Fostering health-preserving behavior and the culture of healthy living is considered as a priority task for preventive medicine in the current context, characterized by relatively low birth rates and a progressively aging population [1–4]. Given that a significant portion of preventive work falls within the duties of medical personnel providing primary medical and social care to the population, fostering attitudes toward a healthy lifestyle among medical students is a crucial task of higher medical education [5–8].

Adequate physical activity is an integral part of a healthy lifestyle, contributing to the maintenance of cardiovascular health and the prevention of metabolic syndrome and obesity [9–13]. A high risk of physical inactivity is emerging among students in the context of the high level of informatization of public life, the widespread development of online delivery services, and the growing popularity of network forms of interpersonal communication [14–17]. In this regard, studying the hygienic features of medical university students' physical activity is highly relevant.

The study aimed to identify the features of medical students’ physical activity and the risk factors influencing the development of physical inactivity during the period of study.

METHODS

The cross-sectional descriptive study was conducted at the Department of General Hygiene of the Pavlov Ryazan State Medical University of the Ministry of Health of the Russian Federation. We conducted an anonymous online questionnaire survey of 431 1^st to 6^th-year students of the Pavlov Ryazan State Medical University on the forms.yandex.ru platform using questions from the Physical Activity Level Self-Assessment Form adapted by А.V. Kabachkova (2025). Inclusion criteria: The respondent is a student of the Pavlov Ryazan State Medical University of the Ministry of Health of the Russian Federation, he/she has submitted the informed consent to take part in the study, he/she has answered all questions of the online questionnaire. Exclusion criteria: incorrectly filled online questionnaire. The sample size was determined using the standard formula for sampling without replacement.

Relative values ​​were calculated when assessing the rate of various motor activity variants. Significance of differences in the frequency analysis was assessed using the chi-squares test (χ²); pairwise comparison of relative values ​​was performed using Student's t-test. The differences were considered significant at р < 0.05. Statistical data processing was performed in MS Excel (Microsoft; USA) and Jasp 0.97 (University of Amsterdam; Netherlands) software packages.

RESULTS

The study showed that the majority of students enrolled (61.95%) had low physical activity (tab. 1). High and sufficient physical activity was typical for a small proportion of respondents (1.62 and 5.80%, respectively), whereas other students had average levels. We revealed significant gender differences in the physical activity of medical students, reflected by the higher rate of moderate, sufficient, and high physical activity in male respondents (χ² = 20.36; р < 0.001).

The study revealed significant differences in the distribution of students with varying levels of physical activity across different years of university study (χ² = 25.9; р = 0.039) (tab. 2).

The fact that students with high physical activity were found only in the first three years of university attracts attention, and their share was insignificant and fell within the range of 0.63–3.81%. The majority of students in all years of study had low physical activity, and their share increased from the first to the third year of study from 56.18 to 74.29%, reaching its maximum. Then, in the fourth year of study, it dropped to a minimum (52.6%), primarily due to increasing the proportion of students with sufficient and moderate physical activity to the maximum level (to 10.53 and 36.84%, respectively). However, during the next two years of study, the prevalence of low physical activity among students began to rise again: to 68.97 and 70.00%, respectively.

It should be noted that no significant effect of age or faculty on the medical students’ physical activity was found.

It seems interesting to consider distinct components of the students’ physical activity determining its overall score. The study has shown that 35.75% of students always use the stairs instead of the elevator, while the proportion of such students among males (46.75%) is significantly higher than among females (30.13%) (t = 3.46; р < 0.05). A total of 37.50% of the students engage in high-intensity physical activity for 20 min or more, 2–3 days a week, males more often (45.45%), than females (33.34%) (t = 2.48; р < 0.05). A total of 46.93% of respondents perform strength exercises very rarely, and the proportion of such individuals among females is 54.97%, which 1.7 times higher, than among males (t = 5.06; р < 0.05). A total of 34.42% of men and 1.5 times fewer women practice physical activity of this type 2–3 days a week (t = 2.48; р < 0.05).

One in three survey participants, regardless of gender, spends more than 5 h a day in front of a television, computer, tablet, or smartphone; 46.87% of respondents spend between 3–5 h a day interacting with electronic devices, while others spend less than 2 h. At the same time, 46.93% of medical students read books for more than 2 h a day, 31.8% for 2 h, and 16.23% for about an hour. No significant gender differences were found in the distribution of students based on the time spent with books or electronic devices.

A decrease in the proportion of students with low physical activity is observed as the time spent on electronic devices decreases: from 74.15 to 43.90%, respectively (χ² = 34.5; р < 0.001) (tab. 3). 

Reduction of the time spent using electronic devices is reflected in the increase in the fraction of respondents with sufficient or moderate physical activity: from 3.40 to 9.76% and from 21.77 to 40.4%, respectively. At the same time, the highest proportion of respondents with high physical activity was reported for the group with the least time spent using electronic devices.

DISCUSSION

The high prevalence of low physical activity among medical university students (61.95%) identified in the study is fully consistent with the results of other researchers, according to which the lack of physical activity was reported in 57–64% of students [18–20], and 48.6% of students lead a sedentary lifestyle [21]. At the same time, there are studies with a more optimistic assessment of the medical students' physical activity. According to the results of some studies, more than half of medical students had high physical activity [22]. According to other data, only 30.9% of medical university students had physical activity levels below the norm recommended by the World Health Organization (WHO) [23]. According to our data, 37.5% of students engaged in high-intensity physical activity 2–3 times a week, which is consistent with findings from other studies [24]. The reported higher physical activity of males compared to females has been also confirmed by other authors [25]. Our study has revealed no gender differences in the distribution of students based on the time spent using electronic devices, whereas data from other authors suggest that women tend to spend more time on smartphones and using social media [16, 25]. The time spent on electronic devices has an adverse effect on students' physical activity, which is fully consistent with the findings of other authors [25].

It should be noted that insufficient physical activity being a risk factor for metabolic disorders leads to the body mass index increase [26, 27]. Encouraging physical activity among medical students is important for maintaining health and training future physicians [25].

CONCLUSIONS

The majority of medical university students (61.95%) are characterized by low physical activity, which is more prevalent among females (69.5%) than among males (47.5%) (р < 0.001). In general, the trend is observed toward a decrease in the medical students’ physical activity from the first to the third year, a significant increase in the fourth year, and a further decline by the sixth year. A higher rate of high-intensity physical activity and strength exercises was observed among men compared to women. At the same time, nearly half of the students of both genders spent 3–5 h on electronic devices and more than 2 h a day reading. Risk factors for low physical activity among medical students include studying in the third or sixth year of medical university, female gender, and significant time spent using electronic devices.