A cross-sectional study on patterns, motivating factors and barriers for physical activity among undergraduate medical students

Introduction: There is little published information exploring the perceptions and physical activity patterns among undergraduate medical students in our country. So this study was conducted with the following objectives: 1. To assess the perceptions about knowledge regarding physical activities among undergraduate medical students; 2. To assess their self-reported physical activity practices. Materials and Methods:This cross sectional study was conducted in Kasturba Medical College, Mangalore from 12th to 30th April, 2012. A total number of 427 students were chosen at by using the formula for infi nite population. Tools: 1. A semi-structured questionnaire to know perceptions, barriers, and practices about physical activity; 2. Physical activity was assessed using International Physical Activity Questionnaire (IPAQ). Analysis was done by using SPSS version 11. Signifi cance of differences across various levels of physical activity between different age-groups and gender were made by chi square test. Results: 376 students participated. Majority of them had high physical activity (54.75%). Knowledge was poor about prevention of diabetes (68.9%), stroke (61.6%), and osteoporosis (33.8%). Majority (82.4%) of them perceived healthrelated benefi ts of physical activity as motivating factors rather than prevention of chronic noncommunicable diseases. Most of them (72.3%) have enrolled in life style modifi cation activities like yoga, going to gymnasium, etc. Conclusion: Most of the students fall into moderate physical activity group. Health-related benefi ts were the driving force for doing physical activity.


INTRODUCTION
Adequate physical activity is very essential in order to have good health.Chronic disease is likely to be the primary disease cluster in India in the future. [1]Physical inactivity is an important risk factor for the development of several chronic diseases including coronary artery disease, hypertension, diabetes, cancers, obesity, and osteoporosis. [2,3]This mainly occurs due to the changing lifestyles of people.
In an academically demanding environment of college, students tend to do less physical activity. [4]ne published study conducted on junior doctors from India did not explore the knowledge about physical activity or patterns of physical activity. [5]Another published from India which reported the patterns of physical activity did not explore if any students made a attempt change their lifestyle. [6]A comprehensive approach which explores various aspects would enhance the understanding.

Study setting
Kasturba Medical College, Mangalore, South India.

Study duration
This study was conducted in the Month of April 2012.

Study population
Undergraduate medical students of KMC (1 st and 2 nd year MBBS students), Mangalore.Inclusion criteria: All undergraduates who were present in the classrooms and willing to participate were included in the study.Those who were not willing were excluded.

Sample size
Assuming that at least 50% of the students would undertake one or the other kind of physical activity, for 95% confi dence interval, 85% power, and 10% non-response, the sample size came to be 427.

Sampling
Non-random sampling.The students who met the study criteria as mentioned above were considered.

Study instruments
1.A semi structured questionnaire was devised to collect the following components of information from the study population: a. Characteristics of study subjects like age, gender, and semester; b.Perceptions and barriers about physical activity; and c.Physical activity practices measured by International Physical Activity Questionnaire (IPAQ). [7]. IPAQ [7] : a.The development of an international measure for physical activity commenced in Geneva in 1998; b.This questionnaire is devised for a 15-69 age group; c.There are 2 forms -short and long.The short form was used in our study as it was more appropriate for younger individuals; and d.The short version has seven questions, which enquires about the time spent in being physically active in last 7 days.Physical activity is graded as mentioned below.

Operational defi nitions
A. Physical activities are activities where there are movements which increase heart rate above its resting rate, whether it is done for pleasure, work or transportation. [7]. Grades of physical activity: 1. Low: is the lowest level of physical activity.a. vigorous-intensity activity on at least 3 days and accumulating at least 1500 minutes/week or b. 7 or more days of any combination of walking, moderate-intensity or vigorous intensity activities achieving a minimum of at least 3000 minutes/week. [7]nternational physical activity.This would reduce the risks of chronic diseases in the long run.

Motivation and barriers
Majority of the students liked to do physical activity.Perceived benefi ts of physical activity and their knowledge are good among medical students.Most of the students have reported health-related benefi ts as the reason for doing physical activity.Certain students do it to get good sleep and to avoid stress and depression.Even their motivation was for health-related benefi ts rather than prevention of chronic diseases.Bharathi et al., reported that older adults performed household chores to a greater extent than the younger individuals who spent more time on their hobbies. [8]Rees et al., have reported that physical activity among young adults serves to show off their skills, enjoyment and using exercise as a way of relieving stress. [9]ur study population consists of younger individuals.This explains the pattern of physical which is mainly sport related which can be attributed to younger age.

Gender differences
Gender differences were statistically significant but the differences based on semester were not.U.S. Department of health and human services has reported that, males are more likely than females to participate in vigorous physical activity, strengthening activities, and walking or bicycling. [10]We found that higher proportion of females had high physical activity, and the differences were statistically signifi cant.Age-group of respondents in our study (18 + years) was higher than the reported from US (12-21 years).Besides the study population consisted of medical undergraduates as compared to younger students from US which could explain the differences.

Limitations
There are some limitations.The non-response rate was slightly higher (11.94%) than what we anticipated.But the response rates observed in our study was higher than those reported by others. [8,11]e cannot rule out response bias as it is a questionnaire based study.

CONCLUSION
Most of the students fall into moderate physical activity group.Health-related benefi ts were the driving force for doing physical activity.
Table 4: Grading of physical activity (IPAQ [6] ) (n = 376) So this study was conducted with the objectives: International Journal of Medicine and Public Health | Oct-Dec 2014 | Vol 4 | Issue 4 Journal of Medicine and Public Health | Oct-Dec 2014 | Vol 4 | Issue 4 Five or more days of moderate-intensity activity or walking of at least 30 minutes per day or c.Five or more days of any combination of walking, moderate-intensity or vigorous intensity activities achieving a minimum of at least 600 min/week.3. High: Any one of the following 2 criteria: Those individuals who do not meet criteria for categories 2 or 3 are considered low/inactive.2. Moderate: Any one of the following 3 criteria: a. 3 or more days of vigorous activity of at least 20 minutes per day or b.

Table 3 : Pattern and duration of physical activity (n = 376)
International Journal of Medicine and Public Health | Oct-Dec 2014 | Vol 4 | Issue 4