Physical and physiological benefits of small sided recreational handball in untrained males: relationship of body fat with aerobic capacity

Background and Study Aim. Exercise and Recreation play major role in promotion of health and fitness. Recreational exercise or sports can be useful in physically inactive population. The aim of study was to investigate the effect of recreational handball on body fat percent, VO2max, blood pressure and resting heart rate. Another purpose to find relationship between VO2max and body fat percentage. 
Material and Methods. Twenty-four students were randomized into intervention (n=14) and control group (n=10). The intervention group was asked to play recreational handball for 12 weeks. Handball training was held twice a week for 30 minutes duration. The Control group performed their normal routine. Aerobic capacity measured using single-stage treadmill test. Body fat was measured with Omron Body Fat Analyzer. T-test was employed to find a significant difference in the two groups. For the relationship in aerobic capacity and body fat, Pearson Product Moment Correlation was used. 
Results. We found significant difference in body percent (t22 = 2.031, P = 0.054). No significant difference was seen in aerobic capacity (t22 = 1.578, P = 0.129), systolic blood pressure (t22 = -1.637, P = 0.116), diastolic blood pressure (t22 = -1.562, P = 0.133) and resting heart rate (t22 = 1.620, P = 0.120). Significant relationship was established between body percent and aerobic capacity (r= -5.23, n=14, p= 0.055) in the intervention group. 
Conclusions. It can be concluded that recreational handball was useful in eliciting good response with respect to reduction of body fat in intervention group. However, recreation handball sessions were not effective in reducing blood pressure, resting heart and aerobic capacity among untrained males. A significant relationship was observed in VO2max and percent body fat.


Introduction
Exercise and recreation play major role in promotion of health and fitness. Recreational exercise or sports can be useful in physically inactive population. Physical inactivity as per WHO, is a major risk factor for global mortality [1]. Low physical fitness level is result of sedentary lifestyle. Participating regularly in physical activity proved to be beneficial to individual health and supervised training interventions are an important took for preventing and treating lifestyle related diseases [2,3] There is a concern about poor adherence to prescribed exercise programmes specially in long term [4].
It has been reported that there are certain team games which can bring a sustainable training intervention that can effectively induce large range fitness and health benefits and that too in motivating environment, although not much research has been done in this area [5]. Further in Denmark and also worldwide, there is high dropout rate in response to traditional exercise regime [4,6]. There is a need to strategize and identify new ideas and activities which can motivate individuals to remain fit and active providing long lasting changes in their lifestyle and prolonged physiological perspectives [7].
It has been found in recent studies that recreational Therefore, we studied the effects of small sided recreational handball on VO 2 max, body fat percent, resting heart and blood pressure in untrained male. We also investigated the relationship of aerobic capacity and body fat percent.

Participants
Participants were untrained male residing in campus of King Fahd University of Petroleum & Minerals. Total 24 participants were selected randomly following exclusion criteria. They were fully informed about the risk and written consent was obtained. This study was approved by Research Committee of King Fahd University of Petroleum and Minerals through project IN191046, 29 March, 2020. Exclusion criteria were the following: participants involved in regular physical activities with in previous one year, who were playing regular handball; participants on medications and suffering from cardiovascular diseases or obesity.
Procedure Project was carried out for 12 weeks. Two groups were formed to study the effects. Group one was intervention with 14 participants. Group two was control with 10 subjects. Subjects were assessed and tested at the baseline and at the end of 12 week of intervention. Participants were advised not to involve in any other physical activities during the period of 12-week intervention. Twelve weeks of supervised small sided recreational handball was given to the participants in intervention group. There was total four teams. Each team consists of 4 players instead of regular seven. All games were played on handball court measuring 40x30m. All sessions were organized during evening hours. Frequency of sessions was twice a week for 30 minutes. Participants did warm up for 10 minutes which consists of jogging and handball drills. After finishing of each session participants performed cooling down exercise for 10 minutes. All the training sessions were supervised personally by the research team. Heart rate of participants in intervention group was measured by heart rate monitors during all handball training sessions.
Measurements and Testing Protocols Age, weight, height, percent body fat was recorded at the baseline. Body fat percentage was measured using Omron body sensor. Hear rate for participants in handball training was measured by Polar FT7 Heart Rate Monitor. Blood pressure and resting heart rate was checked and recorded after resting in supine position for at least 20 minutes using Omron Blood-Pressure Monitor. VO 2 max was tested prior to exercise training programme by single stage treadmill walking test. It is test for submaximal aerobic fitness which estimates VO 2 max. It was suitable for people with less risk, who were healthy, non-athletic adults with age range from 20-59 [15].
Statistical Analysis Collected data were presented as means and standard deviation. Data were assessed for normality by Shapiro Wilks test. Baseline measurements were checked for any group differences before intervention using T Test. Between groups differences in delta values (post minus pre-values) were tested by Independent T Test. P-value for significance was set at 0.05. SPSS for Windows, version 26.0, was used for statistical analysis.

Results
Participant's mean age was 19.78±1.05 years and 19.60±0.96 years in intervention and control groups (P = 0.664) respectively. No adverse complications were reported. There were no significant differences at baseline between two study groups (table 1).
Handball Sessions From initial enrolment of 26 participants, two participants withdrew from the intervention (small side handball) during the study period. Two participants in control group did not appeared for post intervention measurements. All participants were able to play vigorous game of small sided handball (Mean Average heart rate 168.32±8.60 beats/ minute) for 30 minutes duration (Mean duration of play 28.09±2.63 minutes). Mean Attendance in the intervention group during study period was 94.64% which shows the enthusiasm and interest of participants in recreational handball (Table 2).

Body Fat Percent and Aerobic Capacity
Analysis of data revealed improvement in body fat percent. T Test found significant difference in body fat percent (t 22 = 2.031, P = 0.054), with mean body fat percent was 16.74±5.29 and 14.35±4.14 in IG and CG respectively. We did not observe any significant improvement in VO 2 max after 12 weeks of intervention between two groups (t 22 = 1.578, P = 0.129), where mean VO 2 max was 35.28±2.49 and 36.96±3.60 in IG and CG respectively (table 3, Fig.1).
Resting Heart Rate and Blood Pressure With regard to both blood pressure and resting heart rate, no significant difference was observed post  Fig.1).

Relationship of Aerobic Capacity with Body Fat Percent
We found significant relationship of body fat percent with aerobic capacity (r= -5.23, n=14, p= 0.055) in the intervention group after 12 weeks of supervised handball programme. However, no relationship was seen between body fat and aerobic capacity (r= -0.096, n=14, p= 0.799) in the control group (table 4).

Discussion
Body fat in our study reduced significantly post 12 weeks of recreational handball. Our results are similar to previous study on small sided recreational basketball [16], where body fat was reduced. Another previous study on football have shown significant reduction in body fat after 12 weeks of football intervention [17]. Our results were also supported by another study where body fat percent was significantly decreased after 3 months of half-court basketball game [18]. Small sided recreational football was effective in reducing fat percent in experimental group after 16 weeks of intervention [19]. Higher attendance percentage (94.64%) was one of the strong aspects of this study which shows the enthusiasm among participants. This was also supported by other study which stated that students in university are more likely to appear and participate in physical activities which are social in nature and is not carried out in structured settings [20].
We have observed some improvement in aerobic capacity of intervention group. But this improvement not statistically significant. Although there were no baseline differences in two groups, but higher VO 2 max was seen among participants in the control group compare to intervention. Our intervention was also carried for only two days a week. Results of our study are contrary to previous study of similar nature done on recreational basketball, where significant difference was seen in aerobic capacity after 12 weeks of intervention [16]. Considering nature of handball game and intensity of games in present study, it was expected to see improvement in VO 2 max, but our results did not fall in line with VO 2 max was significantly improved following 3 a side basketball [18]. There are number of previous studies done on small sided football that have shown improvement in aerobic fitness in untrained males [19,[21][22][23].
Interestingly we did not see improvement in blood pressure and resting heart rate between two study groups. Contrarily in previous study resting heart rate reduced 10-15 beats per minute after 12 weeks of badminton sessions [24]. Our results were not in line with other studies where resting heart rate was reduced after 3 months of small sided basketball [18], lower resting heart rate reported after 16 weeks of recreational football [19]. Blood pressure also failed to show any significant improvement in present study. Our results were supported by previous study where blood pressure did not show any significant after small sided basketball [18], no change observed in blood pressure after 12 weeks of small sided basketball training [16]. On contrary both systolic and diastolic blood pressure was significantly reduced in previous study on recreational football [19].
The intervention group in our study have shown a significant relationship in VO 2 max and body fat. This relationship was negative, means with increase in VO 2 max there was a decrease in body fat percent. Our results were supported by pervious study [26] where negative relationship was seen between VO2max and body fat percent. Few more studies observed negative relationship between body mass and VO 2 max per unit of body mass 27, 28].

Conclusions
Small sided recreational handball games were useful in eliciting good response with respect to reduction of body fat in intervention group. Body fat was reduced significant after 12 weeks of intervention. On the other hand, recreation handball sessions were not effective in reducing blood pressure, resting heart and aerobic capacity among untrained males. However, a significant relationship was observed in VO 2 max and percent body fat.

Conflict of interest
The authors report no conflict of interest.