal level should be introduced to the sedentary lifestyle of
young individuals so that future cardio-respiratory complications can be prevented and
kept watch on.
To assess the cardiovascular fitness in healthy young individuals through Harvard step
test
29
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
SUMMARY
30
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
SUMMARY
A student during the course of the medical education is subjected to different kinds of
stressors predominantly the pressure of academics leading to the successful completion
of the educational course. Physical & mental fitness are the key to such a successful
outcome. Physical fitness is used in two close meanings: general fitness-a state of
health and well-being and specific fitness -a task-oriented definition based on the ability
to perform specific aspects of sports or occupations. It is the result of regular exercise,
proper diet and nutrition, and proper rest for physical recovery. There has been a
decrease in physical activity due to a more sedentary lifestyle. However evolution has
not kept pace with automation and humans have not adapted effectively to the
sedentary lifestyles. Inadequate physical activity is responsible for approximately 30%
of all deaths mainly due to heart disease, diabetes & colon cancer1. Rising levels of
obesity are also contributing to these diseases.
This has reached epidemic proportions in many parts of the developing world and is
beginning to affect developing countries like India as well. Obesity, if present in
adolescence leads to obesity in adult life. There is substantial evidence that obesity in
childhood lays the metabolic ground work for adult cardiovascular disease2 .Beginning
an active lifestyle could significantly reduce mortality from these events3 (Paffenberger
R.S. et al ,1994). Regular physical exercise is known to have beneficial effects even in
the untrained person and in diseased states like Diabetes, Obesity & Hypertension. It
was therefore thought to evaluate cardiopulmonary efficiency in medical students to
determine the physical efficiency in these students and plan suitable strategies if
necessary.
Thus, Physical fitness index (PFI) was calculated by measuring heart rate after
performing Harvard step test (HST) which is a common method used to assess cardio respiratory fitness. It is based on the heart rate recovery following a given work load.
The subject was instructed to step up and down on a 42 cm high bench up to
exhaustion. Exhaustion is defined as the time when the subject cannot maintain the
stepping rate for 15 seconds when the rate of stepping is set at 30 cycles per minute.
31
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
Then fitness index was calculated as above formula and the conclusion of the study
indicates that these individuals have the minimum physical fitness to carry out their day
to day activities like climbing up stairs and brisk walking etc .
32
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
BIBLIOGRAPHY
33
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
BIBLIOGRAPHY
1. U.S. Department of Health and Human Services. Physical activity and health: a
report of the Surgeon General. Atlanta: U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, National Center for Chronic
Disease Prevention and Health Promotion; 1996.
2. TANCRED, B key methods of sports conditioning athletics coach,1995, 29(2), p.19
3. J. Watkins, step tests of cardiorespiratory fitness suitable for mass testing , Brit. J.
Sports Med., June 1984, 18(2),p.84-89
4. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath
GW, Thompson PD, Bauman A, et al. Physical activity and public health: updated
recommendation for adults from the American College of Sports Medicine and the
American Heart Association Circulation. 2007 Aug 28; 116(9):1081-93.
5.King H, Aubert RE, Herman WH: Global burden of diabetes, 1995 – 2025: prevalence,
numerical estimates, and projection Diabetes Care1988:21:1414–1431.
6.Astrand PO, Rodahl K, Dahl H, Stromme S. Test book of work Physiology. 4th ed,
1960. p. 281.
7. Jyoti P Khodnapur, Gopal B Dhanakshirur, Shrilaxmi Bagali et al. Status of Physical
Fitness Index (PFI %) and Anthropometric Parameters in Residential School Children
Compared to Nonresidential School Children, Journal of Krishna institute of medical
sciences university, 2012 , 1(2)
8. Blair SN, Kohl HW III, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW.
Physical fitness and all-cause mortality: a prospective study of healthy men and women.
Journal of the American Medical Association 1989;262:2395–2401.
34
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
9. Prasenjit Chuadhary, Pallav Sengupta , Saumaya Ganguli et al. Emerging trend of
gym practice and its consequence over physical and physiological fitness, journal of
biology of exercise , 2012,8.1
10. Karandikar MS, Prasad NB, Asit Kumar. Assessment of Cardiopulmonary Efficiency
Levels in a Student Population, International Journal of Scientific and Research
Publications, Volume 4, Issue 5, May 2014
11. Chatterjee CC. Human physiology. Medical allied agency, 11th ed, p 299312, 1985.
13.Rhyming I. A modified Harvard step test for the evaluation of physical fitness ,Ar.
Physiology J., 1953,1
14. Brouha I, Health CW and Gray B. A step test simple method of measuring
physical fitness for hard muscular work in adult men. Rev Canadian
Biol,1953. 86(2)
35
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURES
36
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURE 11.1
CONSENT FORM
ETHICAL INFORMED CONSENT FORM
STUDY TITLE : TO ASSESS THE CARDIOVASCULAR FITNESS ON HEALTH INDIVIDUALS
THROUGH HARVARD STEP UP TEST .
Subject ‘s name:________________________________________________________________
Age : _______________________years
Gender:__________________________
Address
of
the
subject:
__________________________________________________________________________________
__________________________________________________________________________________
I have been explained in details about the various questions/tests that will be asked /performed is to
assess my functional capacity & health status etc. I have also been explained that all the tests are noninvasive and without any side effects.
I understand that my participation in the study is voluntary and that I am free to withdraw at any
time , without giving any reason , without my medical care or legal right being affected.
I understand that the data obtained through the study may be used for research paper publication and I
also understand that my identity will not be revealed at any cost . I agree to give my consent for
taking my photograph and have no objection against it .
I agree to take part in above study .
Signature of the subject: ________________________________________________________
Signature of the witness:________________________________________________________
Name of witness:______________________________________________________________
Signature of investigator:_______________________________________________________
37
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURE 11.2
ASSESMENT FORM AND DATA COLLECTION SHEET
NO:
NAME:
AGE:
SEX:__________________
OCCUPATION:
ADRESS:
MOBILE NO:
RESPIRATORY RATE:
BLOOD PRESSURE:
HEIGHT:
WEIGHT:
BMI:
HEART RATE:
Pre:
Post:
1. from 1 to 1.5 min:
2. from 2 to 2.5 min:
3. from 3 to 3.5 min:
TOTAL POST HR:
TIME OF EXHAUTION:
FITNESS INDEX:
38
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURE 11.3
MEASUREMENT TOOL
Physical Activity Readiness Questionnaire - PAR-Q
PLEASE READ THE QUESTIONS CAREFULLY AND ANSWER EACH ONE HONESTLY WITH A Y FOR
YES AND N FOR NO:
1. Has your doctor ever said that you have a heart condition and that you should only do physical
activity recommended by a doctor? Y / N
2. Do you feel pain in your chest when you do physical activity? Y / N
3. In the past month, have you had chest pain when you were not doing physical activity? Y / N
4. Do you lose your balance because of dizziness or do you ever lose consciousness? Y / N
5. Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a
change in your physical activity? Y / N
6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart
condition? Y / N
7. Do you know of any other reason why you should not do physical activity? Y / N
39
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURE 11.4
SCALES USED IN OUTCOME MEASURES
40
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
ANNEXURE 11.4
Master chart
41
ASSESSING THE CARDIOVASCULAR FITNESS OF HEALTHY YOUNG INDIVIDUALS USING
HARVARD STEP TEST
SR.NO
AGE
SEX
RR
BP
HEIGHT
WEIGHT
BMI
PRE
HR
POST
HR
POST HR
1 TO 1.5
POST HR
2 TO 2.5
POST HR
3 TO 3.5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
19
20
18
19
20
20
20
20
17
17
20
20
21
20
20
19
20
20
20
20
20
20
20
20
20
21
20
20
20
20
20
20
20
19
19
19
19
20
19
19
19
19
19
20
21
20
20
20
20
20
M
F
F
F
F
F
F
M
F
F
F
M
M
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
M
F
F
F
F
M
16
15
16
15
14
15
16
16
16
16
15
18
14
16
14
16
14
16
14
14
16
16
16
14
16
14
15
15
15
12
14
13
13
13
15
14
17
14
15
16
14
14
14
13
15
14
15
15
12
14
120/84
112/80
120/80
116/80
120/90
130/80
116/80
120/90
110/80
120/80
120/80
120/76
110/80
120/80
110/76
110/80
110/80
120/80
120/80
110/70
120/80
120/86
110/80
120/80
110/80
120/80
110/80
120/84
110/70
120/80
120/80
110/80
120/80
110/80
126/80
110/80
120/80
120/80
120/80
120/80
116/80
118/80
110/80
130/80
110/80
120/80
120/80
126/80
118/80
116/80
173
153
160
153
146
158
147
155
156
155
155
166.5
165
165
156
150
155
155
154
157
156
154
158
153
154
152
150
158
162
157.5
153.5
143
146
158
154
147
160
154
152
153
155
148
155
158
166
160
161
153
156
173
55.5
46
47.5
43.5
49
60
40
60
51
47.3
55
59.3
52.7
50.5
50
50
55
57
47
47
51
50
60
45
48
43
52
55
57.3
51.5
58.9
47.8
41.5
47
44
48
57
46
48
47
45
41
45
60
54
55
55
57
47
58
18.5
19.6
18.5
18.6
23.1
24
18.5
25
18.6
19.7
22.9
19.5
19.4
18.6
20.5
22.2
23.1
23.7
19.8
19.1
21
21.1
24.0
19.2
20.2
18.6
23.1
22.0
21.9
20.8
25
23.4
19.5
18.8
18.5
22.2
22.3
19.4
20.8
20.1
18.7
18.7
18.9
24
19.6
21.5
21.2
24.3
19.3
19.4
82
64
84
70
90
80
75
66
78
80
76
68
77
79
80
72
74
80
80
96
72
68
64
68
88
62
84
84
104
72
80
70
76
80
80
76
78
80
71
74
80
76
80
76
74
81
73
71
70
76
112
118
114
144
120
146
148
128
148
120
156
146
140
156
138
120
162
150
106
132
140
120
150
122
124
126
160
120
146
120
178
110
108
113
114
110
104
120
100
156
136
110
116
176
160
155
159
160
157
110
45
53
53
73
57
46
45
62
50
67
70
49
67
70
67
40
70
65
41
66
83
60
58
51
57
62
71
58
68
53
72
56
50
45
48
58
48
56
65
45
60
51
56
69
55
60
70
56
56
49
41
47
48
44
56
49
44
60
42
55
55
49
64
64
70
35
56
60
42
60
50
58
48
43
51
56
60
57
60
45
76
51
50
35
47
51
40
51
43
43
48
47
54
65
51
56
69
51
52
51
40
41
42
40
56
41
36
59
37
53
59
46
63
63
64
51
49
64
42
50
40
49
35
30
45
52
52
50
63
43
70
49
46
29
38
49
36
49
32
39
33
46
53
60
49
55
59
49
50
49
TOTAL
POST
HR
126
141
143
157
169
137
125
181
129
173
184
144
194
197
201
126
176
189
125
176
173
167
141
124
153
170
183
165
191
141
218
156
146
109
133
158
124
156
140
128
141
96
163
194
155
171
198
156
158
149
TIME OF
EXHAUTION
FITNESS
INDEX
FITNESS
CATEGORY
92
100
104
128
112
57
93
388
92
76
92
199.2
248
126
90
120
96
150
57
96
126
74
120
120
126
96.5
118
70
72
70.2
130
120
150
101
100
86
130
101
174
156
148
144
145
196
102
126
138
126
160
136
36.50
35.46
36.36
40.76
33.33
20.95
37.2
107
35.65
22.109
25
69.16
63.91
31.9
22.38
47.61
27.27
39.68
22.8
27.27
36.41
22.15
42.55
48.38
41.17
28.23
32.24
21.45
18.84
24.82
29.81
38.46
51.36
46.33
37.5
27.21
52.41
32.37
52.14
60.93
52.48
33.33
44.47
50.51
32.90
36.84
34.84
40.38
50.63
45.64
POOR
POOR
POOR
POOR
POOR
POOR
POOR
EXCELLENT
POOR
POOR
POOR
AVERAGE
LOW AVERAGE
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
LOW AVERAGE
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR
POOR