Health Articles – Amirah Amalia

The Influence of Academic Stress towards the Physical Fitness of Medical Students of University of Muhammadiyah Prof. Dr. Hamka

Amirah Amalia¹, Deifa Syaldillah Alya Kirana¹, Dhiki Nugraha¹, Fahmi Muhammad Shiddiq¹, Ferdy Reza Nugraha¹, Mochamad Reza Fachlevy Fauzan¹, Nurul Asysyifa¹, Khansa Afifah Putri Bintang¹, Yustian Wahyu Prasetyo¹, Endin Nokik Stujanna¹,Zaini Kadhafi Saragih¹

(1) University of Muhammadiyah Prof. Dr. Hamka, Faculty of Medicine,
Jakarta, Indonesia

1. Introductions

Academic stress is commonly experienced by students, especially medical students. Academic stress is a negative emotion strongly associated with doubt about coping, and occurs as the result of academic activities. Academic stress may occurs on medical students of Uhamka as the impact of busy schedule, a lot of schedule changes, and a lot of assignments. Medical students may have higher rate of stress probability rather than the students of other majors and faculties. It may happen because medical students have heavier academic activities rather than other students. For example, medical students do clinical skills lab and problem based learning, and those things are not done by students from other majors and faculties. Medical students studies using block system, which result in having a lot more amount of examinations, and that could become one of the stress factors. There are also other stress factors, that are enviromental problems, new college environment, tough study routines, and personal factors.

Those stress factors may decrease the productivity and physical fitness of medical students. Also, medical students’ busy schedule may limit their time of excercising and doing sport activities, and will result in lower rate of physical fitness. Physical fitness is a state characterized by an ability to perform daily activities with vigor, and demonstration of traits and capacities that are associated with low risk of premature development of the hypokinetic diseases.

In this paper, researchers will discuss 2 types of physical fitness, that are musculoskeletal related and cardiopulmonary related. The field of musculoskeletal consist of 7 types of test, that are hand grip test, back test, leg test, push up test, sit up test, and sit & reach test. Meanwhile the field of cardiopulmonary consist of 3 types of test, that are balance test, step test, and beep test.

There are 35 subjects in this research and all of them are medical students of Uhamka. Participants were requested to do physical test that consist of 7 tests that are musculoskeletal related and 3 tests that are cardiopulmonary related. The test was held twice with the interval of 6 months. The first test was held in the beginning of the 1st semester where subjects haven’t experience academic stress. The second test was held in the beginnning of the 2nd semester where subjects have experienced academic stress (assignments, studies, and examinations).

The purpose of this paper is to know wether there is a relation between academic stress and physical fitness or not. The test was held to know the effects of academic stress that are experienced by the medical students of Uhamka, towards their physical fitness.

2. Methods

The first test was held in October 3 & 11 2018. The second test was held in April 23 2019. The first test and the second test has 6 months interval and the quantitative result of both test will be compared using the t test method. Both of the test were held in the hall of University of Muhammadiyah Prof. Dr. Hamka, Faculty of Medicine. There are 35 subjects in this test and all of them are medical students of Uhamka. Subjects’ physical fitness was assesed according to the result of their test. The musculoskeletal test consist of flexibility test (sit & reach test) which used flexometer tool, muscle strength test which used hand grip dynamometer and back & leg dynamometer, muscle endurance test which used the amount of push up and sit up done in 1 minute as it parameter. The cardiopulmonary test consist of balance test, beep test, and step test.

3. Results

3.1. Balance Test

3.1.1. Female

Mean of the balance test in the first semester was 5.70 seconds (dextra) and 5.53 seconds (sinistra). Mean of the balance test in the second semester was 5.30 seconds (dextra) and 4.98 seconds (sinistra). Mean is p = 0.63 (dextra) and p = 0.57 (sinistra) or not significant (p>0.05). The minimum result of the first semester was 1.6 seconds (dextra) and 1.48 seconds (sinistra). The minimum result of the second semester was 2 seconds (dextra) and 1.8 seconds (sinistra). The maximum result of the first semester was 10 seconds (dextra) and 18 seconds (sinistra). The maximum result of the second semester was 13.6 seconds (dextra) and 9.26 seconds (sinistra).

3.1.2. Male

Mean of the balance test in the first semester was 9.73 seconds (dextra) and 7.57 seconds (sinistra). Mean of the balance test in the second semester was 8.90 seconds (dextra) and 7.02 seconds (sinistra). Mean is p = 0.72 (dextra) and p = 0.78 (sinistra) or not significant (p>0.05). The minimum result of the first semester was 1.5 seconds (dextra) and 1.7 seconds (sinistra). The minimum result of the second semester was 3 seconds (dextra) and 2 seconds (sinistra). The maximum result of the first semester was 27.13 seconds (dextra) and 17 seconds (sinistra). The maximum result of the second semester was 18.86 seconds (dextra) and 22.53 seconds (sinistra).

3.2. Step Test

3.2.1. Female
Mean of the heart rate in the first semester was 89 beats/minute (pre step test) and 105 beats/minute (post step test). Mean of the heart rate in the second semester was 89 beats/minute (pre step test) and 102 beats/minute (post step test). Mean is p = 0.92 (pre step test) and p = 0.42 (post step test) or not significant (p>0.05). The minimum heart rate in the first semester was 64 beats/minute (pre step test) and 90 beats/minute (post step test). The minimum heart rate in the second semester was 73 beats/minute (pre step test) and 83 beats/minute (post step test). The maximum heart rate in the first semester was 100 beats/minute (pre step test) and 122 beats/minute (post step test). The maximum heart rate in the second semester was 108 beats/minute (pre step test) and 121 beats/minute (post step test).

3.2.2. Male
Mean of the heart rate in the first semester was 84 beats/minute (pre step test) and 96 beats/minute (post step test). Mean of the heart rate in the second semester was 91 beats/minute (pre step test) and 106 beats/minute (post step test). Mean is p = 0.054 (pre step test) and p = 0.08 (post step test) or not significant (p>0.05). The minimum heart rate in the first semester was 72 beats/minute (pre step test) and 81 beats/minute (post step test). The minimum heart rate in the second semester was 79 beats/minute (pre step test) and 85 beats/minute (post step test). The maximum heart rate in the first semester was 96 beats/minute (pre step test) and 120 beats/minute (post step test). The maximum heart rate in the second semester was 113 beats/minute (pre step test) and 164 beats/minute (post step test).

3.3. Beep Test

3.3.1. Female
Mean of the VO2Max as the beep test result was 25.64 mL/kg/min (first semester) and 25.62 mL/kg/min (second semester). Mean is p = 0.97 or not significant (p>0.05). The minimum result was 23.5 mL/kg/min (first and second semester). The maximum result was 29.8 mL/kg/min (first and second semester).

3.3.2. Male
Mean of the VO2Max as the beep test result was 32.55 mL/kg/min (first semester) and 31.52 mL/kg/min (second semester). Mean is p = 0.61 or not significant (p>0.05). The minimum result was 23.9 mL/kg/min (first and second semester). The maximum result was 39.6 mL/kg/ min (first and second semester).

3.4. Hand Grip Test

3.4.1. Female
Mean of the hand grip test in the first semester was 27.87 kg (dextra) and 25.89 kg (sinistra). Mean of the hand grip test in the second semester was 25.35 kg (dextra) and 23.48 kg (sinistra). Mean is p = 0.11 (dextra) and p = 0.08 (sinistra) or not significant (p>0.05). The minimum result of the first semester was 18.7 kg (dextra) and 17.4 kg (sinistra). The minimum result of the second semester was 17.4 kg (dextra) and 19.4 kg (sinistra). The maximum result of the first semester was 42 kg (dextra) and 38 kg (sinistra). The maximum result of the second semester was 35.3 kg (dextra) and 30 kg (sinistra).

3.4.2. Male
Mean of the hand grip test in the first semester was 38.96 kg (dextra) and 37.61 kg (sinistra). Mean of the hand grip test in the second semester was 39.11 kg (dextra) and 35.35 kg (sinistra). Mean is p = 0.94 (dextra) and p = 0.32 (sinistra) or not significant (p>0.05). The minimum result of the first semester was 31.4 kg (dextra) and 30 kg (sinistra). The minimum result of the second semester was 32.2 kg (dextra) and 26 kg (sinistra). The maximum result of the first semester was 53 kg (dextra) and 55 kg (sinistra). The maximum result of the second semester was 56.1 kg (dextra) and 45.1 kg (sinistra).

3.5. Back Test

3.5.1. Female
Mean of the back test was 58.38 kg (first semester) and 35.14 kg (second semester). Mean is p = 4.73 x 10^-6 or very significant (p<0.05). The minimum result was 37 kg (first semester) and 18 kg (second semester). The maximum result was 92 kg (first semester) and 58 kg (second semester).

3.5.2. Male
Mean of the back test was 100.57 kg (first semester) and 95.92 kg (second semester). Mean is p = 0.56 or not significant (p>0.05). The minimum result was 75 kg (first semester) and 55 kg (second semester). The maximum result was 140 kg (first semester) and 130 kg (second semester).

3.6. Leg Test

3.6.1. Female
Mean of the leg test was 55.76 kg (first semester) and 34.09 kg (second semester). Mean is p = 1.19 x 10^-6 or very significant (p<0.05). The minimum result was 40 kg (first semester) and 10 kg (second semester). The maximum result was 72 kg (first semester) and 60 kg (second semester).

3.6.2. Male
Mean of the leg test was 99.5 kg (first semester) and 100.57 kg (second semester). Mean is p = 0.90 or not significant (p>0.05). The minimum result was 70 kg (first semester) and 60 kg (second semester). The maximum result was 139 kg (first semester) and 145 kg (second semester).

3.7. Sit Up Test

3.7.1. Female
Mean of the sit up test was 25x/minutes (first semester) and 21x/minutes (second semester). Mean is p = 0.07 or not significant (p>0.05). The minimum result was 11x/minutes (first semester) and 6x/minutes (second semester). The maximum result was 45x/minutes (first semester) and 32x/minutes (second semester).

3.7.2. Male
Mean of the sit up test was 28x/minutes (first semester) and 29x/minutes (second semester). Mean is p = 0.91 or not significant (p>0.05). The minimum result was 12x/minutes (first semester) and 14x/minutes (second semester). The maximum result was 48x/minutes (first semester) and 50x/minutes (second semester).

3.8. Push Up Test

3.8.1. Female
Mean of the push up test was 24x/minutes (first semester) and 21x/minutes (second semester). Mean is p = 0.17 or not significant (p>0.05). The minimum result was 11x/minutes (first semester) and 12x/minutes (second semester). The maximum result was 35x/minutes (first semester) and 32x/minutes (second semester).

3.8.2. Male
Mean of the push up test was 30x/minutes (first semester) and 33x/minutes (second semester). Mean is p = 0.42 or not significant (p>0.05). The minimum result was 18x/minutes (first semester) and 20x/minutes (second semester). The maximum result was 41x/minutes (first semester) and 50x/minutes (second semester).

3.9. Sit and Reach Test

3.9.1. Female
Mean of the sit and reach test result was 35.04 cm (first semester) and 34.11 cm (second semester). Mean is p = 0.56 or not significant (p>0.05). The minimum result was 25 cm (first semester) and 23 cm (second semester). The maximum result was 49 cm (first semester) and 42 cm (second semester).

3.9.2. Male
Mean of the sit and reach test result was 34.07 cm (first semester) and 34.64 cm (second semester). Mean is p = 0.86 or not significant (p>0.05). The minimum result was 10 cm (first semester) and 15 cm (second semester). The maximum result was 47 cm (first semester) and 49 cm (second semester).

4. Discussion

According to the result of the test, the physical fitness rate of female and male medical students of Uhamka that are cardiopulmonary related (beep test, step test, and balance test) happen to be decreasing in the second test. The degradation range is p = 0.08 – 0.092 (not significant). Although the effect was not significant, but it shows that academic stress does give negative impact towards physical fitness that are cardiopulmonary related.

The insignificance of the effect may happen because of the short interval between the first test and the second test which is only 6 months apart, while the standard of the test should be 12 months apart. The physical condition of the subjects at the time they were tested could also influence the result of the test.

Meanwhile in the field of musculoskeletal happen to have different result in female and male. The physical fitness rate that are musculosekeletal related (hand grip test, sit up test, push up test, sit & reach test, back test, and leg test) in male medical students of Uhamka tends to increase insignificantly with the escalation range of p = 0.32 – 0.94. Whereas the physical fitness rate that are musculoskeletal related in female medical students of Uhamka tends to decrease insignificantly in hand grip test, sit up test, push up test, and sit & reach test with the degdaration range of p = 0.07 – 0.56. Meanwhile the result of back test and leg test were decreseaing very significantly with the rate of p = 4.73 x 10^-6 (back test) and p = 1.19 x 10^-6 (leg test).

The physical fitness rate that are musculoskeletal related tends to increase in male and decrease in female. It may happen because stress is more strongly related in symptoms in female, sugesting that they may have greater susceptibility to surrounding stress and to somatic ilness stress.

5. Conclusion

According to the research, academic stress does give negative impact towards the physical fitness rate of medical students of Uhamka, especially in female because female are more susceptible towards stress.

6. References

1. Kim, Chun. 2018. The Effect of the Type of Physical Activity on the Perceived Stress Level in People with Activity Limitations. Korea: Korean Society of Excercise Rehabilitation.

2. Sandanger, Inger. 2004. Is Women’s Mental Health More Susceptible than Men’s to the Influence of Surrounding Stress. Norway: University of Oslo.

3. Sigmundsson, Hermundur. 2015. Perceived Stress and Musculoskeletal Pain Are Prevalent and Significantly Associated in Adolescents : an Epidemiological Cross Sectional Study. BMC Public Health.

4. Qamar, Khadijah. 2015. Factors Associated with Stress Among Medical Students. Pakistan: PubMed.

5. Wunsch, Kathrin. 2017. The Effect of Physical Activity on Sleep Quality, Well-Being, and Affect in Academic Stress Periods. Germany: Albert-Ludwigs University.

6. Yorks, Dayna. 2017. Effects of Group Fitness Classes on Stress and Quality of Life of Medical Students. England: University of New England.

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