Fitness level and the relationship between heart rate, body water, dehydration symptoms in adolescents during a pandemic

This study was conducted to find out the body response occurred immediately after bleep test after undergoing a pandemic period of more than one year. This research is an analytic observational study with a cross-sectional approach, using the purposive sampling technique. The research subjects were 43 students, 14 women and 29 men with the criteria (1) sports students who were physically active three times a week during the last 1-2 months; (2) no injury or (3) illness in the last 3-7 days. The instruments used are polar heart rate monitor h-10 (measure heart rate), Omron HBF 375 Karada Scan (assess the percentage of water in the body), and urine color scale (dehydration predictor). Data analysis through homogenity test, Kolmogorov-Smirnov normality test, and Pearson Correlation test. The findings of this research were female (30.2 ± 2.63) and male (36.8 ± 5.31) VO2Max concluded as fair category. There was no significant relationship between heart rate with body water (0.071 > 0.05) and urine color (0.557 > 0.05), even body water and urine colour (0.10 > 0.05). The pandemic period is proven to make fitness levels stand in a fair category. Heart rate, body water percentage, and dehydration do not have a significant relationship with each other.


INTRODUCTION
During the pandemic, almost everyone experiences limitations in movement except for the essential sector in the health sector. Most people stay at home without any activities. All forms of communication have suddenly turned online, including in education, notably higher education (Abidah et al., 2020;Besser et al., 2020;Xhelili et al., 2021). This new habit will undoubtedly change the lifestyle of each individual. Prolonged time in front of the screen becomes routine and repetitive every day. In addition, it is feared that there will be problems with sedentary behavior (Dunstan et al., 2012;Inyang, 2015), especially at risk of attacking young children. There needs to be the best solution, such as getting used to doing sports or exercises to increase body immunity (Constandt et al., 2020).
The long-sitting time due to online learning negatively impacts (Y Chau et al., 2016). One of them is on student fitness. Student fitness will tend to decrease and decrease exercise habits due to the new normal changing lifestyle. Therefore, measuring the maximum lung capacity is necessary to observe the extent of the development or decline in student fitness conditions during the pandemic. The purpose of a fitness test is to raise awareness of several aspects of fitness related to health that will experience an acute response that is different from the previous fitness condition. This identification is helpful for students to understand their body conditions, including heart rate, body water percentage, and dehydration when doing sports with maximum intensity.
The heart rate is related to body adaptation to the exercise intensity, the higher the intensity, the higher the heart rate (Johnson et al., 2017; Levine & Buono, 2019). Meanwhile, body water percentage will relate to a person's balanced fluid intake during the pandemic. As all we know, eight glass of water should be fulfilled on a day (Kemenkes RI, 2020), if someone has insufficient hydration will experience a performance drop (Owen et al., 2013) and dehydration (Kenefick & Cheuvront, 2012). While adolescents often skip beverage intake (Mata et al., 2021). Ultimately, after carrying out a fitness test, it will discover whether a person is experiencing a lack of fluids from maximum exercise (Bibiloni et al., 2018;Kuecher et al., 2017;Perrier, 2017), due to the body's maximum work and lack of time to get fluid intake during the test. This study is crucial considering that most adolescents or young adults are only active at home during the pandemic, if linked with basic theory, there will be a tendency to reduce physiological responses toward maximum intensity exercise if there is applied lower in duration, frequency, or variation of the exercise, therefore adaptation is needed (Kenney et al., 2015). The purpose of maximum intensity exercise is based on continuous fitness monitoring to prevent accumulation of derivation physical ability.
So far, most studies have only discussed how the pandemic has led to changes in body functions, such as reduced bodywork efficiency and recovery after exercise (Mozolev et al., 2021). One of the longitudinal studies discussing the effects of the pandemic on physical activity patterns tracked by using BetterPoints Smartphone explained a significant change in physical activity was found between a week before the first case of COVID-19 was published (as initial data) to the week when activity restrictions were removed (McCarthy et al., 2021). In addition, some studies only explain how the pandemic affects physical activity levels (M. Brown et al., 2021;Zenic et al., 2020). The previous study found about fitness level on professional football athletes (Rampinini et al., 2021

METHOD
This study was an analytical observational conducted with a crosssectional approach, emphasizing the observation of data carried out on the dependent and independent variables. An analytical observational study is carried out by making observations without treatment from the researcher (Ary et al., 2010;Creswell & Creswell, 2018).
Study subjects were collected using purposive sampling (Creswell & Creswell, 2018), where subjects were selected following predetermined

Study Protocol
Subjects are required to fast for approximately 6-8 hours since the night. Thirty minutes before the test was given 500 ml of drinking water (Syafriani et al., 2014 The heart rate is described in Table 2, where before the test, the heart rate was very low, while immediately after Bleep test, the heart rate experienced a high increase. It was described with an average of 150 beats/minute, categorized as medium-high intensity. The average test seemed not optimal because it was carried out in the morning, and the subject felt their body condition was constrained and heavy when moving. When viewed in detail from the overall data, some people experienced a significant increase of up to 180 beats/minute (90% maximal heart rate).
bleep test forced the subjects to perform maximum performance coupled with the rhythm of the music or the signal of the beeping rhythm that makes the subject have to adjust the speed and frequency of steps.      From the data of heart rate, hydration, and urine obtained as samples, the relationship between heart rate and hydration (0.071 > 0.05), heart rate and urine color (0.557 > 0.05), and hydration and urine color (0.10 > 0.05) are shown in Table 2. It reveals that no significant relationship was discovered among the three variables. Physical fitness will correlate with several components related to health, such as heart rate, body water percentage, and dehydration during physical activity. Heart rate can be used as a predictor of exercise intensity.
The work of the heart should be more effective and efficient when doing Bleep test for active people in sports or athletes. For athletes, the efficiency of pumping blood by the heart occurs due to long-standing adaptations according to training age. For anaerobic-dominant athletes, the expected adaptation is an enlargement of the heart muscle, while in aerobic-dominant athletes, an increase in heart volume or size is expected with the belief that the efficiency of a large blood pump in one heartbeat can be achieved (Porcari et al., 2015).  . Maximum aerobic ability and heart rate variation will increase with physical activity intervention (Sharma et al., 2017). Previous studies on the fitness test treatment showed that VO2Max ability had an opposite relationship with resting heart rate, associated with exercise age, fitness, and body mass index (Fan et al., 2020). Hence, the higher a person's VO2Max value, the lower the heart rate, compared to untrained individuals or are not physically active.
Fluid intake during exercise is essential and must be considered before, during, and after exercise (Armstrong, 2021;Je´quier & Constant, 2010;Kenefick & Cheuvront, 2012;McDermott et al., 2017). For sports that are carried out for less than 60 minutes, the reduced fluid can be replaced with mineral water intake only (Je´quier & Constant, 2010;Porcari et al., 2015). If the exercise duration ranges from 60 -120 minutes, then mineral water alone is not enough, but an additional intake of electrolytes contained in sweat as metabolic waste is also required (Armstrong, 2021;Porcari et al., 2015), usually contained in milk (Amiri et al., 2019;Castro-Sepúlveda et al., 2016;Dow et al., 2019;Russo et al., 2019) and coconut water (Syafriani et al., 2014). After more than two hours of physical activity, in addition to water and electrolytes, it is also necessary to have an additional intake containing carbohydrates and protein, which are usually only found in milk. (James et al., 2019) or sports gel (Dow et al., 2019;Kenefick & Cheuvront, 2012;Porcari et al., 2015). It can be concluded that fluid intake is very important before, during, and after exercise. For example, many teenagers ignore fluid intake and replace it with sports drinks (Mata et al., 2021). Even though it has long been published that the essence of the safest fluid intake can be found easily through mineral water (Je´quier & Constant, 2010), the consumption of mineral water alone is still a lot of teenagers who pass it.
This bad habit causes urine color to become brownish yellow, and if it occurs every day, kidney function will deteriorate. A study explained that adolescents' knowledge of food and beverage intake was negatively correlated with application in everyday life. It indicates that knowledge alone is not enough, but there is a need for reminders and guidance in applying food and beverage intake patterns. However, many studies explained that athletes or ordinary people are motivated to learn and improve food and drink intake patterns (Patton-Lopez et al., 2018).
A body water percentage can be determined by the fluid consumption habits of each individual. The more fluids consumed, such as drinking water, electrolyte drinks, and electrolyte drinks with additional carbohydrate and protein content, the better the body's work will be in supporting each activity.
From a biochemical perspective, water plays a role in chemical reactions, coupled with a catalyst, i.e., enzymes, making the ability to carry out reactions in the body occur quickly. Fluid intake is vital so that a person can meet the fluids in the body to work to break down chemical reactions that occur during the body's activities (Galloway, 2011). The minimum goal is that all individuals know the importance of drinking before, during, and after practice or competition (Bibiloni et al., 2018). After educating people on the importance of fluid intake, implementation in the field will be easier since each individual is aware of the benefits of drinking as recommended (Bibiloni et al., 2018;Mohd Elias et al., 2018;Patton-Lopez et al., 2018;Purcell, 2013;Zaman et al., 2021). Good hydration will affect a person's focus when doing movements (Perrier, 2017;Pritchett et al., 2020).
It is necessary to observe if someone has been doing sports for a long time, but it turns out that they are experiencing a lack of fluid intake without realizing it. It may happen in teenagers actively playing futsal. It turns out that they are at risk of lack of fluid intake due to being undisciplined and educated about the importance of replacing lost fluids (Zein et al., 2020). An instrument to determine whether a person is dehydrated can be easily identified by the urine color (Kavouras et al., 2016). However, there are pros and cons to the recommended use of urinary (Bongers et al., 2018).
However, from the practicality and effectiveness in helping data collection quickly due to repetition of data collection, it is better to use urine color as the main choice (Kavouras et al., 2016). From the urine color, indications of dehydration were indicated on scales 7 and 8, where the urine color was brownish, even dark brown. To prevent the occurrence of yellow-brown and Fitness level and relationship between heart rate, body water, dehydration symptoms in adolescents during pandemic dark brown urine, it is a good idea to drink eight a glass of water a day to be appropriately fulfilled (Kemenkes RI, 2020;Kenefick & Cheuvront, 2012). In this study, it was found that several subjects in the morning had a dark yellow urine color; after being traced, it turned out that the habit of consuming tea and vitamins affects the work of the kidneys, resulting in yellow urine (into the urine color scale 4-6) which indicates that there is an infection. Dehydration is usually characterized by loss of focus (Perrier, 2017;Pritchett et al., 2020), muscle cramp (Maughan & Shirreffs, 2019), heat stroke (Kenney et al., 2015;Porcari et al., 2015), and the worst is collapsing (Khorram-Manesh et al., 2020;Lüning et al., 2019;Thorsson et al., 2021).
The early symptoms of dehydration are usually not realized by many people. Repetitive physical activity has a high risk of dehydration. For example, in Indonesia, festivals or competitions from early childhood to youth are usually held with several matches per day. It has an impact on the physiological aspects of sports actors who will experience fatigue. The fluid intake has not been fulfilled due to the first strenuous activity. After a few hours, the match must be restarted. According to previous references (Porcari et al., 2015), most individuals engaging in such activities will experience excessive fatigue, including weakness, loss of focus, and dizziness. In some cases, some experience fainting due to the hectic schedule of matches in a day. Festivals or competitions like this have occurred since an early age; it is hazardous for young children if they do not get education and guidance from experts. In overcoming this, it is necessary to intervene from practitioners in nutrition and sports physiology so that the competition climate produces favorable conditions for both the organizers, participants, and parents.
Based on the study results, it is discovered that decreased physical fitness conditions, especially in late adolescence (students), occur significantly. Being in front of the screen due to online learning affects fitness, as evidenced by the fair category of all subjects participating in this study. There needs to be intervention from experts and practitioners, as well as technological development innovations, to be able to help improve physical activity habits. Heart rate, body water percentage, and dehydration are not positively correlated, but the three components have their respective roles in helping the body carry out its functions in supporting daily physical activities. The acute response data obtained is expected to make practitioners and academics aware that maximum work will make the body adapt as soon as possible. There needs to be a structured exercise program intervention to improve fitness abilities. It can be said that there was detraining due to the lockdown period being too long during the pandemic.
In following up on this phenomenon, practitioners and academics need to synergize to improve fitness conditions in bulk with innovative programs, besides that the body's adaptation to various stimulations given during exercise needs to adjust to the principle of individualization (Fuchs, 2015;Kenney et al., 2015;Porcari et al., 2015), so that the improvements obtained are right on target and have a good impact slowly.