Physical and health development of female medical university students studying remotely during the COVID-19 pandemic

Introduction

The COVID-19 health crisis has had a major impact on public health, leading to significant changes in education with the transition of teaching online due to school closures [1, 2]. Studies on the impact of COVID-19-induced home isolation on students’ physical fitness have been limited [3], and the long-term effects of the pandemic, self-isolation, and distance learning have yet to be assessed [4]. Studies conducted on five continents have shown that there is currently a lack of knowledge about assessing various aspects of impairment during large-scale disasters such as COVID-19 [5]. A study of the somatic health of students at the Yaroslavl State Medical University (YSMU) was published in the journal Patient-Oriented Medicine and Pharmacy [6]. At the same time, information on the physical development and health of YSMU students who had previously undergone self-isolation, distance learning, and decreased physical activity is lacking.

Objective

1. To assess the physical development and health of first-year female students of Yaroslavl State Medical University who received distance learning at school in the context of the COVID-19 pandemic and home isolation;
2. Determine the level of physical development and health of first-year female students of 2024 who received distance learning at school under the conditions of COVID-19 and isolation;
3. Determine the level of physical development and health of the first-year female students of 2016;
4. Conduct a comparative analysis of the obtained indicators of female students in 2024 and 2016.

Materials and methods

In September–November 2024, the Department of Physical Education and Sports of YSMU conducted a comprehensive examination of 84 first-year female students of the university (group I) who studied in high school during the COVID-19 pandemic in conditions of home isolation, distance learning and reduced physical activity. The comparison group (group II) included 192 first- and second-year female students of YSMU examined in 2016 [7]. Based on the results of the medical examination by the medical commission, students of pathology were identified. A general anthropometric examination was conducted according to the methodological approach adopted at the department and previously published [6]. Based on the data obtained, the body mass index (BMI) was calculated in accordance with the WHO recommendations [8]. Functional tests were performed to objectively assess the state of the respiratory (Shtange, Genchi) and cardiovascular systems (test with 30 squats in 30 seconds) [9]. Quantitative data were processed using the variation statistics method; the significance of the differences was judged by the value of Student's t-test.

Results and discussions

The average age of first-year female students in 2024 was 20.4±0.8, in 2016 – 21.8±0.7 years. Anthropometric data are presented in Table 1.

The female students examined in 2024 had the same indicators in terms of age and height, while they exceeded the female students of the comparison group by 6% in body weight (3.2 kg, at p <0.05) and by waist circumference by almost 11% (p <0.05). The chest volume and vital lung capacity (VLC) in the observation groups did not differ significantly. The parameters of the hand dynamometry turned out to be without significant shifts. BMI was determined based on the anthropometric indicators of the compared groups of female students (Table 2).

It was found that in 2024, normal body weight among female students will be registered 11% less frequently than in 2016. It is noteworthy that the proportion of students with overweight and grade 1 obesity increased by 2 and 3.6 times, respectively. Grade 2 and 3 obesity have not been recorded. The results of the functional tests are presented in Tables 3 and 4.

The time of voluntary breath holding (Stange and Genchi test) in group I was lower by approximately 11 and 8 s, respectively (p <0.05). The obtained data indicate a negative dynamics of oxygen supply to the body and the general level of fitness in first-year female students in 2024 [10].

The use of an additional standard load before the start of the test makes it possible to establish an objective assessment of its impact on the cardiovascular system (CVS) [10]. An atypical response was detected in the 2024 first-year female students, the general feature of which is a slowdown in the recovery period by almost 3 times (compared to group II, p <0.05). Most of the students in groups I and II had a normotonic response to the load [10]. The results of the medical examination by the medical commission indicate deviations in the health of female students in 2024 in 38.1±1.8%, while in 2016 only in 31.6±1.8% of students (which corresponds to an increase of approximately 20%, at p <0.05). The number of diseases by system among female students is given in Table 5.

The most common diseases among female students in 2024 were diseases of the digestive system (20.6%, organs of vision (15.6%), endocrine system and musculoskeletal system (12.5% ​​each). Compared with the observations of 2016, a 2-fold decrease (p <0.05) in the level of pathology of the cardiovascular system and musculoskeletal system was determined. In the structure of diseases of the digestive tract in group I, chronic gastritis and biliary dyskinesia prevail, organs of vision - myopia, and endocrine system-thyroid pathology, students with allergies appeared.

Discussion

The anthropometric indicators obtained in this study correspond to the data published in modern domestic guidelines for girls of the corresponding age [9] and are evidence of the representativeness of the presented materials.

The female students of YSMU examined in 2024 showed an increase in body weight and waist circumference. At the same time, indicators of normal body weight were registered much less frequently, and the proportion of students with overweight and grade 1 obesity increased (compared to 2016). It is known [11, 12] that the lockdown associated with the COVID-19 pandemic caused a variety of emotional problems, including anxiety, depression, and sleep disorders. Many began to cope with their emotions by increasing food consumption (emotional eating) and alcohol consumption, which, combined with a decrease in physical activity, contributed to weight gain and the development of obesity. Emotional eating (stress eating) is defined as a tendency to eat in response to positive and negative emotions, rather than to physical need. Currently, overweight and obesity are rapidly growing, representing a serious health problem worldwide [13], including in Russia [14]. Medical studies have shown that patients are at a higher risk of developing obesity due to factors such as a sedentary lifestyle, insufficient physical activity, unhealthy eating habits, increased stress levels, and a large amount of information to absorb [13, 14]. The authors indicate that among 261 medical students, 16.5% were overweight [13], and in modern Russia, overweight and obesity are observed in more than 80% of medical students with eating disorders [14].

Several studies have been conducted on the impact of online physical education teaching on medical and college students in China during the COVID-19 pandemic [15]. The authors showed that this form is effective in improving indicators such as BMI and vital lung capacity. 

The results of functional tests in female students in 2024 may indicate a decrease in the functional reserve of the respiratory and cardiovascular systems. These data confirm the conclusion that almost half of the examined students in Russian medical universities have signs of cardiovascular diseases [13].

Deviations in the health of female students of YSMU in 2024 amounted to almost 40%. At the same time, a fifth of the pathology is due to disorders of the digestive system. In known observations [14], the level of such pathological shifts in the gastrointestinal tract reaches 50%.

The conducted study opens up the prospect of further observations of the impact of the COVID-19 pandemic on the physical development and health of medical students throughout their studies at the university. At the same time, the Department of Physical Education and Sports of YSMU should be given the important task of conducting medical and pedagogical control over the regime of educational and training classes depending on the physical development, level of training and health of students, which are identified at the beginning of each academic year.

Conclusions

1. First-year female students of 2024 who were in distance learning mode during the COVID-19 pandemic differ from the comparison group in excess body weight, an increase in the number of students with grade 1 obesity. 
2. Deviations in the health of female students in 2024 are more common than in 2016, the most common pathology of the digestive system.