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Stretching exercises accompanied or not with music, reduce the stress level of pre-college student
163
Arch Med Deporte 2016;33(3):163-167
Original article
Summary
In Brazil, many students take preparatory courses for entrance exams at university. However, these tests can be a stressful event,
because their realization usually coincides with a phase of students’ lives when they are still nding out and structuring their
identity. Considering that stress is a prevalent syndrome in young people, especially those in the admission phase in college,
there is a need to evaluate the inuence of strategies aiming to reduce the stress in this population. Thus, we investigate the
eects of a single bout muscle stretching exercise, listening to music and stretching exercise accompanied by music sessions
on the number of stress symptoms in students from preparatory schools for the university admission exams (UAE). Two hundred
fty students were evaluated using Lipp´s Inventory of Stress Symptoms for adults (ISSL). This instrument was standardized
for the Brazilian population, and allows to evaluate the level of stress and determine the number of stress symptoms of an
individual. Volunteers responded the ISSL before and after one of the experimental situations (30 minutes): SA (active and
static stretching exercise), SM (listening to a New Age music), SAM (SA and SM combined) and control situation (SC). It was
veried that 55.2% of the volunteers were stressed. The Kruskal-Wallis test observed signicant dierences (H=13.63; p<
0.01) between SA and SAM situations compared to SC in stressed students (n=138). It was observed signicant reduction
for physical and psychological symptoms in SA and SAM. It was concluded that static and active stretching exercises can be
used before exams to reduce stress symptoms.
Key words:
Muscle stretching exercise.
Music. Stress. University
admission exams.
Young people.
Resumen
En Brasil, muchos estudiantes toman cursos de preparación para los exámenes de ingreso a la universidad. Estas pruebas
pueden ser un evento estresante, ya que por lo general, su realización coincide con una fase de vida de los estudiantes en
la que aún están descubriendo y estructurando su identidad. Teniendo en cuenta que el estrés es un síndrome frecuente
en los jóvenes que están en la fase de admisión a la universidad, se hace necesario evaluar las estrategias dirigidas a reducir
la tensión en esta población. El objetivo de esta investigación fue vericar los efectos del estiramiento muscular, la audición
musical y ejercicios de estiramiento con música en el número de síntomas de estrés en estudiantes de los cursos prepara-
torios para pruebas de admisión universitarias. Doscientos cincuenta estudiantes contestaron el Inventario de Síntomas de
Estrés para adultos de Lipp (ISSL). Este instrumento permite evaluar el nivel de estrés y determinar el número de síntomas de
estrés de un individuo. Los voluntarios realizaron el ISSL antes y después de una de las situaciones experimentales (duración
de 30 minutos): SA (ejercicio de estiramiento estático y activo), SM (música del estilo New Age), SAM (SA y SM combinadas)
y situación control (SC). Vericando que el 55,2% de los voluntarios presentaban estrés. El test de Kruskal-Wallis mostró
diferencias signicativas (H=13,63; p< 0,01) entre las situaciones SA y SAM comparadas a la SC en los estudiantes con estrés
(n=138). También se observó reducción signicativa en los síntomas físicos y psicológicos en SA y SAM. Permitiendo concluir
que el ejercicio de estiramiento estático y activo puede ser utilizado antes de las pruebas de admisión a la universidad como
estrategia para la reducción de síntomas de estrés.
Palabras clave:
Ejercicios de estiramiento
muscular. Música. Estrés.
Pruebas para admisión en la
universidad. Joven.
Received: 05.06.2015
Accepted: 01.09.2015
Stretching exercises accompanied or not with music, reduce the
stress level of pre-college student
Priscila Carneiro Valim-Rogatto1, Gustavo Puggina Rogatto1, Eric Francelino Andrade2
¹Department of Physical Education, Federal University of Lavras, Brazil. ²Department of Veterinary Medicine, Federal University of Lavras, Brazil.
Los ejercicios de estiramiento, acompañado o no con la música, reduce el
nivel de estrés de los estudiantes pre-universitarios
Correspondence: Eric Francelino Andrade
E-mail: ericfrancelinoandrade@gmail.com
Priscila Carneiro Valim-Rogatto,
et al.
164 Arch Med Deporte 2016;33(3):163-167
Introduction
In Brazil, many students take preparatory courses for entrance exams
at university1. However, these tests can be a stressful event, because
their realization usually coincides with a phase of students’ lives when
they are still nding out and structuring their identity.
The term stress has been often related to the response of the
organism before challenging situations, which can harm or weaken it
somehow. When exposed to external stressors, the response of the body
can be identied by three stages: alert, resistance and exhaustion2-4.
Additionally, a new phase was included by Lipp5 during the develo-
pment and validation of an instrument for assessing the symptoms
of stress. It was the stage of near-exhaustion, inserted between the
resistance and exhaustion phase.
Among the most susceptible populations to stress, it highlighted
the teenagers and young adults6. In the academic context, it was obser-
ved that during the period before the entrance exams at university (UAE),
young people showed an increase in the consumption of alcohol and
cigarettes, as well as decrease in physical activity which aggravated even
more stress caused by this situation7. Additionally, stress, both physical
and psychological, can inuence the immune system8.
In this sense, dierent interventions can be eective in reducing
stress levels, emphasizing relaxation techniques involving muscle
stretching and music listening9,10. Thus, considering some physical
symptoms of stress as “feeling of constant physical stress”, “muscle strain”,
“hyperventilation” and “fatigue”11, some body movements alternating
contraction and relaxation could alleviate certain symptoms for some
time or prepare the body for adverse events. With regard to music, a
suitable style could help stretching programs in order to eliminate or
reduce stress points in certain areas of the body12. In this way, the correct
manner to integrate these components can aect physiological and/or
psychological responses of the individual generating dierent reactions
to reduces stress13,14.
Considering that stress is a prevalent syndrome in young people,
especially those in the admission phase in college, there is a need to eva-
luate the inuence of strategies involving stretching and music aiming
to reduce the stress in this population. Thus, the aim of this study was to
investigate the eects of an acute bout of stretching muscle, listening
to music sessions and the association between stretching and music
on the number of stress symptoms on from pre-university students.
Material and methods
This study was approved by the Research Ethics Committee of
the Institute of Biosciences of Universidade Estadual Paulista (UNESP),
Campus of Rio Claro – SP, under protocol 000052/01.
Participants
Two hundred and fty young men and women volunteered to
participate in the study. The inclusion criteria in the study were that
all subjects had completed high school and were regular students
of all preparatory courses for UAE in the city of Rio Claro, São Paulo,
Brazil. In addition to these criteria were only selected individuals who
were classied in at least one of the phases of stress according to the
Lipp’s Inventory of Stress Symptom for Adults (ISSL). In this way, 138
individuals (45 men and 93 women) eectively participated of the
study. The average age of the men was 20.3 ± 5.7 years, while the age
of the women was 19.5 ± 4.7 years. The participants signed a free and
informed consent form allowing their participation in the research.
Later they were randomly divided into four groups: SA - participation
in a stretching session; SM - participation in a Music listening session;
SAM – participation in a stretching session accompanied by music
listening; and SC - continuation of the activities of the preparatory
course in class (control situation). Each experimental situation lasted
30 minutes. Thus, all the experimental conditions were performed on
the same day during the classroom activities.
The songs used were taken from the New Age style album “Secret
Garden - White Stones.”15. This style mix classical music with elements
of folk melodies, making a reinterpretation of classical music, with the
addition of elements from Celtic and Norwegian folklore. This selection
focuses in both music segments stimulative and sedative, the same
procedure adopted by Scheufele16. This author was based on previous
studies that suggested that such variation in musical progress is more
eective for relaxation responses compared to only sedative music
selections. This type of music is usually used in stretching classes,
and contains only instrumental arrangements, being chosen so that
there were not additional factors (vocals, lyrics) that could inuence
the research. The musical selection was used both in SM and SAM
experimental situations. Regarding to stretching, the group SA and
SAM underwent the same protocol described by Valim17. During these
sessions were conducted 18 exercises based on the postures of Hatha
Yoga, combining static and dynamic variations emphasizing breathing
in every movement. The sequence of exercises was started with the
individuals in dorsal decubitus and nalized in standing position17. In
this protocol, every movement was verbally explained and physically
demonstrated (slowly, clearly and objectively) to participants.
The ISSL was applied before and after each experimental situation.
This instrument was standardized for the Brazilian population by Lipp
and Guevara18, and allows to evaluate the level of stress and determine
the number of stress symptoms of an individual4. The ISSL consists
of three tables, corresponding to three-phase Selye´s stress model2,
including the fourth phase (near-exhaustion) found at the time of stan-
dardization of the ISSL18. The rst chart of the instrument is composed
of the symptoms presented by the individual in the last 24 hours and
contains 15 items referring to the symptoms (12 physical symptoms
and three psychological), corresponding to the alert phase. The second
table also provides 15 symptoms (10 physical and ve psychological),
divided into two frames corresponding to the stages of resistance and
near-exhaustion, graded according to a certain minimum amount of
symptoms presented during the last week. The third chart contains 23
items, 12 physical and 11 psychological, corresponding to the symptoms
presented in the last month, featuring thus the exhaustion phase. The
denition of stress phase is given by the sum of the symptoms presented
on each frame. There is a minimum value in each of the stages, which
can characterize the individual as stressed or not.
Stretching exercises accompanied or not with music, reduce the stress level of pre-college student
165
Arch Med Deporte 2016;33(3):163-167
Statistical Analysis
To evaluate the homogeneity of the groups and possible dieren-
ces in stress responses among groups after the experimental situation
Kruskal-Wallis test was used. Multiple comparisons test was used in
order to identify signicant dierences between treatment pairs. To
separately analyze the physical and psychological symptoms and verify
possible changes between before and after each experimental situation,
we used Wilcoxon’s test. The signicance level of 95% (p <0.05) for all
tests was used.
Results
It was observed that from the 250 subjects, 138 (55.2%) were
stressed and 99 (39.6%) showed no stress. Thirteen people (5.2%) were
excluded for not answering the entire quiz or incorrectly performing
the research procedures (eg leave the room before the end of the
experimental situation). Thus, data analysis was applied to a sample of
138 young students, so only those with stress.
Most of the stressed patients were female (67.4%) and 63.8% were
enrolled in daytime, 55.8% practiced some physical activity regularly
and 73.9% were not working.
All stressed volunteers were found in resistance or near-exhaustion
phase, as shown in Table 1.
The Kruskal-Wallis test showed that the group of individual of SA,
SM, SC and SAM were homogenous before each treatment. There were
no signicant dierences in average levels of stress among the four
groups evaluated before the execution of their respective experimental
situations (H = 6; p > 0.05). After 30 minutes from baseline time die-
rences were observed between the experimental conditions (H = 13.63,
p < 0.01). The SA and SAM situations diered from the control situation
(p < 0.001 and p < 0.01, respectively) and SM and SA situations diered
each other (p < 0.05 - Figure 1).
For a more detailed analysis of the reduction of stress, physical and
psychological symptoms were analyzed separately within each experi-
mental situation (Table 2). Using Wilcoxon’s test it was examined whether
there was superiority of one treatment over the other as to the nature
of the data collected. The level of signicance for dierences between
situations before and after the SA and SAM was high (p ≤ 0.01) for both
the physical and psychological symptoms therefore, these conditions
were eective in reducing both types of symptoms of stress.
Discussion
In present study, it was expected better results for the SAM situa-
tion considering the potency of music to the eects of stretching. The
music alone did not bring signicant results, at least 30 minutes, and
the enhancement of benets did not happen because there were no
signicant dierences between the stretch with music and without
music stretching. It is evident the diculty to interpret and relate the
results of the research addressing the utilization of dierent physical
activities or dierent types of music in stress responses. This diculty
is due to the various forms of assessment employed (physical, physiolo-
gical, psychological) and the discrepancy found between the results of
Figure 1. Mean number of stress symptoms of pre-college students
before and after 30 minutes of their respective experimental
conditions.
Table 1. Number of individuals situated in each stress phase.
Table 2. Wilcoxon test values for the physical and psychological
symptoms in each group.
Stress phase
Groups Alert Resistance Near Exhaustion
(n=138) - exhaustion
SA 0 30 1 0
SM 0 30 6 0
SAM 0 38 4 0
SC 0 29 0 0
Total 0 127 11 0
SA: participation in the stretching session; SM: participation in a music listening session; SAM:
participation in a stretching session accompanied by music listening; and SC: continuation
of the activities of the preparatory course in class (control situation).
Groups Physical Psychological
symptoms (z) symptoms (z)
SA -3.91** -2.74*
SM -1.55 -1.01
SAM -3.45* -2.54*
SC -0.29 -0.20
*p ≤ 0.01. **p ≤ 0.0001. SA: participation in a stretching session; SM: participation in a Music
listening session; SAM: participation in a stretching session accompanied by music listening;
and SC: continuation of the activities of the preparatory course in class (control situation).
*: Indicates dierence between before test and after 30 minutes; #: Indicates dierence
from SM and SC groups; ¥: Indicates dierence from SAM group.
Priscila Carneiro Valim-Rogatto,
et al.
166 Arch Med Deporte 2016;33(3):163-167
a further evaluation even in just one study. An example is the study of
Steptoe et al.7 in which the physiological and psychological responses
were compared during the performance of aerobic exercise. These
researchers concluded that, through physiological measurements, ae-
robic training is not associated with stress reduction. However, through
psychological measurements they observed responses associated with
reduced stress as a decrease in tension-anxiety, depression, mental
confusion and improved ability to cope with stress7. Similarly, it was
observed that music therapy decreased anxiety and pain in patients
who underwent cardiac surgery, whereas no dierences were observed
in blood pressure and heart rate of individuals19. However, Möckel et al.20
observed benecial responses related to stress only in physiological
aspects when compared dierent types of music.
The Stretching exercises used in the present study are similar to
Progressive Relaxation (RP), which is the type most often cited in the
literature. RP is characterized by relaxing each muscle or muscle group
so that the individual recognizes the contrast between tension and
relaxation16,21. Thus, stretching can be considered as a sort of relaxation
which promotes reduction of muscle stress levels, respiration rate and
blood pressure, as well as subjective and objective states of excitation
of the individual21. The relaxation exercise has been considered eective
for stress management, being compared to hearing music sessions16.
In this sense, Scheufele16 compared two experimental situations by
checking the eects of RP and classical music in measurements of
attention, relaxation and stress responses. It has been found that the
RP condition showed high scores as relaxation, despite the music have
caused decreased heart rate and provided distraction from stressors.
In the present study, in addition to stretching and music listening
conditions, it was also included the condition stretching accompanied
by music, so that to the research could reproduce the actual situation
of stretching classes and not just in a controlled experimental condition.
Robb22 compared four experimental conditions: Progressive Relaxation
associated with music (RP + M), Progressive Relaxation (RP), music Hea-
ring (M), and control situation of silence (S) on anxiety and perceived
relaxation and found that each treatment might be equally eective,
producing signicant changes in anxiety and perceived relaxation.
Möckel et al.20 stated that music with faster tempo increases heart
rate whereas classical and New Age decreases and stimulates physical
and mental relaxation. These researchers observed signicant reductions
in the concentration of plasma cortisol – the hormone related to stress
- in meditative slow pace music hearing.
Regarding to the use of sedative music (slow), excitatory (quick),
classical music or music preference of listeners, categorical statements
about their suitability for stretching activity still cannot be made due
to the few studies in this area or the contradictory results already sub-
mitted. In the Iwanaga & Moroki study13, listening to classical exciting
music brought feelings of vigor and tension to listeners while sedative
classical music brought relief from tension. However, the authors also
found that musical preference did not aect physiological responses
as heartbeat, breathing and blood pressure, caused by hearing both
songs. Thus, these authors concluded that the dominant factor on the
emotional response was the type of music rather than musical prefe-
rence. However, the classical style is the least heard by young people,
being less present in the daily lives of these individuals23.
In this sense, it was reported that the styles of music listened by
more young people of both sexes aged 18 to 30 were the Rock (93%),
Pop (66%) and the New Wave (57%), which are styles described as pre-
ferred for the practice of aerobics24. Thus, there are dierences in the
eects of the listening session according to the type and characteristics
of music applied. The New Age music used in present study is similar to
classical music; it is derived from the union with Folk, characterized by
spatial sounds, sharp melodies and soft harmonies. The New Age style
evidently diers from songs with faster tempo and stronger rhythms
such as Rock or Techno-music. Listening to Techno-music, for example,
may cause increase in heart rate and blood pressure, as well as, in adre-
nocorticotropic hormone (ACTH) and cortisol levels. Therefore this type
of music is not suitable for the reduction of stress25. Furthermore, softer
songs may promote therapeutic implications on stress treatment26.
Regarding the physical and psychological symptoms analyzed
separately, it is considered that relaxation techniques may be more
eective for certain symptoms of stress27. The Yoga, a somatic relaxation
technic, focuses directly on the body and is considered most eective
in the treatment of physical stress symptoms (eg muscle tension ,
tachycardia, loss of energy and physical fatigue) while the cognitive
techniques are more eective in changing mental processes that result
in cognitive symptoms such as anxiety, worry and insomnia27. However,
the results of the present study show that a “physical” intervention may
also decrease psychological symptoms of stress.
Alter Jr28 reports through physiological mechanisms, why and
how the stretching exercise can be used to facilitate the relaxation.
Such mechanisms involve the adjustment of components such as the
Golgi tendon organs and muscle stretching receptors (muscle spindle)
which promotes reduction of muscle tension and increase in relaxation.
Additionally, proper breathing also assists in reducing tension28.
Conclusion
Based on the results obtained in this study we can conclude that 30
minutes of stretching, accompanied or not by New Age music, signi-
cantly reduced the stress symptoms (both physical and psychological)
in pre-college students. Although it cannot be statistically armed
that New Age music style reduces stress, it can be armed that music
listening during stretching exercise did not negatively interfere on
exercise ecacy for stress symptoms reduction. Future studies should
be conducted using another musical style to verify the inuence on
stress reduction.
The stretching, static and active, can be prescribed for young
people during the period of evaluation tests as a strategy to decrease
stress symptoms and can then be adopted as a coping strategy for this
type of population.
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María Perales, por el trabajo titulado "Fetal and maternal heart rate responses to exercise
in pregnant women. A randomized Control Trial", con coautoría de Silvia Mateos, Marina
Vargas, Isabel Sanz, Alejandro Lucia y Ruben Barakat.
Oriol Abellán-Aynés, por el trabajo titulado “Anthropometric prole, physical tness
and dierences between performance level of Parkour practitioners”, con coautoría de
Fernando Alacid.
Eliane Aparecida de Castro, por el trabajo titulado “Peak oxygen uptake prediction
in overweight and obese adults" con coautoría de Rocio Cupeiro, Pedro J. Benito, Javier
Calderón, Isabel R. Fernández y Ana B. Peinado.
PREMIOS FEMEDE A LA INVESTIGACION 2015
Los trabajos que han logrado los premios FEMEDE a la investigación en el año 2015,
consistentes en la publicación en la revista Archivos de Medicina del Deporte, junto
con una dotación de 600 euros y el certicado acreditativo son los que se relacionan
a continuación con sus correspondientes autores:
