QCT as an Alternative of HST

Brief Paper : Physiology

Queen’s College Step Test as an Alternative of

Harvard Step Test in Young Indian Women
Amit Bandyopadhyay

Lecturer, School of Health Sciences

School of Health Sciences (PPSK), University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
bamit74@india.com
[Received June 8, 2007 ; Accepted September 11, 2007]

Indian women often report premature exhaustion in the lower limb while performing the
Harvard step test (HST) for measurement of physical fitness index (PFI) whereas they can
easily perform the Queen’s college step test (QCT). 155 sedentary females of 19-24 years
were selected for the study from Institute of Dental Sciences, UP, India to evaluate the
applicability of QCT as an alternative of HST. They were divided into study group (n=100)
and confirmatory group (n=55). All subjects performed QCT comfortably but 35 (20 from
study group and 15 from confirmatory group) of them could not properly perform the HST
due to premature fatigue in their legs and therefore these 35 subjects were discarded from
the study. Existence of significant correlation (r =-0.90, P<0.001) between PFI and QCT
heart rate depicted the following prediction norm for PFI from QCT heart rate : Y = 195.06
– 3.09 X (SEE = 3.09). Prediction of PFI by this norm in the confi rmatory group showed
insignificant variation with the directly measured value from the HST. Bland and Altman’s
analysis also indicated that QCT norm predicts the PFI with 95% confi dence interval.
Moreover, QCT is easy to perform and the derived norm from QCT predicted the PFI score
with substantially small standard error of estimate. Therefore, QCT is recommended as
a valid and authentic test for evaluating PFI in young sedentary females of Uttar Pradesh,
India.

Keywords: QCT, Harvard step test, PFI, Indian females

[International Journal of Sport and Health Science Vol.6, 15-20 2008]

1. Introduction like India. Culpepper and Francis (1987) reported

Measurement of Physical fi tness index (PFI)
is extremely valuable in the fi eld of Sports and
Exercise Science and it is determined by Modifi ed
Harvard Step Test (HST) (Sloan 1959, Chatterjee,
et al., 2002). Sedentary Indians are often compelled
to stop the stepping exercise of HST because of
some premature fatigue in their lower limbs rather
than cardiorespiratory exhaustion (Bandyopadhyay
2007). The subjects report that the stool height and
the stepping cadence of HST are very high which
hinder the comfortable lifting up and pulling down
their legs during the stepping process and that leads
to onset of premature fatigue in their legs. The
biomechanical efficiency and work rate is determined
by the step height (Francis and Brasher 1992).
The HST was designed on the Western population
whose stature and knee height are generally higher
than those of the populations of Eastern countries
that accommodation of step height to the subject’s
statute height is needed for the better estimation of
aerobic capacity, but such adjustment procedure
needs complicated modifi cations for each subject
with respect to the individual’s body height, knee
height and hip angle. Moreover, Ashley, et al., (1997)
reported that step tests based on subjects’ stature
do not more accurately predict the aerobic capacity
than those using a standardized bench height. These
fi ndings suggest that the application of HST in
Indian context needs further standardization either by
adjustment of stepping height and stepping cadence
or by replacement with some other suitable step test
protocol.
Queen’s college step test (QCT) is another
step test that is frequently used to determine the
cardiorespiratory fi tness in terms of maximum
oxygen uptake or VO 2max (Das and Bhattacharya
1989, Das and Bhattacharya 1995, Das 1991,

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Bandyopadhyay, A.
Wassmer and Mukerjee 2002, D’Alanzo, et al.,
2006) and it requires the same infrastructure like
HST. This particular step test has already been
standardized among Indians who can easily perform
this test without any premature exhaustion probably
for its simple experimental protocol with lower stool
height (16.25 inches) and slower cadence (Das and
Mahapatra 1996, Chatterjee, et al., 2001, Chatterjee,
et al., 2004, Chatterjee, et al., 2005). Thus, QCT can
be considered as an alternative step test of HST in
Indian population provided it is properly validated
and recommended. The application of QCT as an
alternative of HST for determination of PFI in Indian
males has already been established and recommended
(Bandyopadhyay 2007), but similar study in Indian
females has not yet been conducted. The present
study was therefore undertaken to assess the
suitability for application of QCT as an alternative of
HST to determine PFI in young sedentary females of
Uttar Pradesh, India.
2. Methodology
2.1. Study population
One hundred and fi fty fi ve (155) healthy young
sedentary female students belonging to age group
of 19 to 24 years from the same socio-economic
background were recruited for the study on the basis
of simple random sampling from Institute of Dental
Sciences, Bareilly, Uttar Pradesh, India. Out of
the 155 participants, 100 individuals were further
separated by simple random sampling method as
‘Study Group’ and the remaining 55 participants
were termed as ‘Confi rmatory Group’. All the
participants performed QCT properly but 20 and 15
participants from ‘Study Group’ and ‘Confirmatory
Group’, respectively, reported early onset of pain in
the leg muscles while performing the HST and failed
to complete the test properly due to the premature
fatigue in lower limbs. Hence they were discarded
from the study.
Age of each subject was calculated to the nearest
year from the date of birth as obtained from the
Institute’s record. Body mass and body height were
measured with a standard weighing machine that
included a height measuring stand (Avery India Ltd.,
India). Body mass was measured to an accuracy of +
0.250 kg and height to an accuracy of + 0.50 cm.
16
2.2. Preparation of Participants
The participants reported at 10 a.m. after having
light break fast at least 2 to 3 hours prior to the test
and refrained from any physical activity during that
period. The entire experimental procedure was
explained to the subjects to allay their apprehension.
QCT and PFI were performed at an interval of 4
days by random sequencing or cross-over design
in which QCT was followed by PFI in half of the
sample whereas PFI was followed by QCT in the
other half of the sample to avoid any possibility of
bias (Chatterjee, et al., 2005). The participants had
no history of any major disease and did not follow
any physical conditioning program, apart from
some recreational sports. A regression equation for
prediction of PFI from QCT was computed from
the study group. The equation was validated in the
confirmatory group.
2.3. Determination of PFI
PFI was measured by HST (Sloan 1959,
Chatterjee, et al., 2002) which was performed on a
stool of 17 inches height with the stepping cadence
of 30 cycles/minute which was set by a metronome.
The maximum duration of the exercise was 5
minutes or up to that moment when the subject was
exhausted. After exhaustion or completion of the
exercise, the subject was asked to take complete rest
on a easy chair and three recovery heart rates were
measured from carotid pulse during 1 – 1.5 min, 2 –
2.5 min and 3 – 3.5 min of the recovery period. The
following equation was used to calculate the PFI:
PFI = (Duration of Exercise in Seconds x 100)/(2 x
Sum of the three recovery heart rates)
2.4. Queen’s College step test
QCT was performed on a stool of 16.25 inches
height for a total duration of 3 minutes with the
stepping cadence of 24 cycles/minute, which was set
by a metronome. After completion of the exercise,
the subject was asked to remain standing and the
carotid pulse rate was measured from 5–20 seconds
of the recovery period (Chatterjee, et al., 2005).
The Ethics Committee of the Institute had approved
the study design and each participant provided written
informed consent. All experiments were performed at
a room temperature varying from 27 to 300C and at a
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 QCT as an Alternative of HST

relative humidity ranging between 70 and 85 per cent. Table 1 Physical parameters, QCT Heart Rate and PFI score
of the participants.
2.5. Statistical Analysis Category Age Body Body QCT Heart PFI
(Years) Height Mass Rate or QHR
(cm) (kg) (Beats)
Paired t-test, Pearson’s product moment correlation,
linear regression statistics and Bland and Altman Study Group 20.80 158.27 51.43 42.33 64.26
(n = 80) + 2.15 + 2.17 + 3.61 + 1.88 + 6.46
approach for limit of agreement (Bland and Altman
1986) were used for statistical treatment of the data. Confirmatory Group 21.04 159.05 50.82 42.07 63.40
(n = 40) + 2.60 + 2.74 + 4.18 + 2.05 + 5.66
The level of significance was considered at P<0.05. NS NS NS NS NS

Values are presented as mean + standard deviation

3. Results NS = Not significant

Means and standard deviations of physical 3

parameters, QCT heart rate (QHR) and PFI of the

Difference between directly measured and predicted PFI

participants are presented in Table 1. The parameters 2

did not show any significant difference between the

‘study group’ and the ‘confirmatory group’. In the 1

study group, existence of significant correlation (rr = values

- 0.90, P<0.001) between QHR and PFI revealed the

0
50 55 60 65 70 75 80

following norm for prediction of PFI by using QCT

-1
in the studied population:
PFI = 195.06 – 3.09 x QHR (SEE = 3.09) -2
Application of this QCT based prediction norm
in the confi rmatory group depicted insignifi cant -3

variation between the PFI scores obtained from HST Average of PFI value obtained from direct measurement and from the norm

(63.40 + 5.66) and QCT norm (63.47 + 6.33). The Mean of difference
Mean + 2 SD
standard error of estimate (SEE) of the prediction
Figure 1 Plotting of difference between PFI values against
norm (4.87% of the mean PFI score) is substantially their means.
small enough to refl ect the authenticity of the
prediction norm. Bland and Altman’s method for 85
Y = 1.0591 X – 4.6237
limit of agreement approach (Bland and Altman r = 0.947, P<0.001
80
1986) also revealed that the mean difference between
PFI scores obtained from QCT

PFI scores obtained from HST and QCT norm is 0.07 75

(Figure 1) with 95% confidence interval, indicating 70

that the norm obtained from QCT predicts the PFI

65
value by between 1.27 and -1.13. The limits of
agreement (-2.33 and 2.47) are also small enough for 60

QCT to be used confidently as an alternative of HST 55

for prediction of PFI in the studied population. 50

However, the significant relationship between HST 50 55 60 65 70 75 80

and QCT have been have been explored further in PFI scores obtained from HST

Figure 2. Figure 2 Relationship between HST and QCT in terms of

PFI scores.
4. Discussion

Proper corrections of step height and hip angle can
accommodate a subject to perform a step test more
conveniently and that provides a better estimation of
aerobic capacity (Culpepper and Francis 1987). But,
the practical problem of such corrections is that it is
to be adjusted in case of each and every individual
who is performing the test and that deviates from
the standard norm of a testing protocol. Moreover,
it consumes more time that may pose as a hurdle
when the study is being conducted in a large sample.

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Bandyopadhyay, A.
Ashley, et al., (1997) contradicted that step tests based
on subjects’ stature do not more accurately predict
aerobic capacity than those using a standardized
bench height. So, it is desirable to recommend one
specific protocol with a particular step test that can be
acceptable to a particular population.
Indian females often fail to complete the HST
because of premature fatigue in their lower limb
though they do not reach their cardiorespiratory
exhaustion level. This is due to the higher stool height
and faster cadence of HST. It has been reflected in
the present study that 35 out of 155 participants failed
to complete the HST because of such premature
fatigue where as all of them could complete the QCT
satisfactorily. The similar finding was also observed
in their male counterparts (Bandyopadhyay 2007).
So, replacement of HST by QCT would be a desirable
solution as far as measurement of PFI among Indian
females is concerned.
The PFI score obtained in the present study
corroborates with the previous fi ndings in Indian
females (Hasalkar, et al., 2005) but the value is lower
than their male counterparts (Bandyopadhyay 2007).
Paired t-test indicated that the PFI values obtained
from the HST and from the QCT norm, respectively,
exhibited insignificant variation between their means.
Further analysis of the data by Bland and Altman’s
method of limit of agreement approach (Figure 1)
depicted that QCT can be applied to determine the
PFI score in young sedentary female population
of Uttar Pradesh, India. Moreover, QCT is more
suitable and practicable because (i) it will enable the
participants to complete the step test conveniently
without any premature fatigue, (ii) measurement of
only one recovery heart rate will predict the PFI, and
(iii) by using the same heart rate subject’s VO2max
can also be predicted by using the following equation
(Chatterjee, et al., 2005):
VO2max (ml/kg/min) = 54.12 – 0.13 x QCT Heart
Rate
5. Conclusion
From the present observation the Queen’s College
Step Test or QCT is recommended as a valid test
and alternative method of HST to evaluate PFI
by using the currently derived equation in young
sedentary females of Uttar Pradesh, India. Moreover,
application of QCT in the studied population will
simultaneously provide the PFI score as well as the
18
VO2max of the subject.
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International Journal of Sport and Health Science Vol.6, 15-20, 2008
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Name:
Amit Bandyopadhyay
Affiliation:
Lecturer, School of Health Sciences
Address:
School of Health Sciences (PPSK), University Sains Malaysia,
Health Campus 16150 Kubang Kerian, Kelantan, Malaysia
Brief Biographical History:
Academic Qualification:
▲
Obt ai ne d Ba chelor of Scie nce ( B.Sc.) w it h Honou r s i n
Physiolog y and Master of Science (M.Sc.) in Physiolog y
with specialization in Sports & Exercise Physiology from the
University of Calcutta in 1997 and 1999, respectively, securing
First Class in both the examinations.
Awarded Ph.D. in September 2004 from the University of
Calcutta.
Research Experience:
▲
Ongoing research career started in January 2000. Dr. Amit
Bandyopadhyay has been conducting various short and term and
long term research projects time to time in the field of Sports
and Exercise Physiology. Published twenty five (25) research
papers in the scientifi c journals of national and internatinal
repute. Many abstracts and full papers have been published in
the conference proceedings for the oral presentations. Prticipated
in conferences and other related scientific programs with invited
lectures and award winning papers.
Awards Received:
▲
Received cash award under the National Scholarship Scheme of
Government of India for the outstanding performance in the B.
Sc. (Honours) Examination.
Honoured with prestigious Prof. B. B. Sarkar Memorial Research
Award in 2001 by The Physiological Society of India.
Awarded Dr. Satyaranjan Dasgupta Memorial Prize in 1999.
Teaching Experience:
▲
Parallel with research, devoted in teaching as Permanent and
Pert-time or Guest Lecturer of General Human Physiology in
undergraduate and postgraduate courses of different Universities
since December 1999.
Currently working as a Lecturer of Exercise Physiology under
the Spor ts Science Prog ram me (underg raduate and post-
graduate) of University Sains Malaysia, Malaysia.
Hobby:
▲
Playing Table Tennis, Traveling
Main Works:
• Bandyopadhyay A. Anthropometry and body composition in
soccer and volleyball players in West Bengal, India. Journal of
Physiological Anthropology (Japan) 26: 501-505, 2007.
• Bandyopadhyay A and Bandyopadhyay P. Cardiorespiratory
fitness in college students of Uttar Pradesh, India. Journal of
Exercise Science and Physiotherapy (India) 3: 38-41, 2007.
• Bandyopadhyay A, Tripathy S, Kamal RB and Basak AK.
Peak expiratory flow rate in college students of Bareilly in
Uttar Pradesh, India. Indian Biologist (India) 39: 71-75, 2007.
• Bandyopadhyay A, Basak AK, Tripathy S and Bandyopadhyay
P. Peak expiratory flow rate in female brick field workers of
West Bengal, India. Ergonomics SA (South Africa) 18: 22-27,
International Journal of Sport and Health Science Vol.6, 15-20, 2008
http://www.soc.nii.ac.jp/jspe3/index.htm
QCT as an Alternative of HST
2006.
• Bandyopadhyay A, Chatterjee S, Chatterjee P, Papadopoulou
SK and Hassapidou M. VO2 max of boys according to obesity
stat us. Jou r nal of Human Movement St udies (U K) 51:
167-180, 2006.
• Chatterjee S, Chatterjee P, Bandyopadhyay A. Skinfold
thickness, body fat percentage and body mass index in obese
and non-obese Indian boys. Asia Pacific Journal of Clinical
Nutrition (Australia) 15: 231-235, 2006.
• Chatterjee S, Mitra SK, Chatterjee P and Bandyopadhyay A.
Pulmonary function in male brick field workers. Biomedicine
(India) 26: 53-59, 2006.
• Chatterjee S, Chatterjee P and Bandyopadhyay A. Prediction
of maximal oxygen consumption from body mass, height and
body surface area in young sedentary subjects. Indian Journal
of Physiology and Pharmacology (India) 50: 181-186, 2006.
• Chatterjee S, Chatterjee P and Bandyopadhyay A. Validity of
Queen’s college step test for estimation of maximum oxygen
uptake in young Indian women. Indian Journal of Medical
Research (India) 121: 32-35, 2005.
• C h a t t e r j e e S , C h a t t e r j e e P a n d B a n d yo p a d h y a y A .
Cardiorespiratory fitness of obese boys. Indian Journal of
Physiology and Pharmacology (India) 49: 1-5, 2005.
• Chatterjee S, Chatterjee P, Mukherjee PS and Bandyopadhyay
A. Validity of Queen’s college step test for use with young
Indian men. British Journal of Sports Medicine (UK) 38:
289-291, 2004.
• Chatterjee S, Chatterjee P, De SK and Bandyopadhyay A.
Resting blood pressure and peak heart rate of smokers of
different age groups. Ergonomics SA (South Africa)16: 36-44,
2004.
• Chatterjee S, Chatterjee P, Mukherjee PS and Bandyopadhyay
A. Vertical jump test on school going boys and girls. Indian
Journal of Physiology and Allied Sciences (India) 58: 66-69,
2004.
• Bandyopadhyay A and Chatterjee S. Body composition,
morphological characteristics and their relationship with
cardiorespiratory fitness. Ergonomics SA (South Africa) 15:
19-27, 2003.
• C h a t t e r je e P, Mu k h e r je e PS a n d B a n d yo p a d hyay A .
Assessment of body mass index, percentage of body fat,
skinfold and girth measurements in Bengalee School Boys.
Indian Biologist (India) 34: 51-57, 2002.
• Chatterjee S, Chatterjee P, Mukherjee PS and Bandyopadhyay
A. Evaluation and interrelationship of body mass index,
percentage of body fat, skinfolds and girth measurements in
boys of 10-16 Years. Biomedicine (India), 22: 9-16; 2002.
• Chatterjee P, Bandyopadhyay A, Bagri M and Lahiri S.
Physiological adaptation in arid and aquatic sportspersons.
Indian Journal of Physiology and Allied Sciences (India) 56:
98-104, 2002.
• Chatterjee S, Bandyopadhyay A, Chatterjee P, Sen J and
Mukherjee PS. Shor t ter m training induced changes in
recovery cardiac cost and physical fitness index of smoker and
non-smoker university students. Indian Journal of Physiology
and Allied Sciences (India) 56: 16-24, 2002.
• C h a t t e r j e e S , C h a t t e r j e e P a n d B a n d yo p a d h y a y A .
E n u m e r a t i o n of v a l i d i t y f o r p r e d i c t e d VO 2 m a x b y
Queen’s college step test in Bengalee boys. Indian Journal of
Physiology and Allied Sciences (India) 55: 123-127, 2001.
• K a m a l R B , Tr i p a t h y S , J a i s w a l G , M i s h r a R a n d
Bandyopadhyay A. Blood level of vitamin C and vitamin E
19
Bandyopadhyay, A.

in undergraduate medical students of Uttar Pradesh, India.

Indian Journal of Physiology and Allied Sciences (India). (IN
PRESS)
• Bandyopadhyay A. Physical parameters are good predictors
of cardiorespiratory fitness in male college students of India.
World Heart Journal (UK). (IN PRESS)
• Bandyopadhyay A. Queen’s college step test - an alternative of
Harvard step test in young Indian men. International Journal
of Applied Sports Science (Korea). (IN PRESS)
Membership in Learned Societies:
• Life member and Fellow of International College of Nutrition
(FICN).
• Life member of The Physiological Society of India.
• Member of the Indian Science Congress Association (Section:
Medical Sciences including Physiology).
• Life member of the I ndian Associat ion of Biomedical
Scientists.

20 International Journal of Sport and Health Science Vol.6, 15-20, 2008

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