Drugs and Cell Therapies in Haematology (ISSN: 2281-4876)

Volume 10 Issue 2 (2021)

Differences in Oxygen Saturation before and after Physical Activity in

Exercise Trained Men and Untrained

Huldani1, Asnawati1, Dona Marisa1, Wafa Ahdiya2, Muhammad Hasan Ridhoni2, Annisa Putri
Febriyanti2, Raida Namira2, Rizky Nabila Febriani2

1
Department of Physiology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin,
South Kalimantan, Indonesia
2
Student of the Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, South
Kalimantan, Indonesia
Email: huldani@gmail.com

ABSTRACT
Oxygen saturation is the amount of oxygen transport capacity in the blood expressed in percent
with normal values ranging from 95-100%. The need for oxygen will increase during physical
exercise, so that ventilation and blood flow will increase which causes more oxygen to diffuses into
the pulmonary capillaries and binds to hemoglobin. Writing this literature review is to analyze the
difference in oxygen saturation before and after physical activity in men who exercise and don’t. The
reference data in this article study was obtained by searching using PubMed and Google Scholar
published in 2012 to 2021. After the search and article selection process, 8 articles were included in
this literature review. A total of 3 articles showed that there was an increase in oxygen saturation
after physical activity in both people who did sports and those who did not. Meanwhile, the other 5
articles showed that there was a decrease in oxygen saturation after physical activity in both people
who exercised and those who did not. It can be said that oxygen saturation after doing physical
activity, both people and not will experience a decrease. The decrease was greater in people who did
no more than people who exercised.

Keywords: Oxygen saturation, physical exercise, exercise trained men

1. INTRODUCTION
Physical exercise can be defined as an activity carried out to improve or maintain body fitness
and can provide many benefits so that it makes the body less susceptible to various diseases and
health problems. Physical exercise can be obtained based on chronic physical exercise in athletes
who are programmed, regular and competitive) or not acute physical exercise in programmed
people). Based on the process of energy formation can also be divided into two, namely aerobic and
anaerobic physical exercise. The harder physical exercise you do, the more your heart will work.
Muscle needs will increase from normal when doing physical exercise so that the body will
maximize the cardiorespiratory system to supply the muscle needs for oxygen.1-4
A person's cardiorespiratory resistance can increase with certain exercises, therefore people
who exercise will have a better cardiorespiratory system or lung diffusion capacity than people who
do not. A person's ability will be higher if a person's physical ability is also high which makes a

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person more able to cope with the given workload.4 Athletes who have good anaerobic exercise
abilities will be able to do exercises with maximum intensity in a short time.1
Physical exercise will make several changes in the body, one of which is oxygen in the blood.
Oxygen is much needed when a person does physical exercise as an energy requirement. Assessment
of oxygen levels in the blood is seen from oxygen saturation as measured by oximetry which is a
device for measuring oxygen levels in the blood at the tips of the fingers and toes. If the oxygen level
in the blood is low and exceeds the normal limit, it will be dangerous for the body because it can
cause fainting and even death.5,6
Oxygen saturation is the level of oxygen in the blood expressed in percent. In the blood state
most of the oxygen is transported with respect to hemoglobin. There are several factors that affect
oxygen saturation, including the amount of oxygen entering the lungs (ventilation), the rate of
diffusion, and the capacity of hemoglobin to carry oxygen. oxygen will increase in line with
increasing the work of doing physical exercise, so that blood flow will increase, and a lot of oxygen
that diffuses into the capillaries can be connected with hemoglobin, so that it is assessed whether the
oxygen saturation will increase or not.1,2
In this literature review, the author will conduct an interest in the related literature, to see
whether an athlete and non-athlete will actually experience an increase/decrease in oxygen saturation
values after doing activities.

2. REVIEW METHOD
2.1 Design of the Study
The research method used is the literature method by analyzing research that has been carried
out on a topic related to differences in oxygen saturation before and after physical activity in men
who are trained in sports and untrained.

2.2 Literature Search Strategy

The criteria for the articles used are articles in English and Indonesian which were published in
2012-2021. The reference data in this article review was obtained by searching using PubMed and
Google Scholar based on predetermined keywords. The keywords used include, “acute physical
exercise”, “basketball”, “SpO2”, “futsal”, ”the effect of aerobic”, “sport athletes”, “training
program”, “oxygen saturation”, “exercise”, “men”, “capillary blood volume”, “sprint running”,
“hypoxia affects”, “oxygenation”, “running” with a search strategy using the phrases “…” and …;…
as well as Boolean logical operators, namely OR and AND to obtain more accurate information.

2.3 Analysis
The initial search for articles by looking for articles that contain independent variables, namely
physical activity, the dependent variable of oxygen saturation before and after physical activity and
the research subjects in the article are men who are trained in sports (athletes) and not trained in
sports. Articles that meet the inclusion criteria will be used as a study in writing a literature review.
The inclusion criteria in this literature review are research articles that discuss differences in oxygen
saturation before and after physical activity in men who are trained in sports and untrained, the
search for articles is limited from 2012 to 2021 which can be accessed free of charge full text in pdf
format. Meanwhile, the exclusion criteria used were library sources that were not related to topics

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and publications before 2012 and the preferred method was cohort study or field experimentation.
Articles that met the inclusion criteria were then analyzed descriptively by describing and comparing
research results related to differences in oxygen saturation before and after physical activity in men
who were trained in sports and untrained.
The initial search results for articles in the electronic journal database found 50 articles, with
details: PubMed with 10 articles and Google Scholar with 40 articles. After implementing the
selection process in the form of checking titles and abstracts as well as inclusion and exclusion
criteria, the total remaining articles included in this literature review were 8 articles (Figure 1).

Figure 1 Literature Tracing Flowchart

3. RESULTS AND DISCUSSION

The essence of the literature used is the name of the researcher, research title, year of
publication, method, number of samples from the intervention group and control group, results and
conclusions of the study. The digest will be entered into a table so that the extraction results are
easier to read, as shown in the following table (Table 1).

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Table 1 Differences In Oxygen Saturation Before And After Physical Activity In Exercise
Trained Men And Untrained

Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

1. Compariso Mana 36 Field - The average value - There is no

n of do researc experi of oxygen significant
oxygen h ment saturation in male difference in
saturation subjects with subjects before oxygen
before and (10 pre- running was saturation
after men post 98.10% and after before and
performin and 26 one running 98,20% after
g acute women group - The average value performing
physical aged test of oxygen acute
exercise 16-20 design saturation in physical
on years) female subjects exercise on
students of before running is students of
the 98.31% and after the Faculty of
Faculty of running 98,65% Medicine,
Medicine, - The average value Sam
Unsrat of oxygen Ratulangi
Batch saturation in all University
2019, subjects before
(Rompas running was
SE, et al.; 98.25% and after
2020)1 running 98.53%
with p value=
0.111 (p> 0.05)
which showed that
there was no
significant
difference between
the pre-test and
post-test oxygen
saturation values.
- The distribution of
oximeter values
measured in 36

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Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

subjects showed a
decrease in oxygen
saturation in 9
subjects, an
increase in oxygen
saturation in 16
subjects, and a
steady oxygen
saturation in 11
subjects.
2. The effect Gazia 10 male Cross- - The average value - Short-term
of short- ntep, soccer sectio of the pretest SpO2 exercise
term Turke players nal in the soccer player lowers
exercise y and 8 group was oxygen
on oxygen healthy 97.20±1.26 while saturation but
saturation boys the average value regular
in soccer of the posttest was exercise does
players 95.40±1.26 which not affect
(Daglioglu had a significant changes in
O, et al.; decrease with p oxygen
2013)7 value = 0.016 saturation in
(p<0, 05) short-term
- The mean value of exercise.
pretest SpO2 in the
group that rarely
exercised was
97.38 ± 1.30 while
the mean value of
posttest was 96.50
± 1.07 which did
not have a
significant
decrease with p
value = 0.064 (p >
0 ,05)
- When the two
groups were

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Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

compared, there
was no significant
result on SpO2
because it had a p
value of 0.249 (p>
0.05).
3. Are there Canad 16 Cohor - At rest the average - There was a
sex a women t SpO2 value for decrease in
difference (mean study men is 98.9±1.1 the SpO2
s in the age but after exercise it value of men
capillary 26±6.4) becomes 97.1±1.9 after doing
blood and 16 acute
volume men physical
and (mean exercise.
diffusing age
capacity 22±2.7)
response were
to physica
exercise? lly
(Bouwsem active
a MM, et
al.; 2017)8
4. The effect FK 32 Field - The average value - There is a
of acute Unsra student experi of oxygen significant
physical t s of FK ment saturation in men increase in
exercise Camp Unsrat with before physical oxygen
on oxygen us, basketb pre- activity is 97.42% saturation
saturation Malal all post while the average value with p
in ayang players one oxygen saturation value = 0.041
basketball (26 group after physical after doing
players at males test activity in men is acute
the and 6 design 97.85% physical
Faculty of females - The average value exercise.
Medicine, ). of oxygen
Unsrat saturation in
(Simanjun women before
tak RH, et physical activity is

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Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

al.; 2016)6 97.50% while the

average oxygen
saturation after
physical activity in
men is 98.17%
- The average value
of oxygen
saturation in all
subjects before
physical activity
was 97.44% and
after running
97.91% with p
value = 0.041 (p <
0.05)
5. The effect Surab 20 male Field - The average value - The use of
of wearing aya futsal experi of the pretest SpO2 masks during
a mask players ment in group B (not light exercise
while aged with wearing a mask) does not
exercising 16-20 pre- was 97.6% while affect oxygen
on oxygen years post the average value saturation
saturation one of the posttest was levels in the
in the group 97.8% blood.
blood test - In the results of the
(Salviano design pretest group B p
KC, value = 0.177, it
Rochmani can be said that the
a A; data is normally
2021)9 distributed and the
posttest group B
has a sig value. is
0.025, it can be
said that the data is
not normally
distributed.
6. A Austr 10 Cohor - Oxygen saturation - This study
clustered alia males t before RSR444 revealed a

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Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

repeated- who are study and after warm-up decrease in

sprint amateur was 97.2±1.5%, oxygen
running athletes after 8th sprint was saturation in
protocol of 93.8±3.6 %, and male athletes
for team- sports after 16th sprint after physical
sport teams was 94.5±2.5%. activity
athletes with an
per average
formed in age of
normobari 22.6±4.
c hypoxia 7 years.
(Morrison
J, et al.;
2015)10

7. Sex Canad 21 men Cohor - Oxygen saturation - In the results

difference a and 19 t in men before of this study,
s in women study physical activity is the oxygen
respiratory aged 97±2% and after saturation
muscle 19-37 physical activity, before
activation years namely the activity was
patterns who exercise test higher than
during had a cycling as hard as after physical
high- habit possible with a activity in
intensity were rhythm of 60 men, which
exercise in include rotations per means that
healthy d in the minute, oxygen the oxygen
humans active saturation in men is saturation
(Mitchell categor 95±3% value
RA, et al.; y. decreased
11
2018) after physical
activity.

8. Hypoxia Germ 9 male Cohor - In this study, it was - This study

afects an runners t found that there states a
tissue particip study was a decrease in decrease in
oxygenati ating in oxygen saturation male runner

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Research
N
Title, Particip Metho
o Place Result Conclusions
(Authors; ants ds
.
year)

on the under normoxia, athletes after

diferently triathon during the resting physical
in the (mean period (99.4±0.5) activity.
thigh and age = to the time when
calf 24±3 the VO2 max value
muscles years) reached its peak
during value (1.3±2.4).
increment
al running
(Osawa T,
et al.;
2017)12

In the study of Rompas et al in 2020 with untrained subjects, it showed an increase in the
average value of oxygen saturation in male subjects after physical activity (100 meter sprint) by
0.1% as well as in female subjects by 0.34%. The mean value of oxygen saturation of all subjects
increased by 0.28% after physical activity but this study experienced an insignificant increase. The
things that may cause the meaning of this study are related to the type of physical exercise
performed, the frequency and duration of the exercise carried out.1
The results of research by Simanjuntak et al in 2016 with basketball trained subjects showed an
increase in the average value of oxygen saturation in male subjects after physical activity (basketball
exercise for 20 minutes) by 0.43% as well as in female subjects by 0.67%. The mean value of
oxygen saturation of all subjects experienced a significant increase of 0.73% after physical activity.
People who are trained in physical activity can improve cardiovascular ability, vital lung capacity
and increase oxygen uptake by the lungs so that the oxygen used by the body will be quickly
replaced.6 There is also a study by Salviano and Rochmania in 2021 on male futsal trained subjects,
not showing a significant increase in oxygen saturation. significant in group B (not wearing a mask)
after physical activity (futsal for 27 minutes) with a magnitude of 0.2%.9
In the study above, the types of sports that experienced an increase in oxygen in people who
were trained in sports occurred in basketball and futsal players. The highest increase in oxygen was
in Simanjuntak's research with basketball athletes as research subjects. The possibility that causes the
increase is because after 4 minutes of physical exercise, there will be an increase in oxygen uptake
by the lungs by 15 times than normal and decreases little by little until 40 minutes after physical
exercise. And there will be an increase in blood flow up to 25 times during exercise. More oxygen
will diffuse into the pulmonary capillaries and bind to hemoglobin when ventilation and blood flow
increase, so that the body can maintain oxygen levels in the blood so as not to decrease during
physical exercise and the oxygen saturation value after physical exercise will remain or increase

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which can help the body for a longer and optimal physical exercise because if the oxygen supply to
the muscles is sufficient, the energy needs will be more easily met. 2,6,13
In several other studies, there are also those that show a decrease in oxygen saturation after
physical activity in male subjects trained in sports and untrained. Like Bouwsema et al's study of
people who were not trained in sports in 2018 the average SpO2 value of men decreased by about
1.7% after exercise (cycle ergometer). physical activity (sprints).10 Likewise in 2 other studies,
namely Mitchell et al. in 2018 experienced a decrease in oxygen saturation of about 2% after
physical activity (cycling as hard as possible) and Osawa et al. in 2017 experienced a decrease in
oxygen saturation of about 8.1% after physical activity (running on a treadmill).11,12
Based on the type of exercise in trained people, decreased oxygen is common in soccer players
and runners. The decrease in oxygen that occurred in the above studies may be due to the increased
oxygen demand during physical activity related to the Hb-O2 dissociation curve. The definition of
the Hb-O2 dissociation curve is the percentage of Hb saturation as a function of PO2 in graphical
form. During physical activity, CO2 will increase its production so that lactic acid builds up and
blood pH increases which makes all curves shift to the right, meaning that hemoglobin oxygen
saturation is lower even though the partial oxygen pressure is the same during exercise.14,15
When the affinity of Hb with O2 decreases, the curve shifts to the right, there are several things
that can cause the curve to shift to the right which will decrease the percentage of Hb saturation,
including: (1) an increase in body temperature during physical activity which will decrease the
affinity of Hb for O2 and help transport O2 into body tissues with high demand for O2, (2) an increase
in the concentration of 2,3-DPG through its binding to the chain of deoxyhemoglobin and a decrease
in the affinity of Hb for O2, (3) a decrease in pH or an increase in PCO2 will decrease the affinity of
Hb for O2 and carries the release of O2 loads into the tissues (Bohr effect), for example during
physical activity, body tissues produce more CO2 and a decrease in tissue pH occurs through the
Bohr effect and stimulates O2 transport to muscles that perform physical activity.15
The increase/decrease in oxygen saturation that occurred in the studies above, in addition to
being related to the Hb-O2 dissociation curve, is also associated with a person's cardiorespiratory
endurance. The ability of the heart, lungs, blood vessels and large muscle groups to deliver adequate
amounts of oxygen to cells to perform vigorous exercises over long periods of time is the definition
of cardiorespiratory endurance. There are several factors that affect a person's cardiorespiratory
endurance, namely sub-maximal load, circulatory system, intensity, frequency, duration of exercise,
heredity, age and gender.16
The ability to expend a fairly large amount of energy over a long period of time is related to the
supply of oxygen throughout the body, so that when doing physical activity oxygen needs are still
met. Therefore, cardiorespiratory endurance is the most important component in a person's physical
fitness. Someone who has a good level of cardiorespiratory endurance will be more efficient in the
use of oxygen so that they can carry out daily activities without experiencing fatigue.16
Increased oxygen demand by working muscles will occur during intense physical activity. In a
properly trained person, oxygen consumption and total pulmonary ventilation increase about 20
times during maximal intensity exercise. Arterial and venous oxygen will increase because more
blood oxygen is released to working muscles, so venous blood oxygen is reduced during intense
physical activity, which will cause oxygen delivery to tissues to increase by up to three times than

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normal conditions. An increase in the arteriovenous oxygen difference occurs together with an
increase in cardiac output and air exchange in response to strenuous exercise.16
Oxygen saturation is the amount of oxygen transport capacity in the blood expressed in
percent. Normal oxygen saturation ranges from 95-100%. A small amount of oxygen in dissolved
form is carried in the blood which is substantially bound to hemoglobin. The need for oxygen will
increase in line with the increase in work intensity when doing physical exercise, so that ventilation
and blood flow will increase which causes more oxygen to diffuse into the pulmonary capillaries and
bind to hemoglobin, so it can be assessed whether oxygen saturation will increase or not.1,2,14,17
A systematic process that is carried out repeatedly, progressively, and has the aim of improving
physical abilities and maintaining physical fitness to avoid various diseases is the definition of
physical exercise. Cardiorespiratory endurance can increase with certain exercises, for example,
sports athletes are better than untrained people.4 In Damayanti's 2016 study, the average value of
oxygen saturation in athletes was higher than the value of oxygen saturation in non-athletes. This
study also states that there is a significant relationship with the frequency of exercise with oxygen
saturation (p=0.000).18 The greater a person's physical ability, the higher the person's productivity.
According to WHO, people who exercise inadequately will increase all-cause mortality by 20%-30%
compared to people who exercise at least 150 minutes of moderate intensity per week.4
O2 levels in the blood is one of the causes of changes in the body due to physical exercise.
Normally in the blood there is a reserve of O2. The body requires large amounts of O2 to meet its
energy needs during physical exercise. Oxygen will be taken up by the blood through the lungs and
binds to Hb. If the level of O2 in the blood decreases past normal limits, it can cause fainting and
even death.1,6
Aerobic exercise is one example of physical activity that can stimulate the heart to increase the
amount of oxygen bound to hemoglobin and passed on to muscles and working cells to be used as
ATP (adenosine triphosphate). Exercise in addition to increasing oxygen uptake also increases the
capacity of the blood to carry oxygen so that the pulse rate is lower at rest and during activities.19-23
Aerobic physical exercise is an exercise that requires the help of oxygen to produce body
energy and is carried out repeatedly, rhythmically, by involving large muscle groups in aerobic
physical activity that uses aerobic metabolism to release energy in the form of ATP from
carbohydrates, amino acids, and acids. fat. Some examples of aerobic exercise include cycling,
dancing, jogging, swimming and running.1,24-7
Aerobic physical exercise is very dependent on the availability of oxygen to help the process of
burning energy sources. 1,28 There are many benefits for the body with physical exercise, someone
who is diligent in physical exercise can do a muscle work more efficiently than people who rarely do
physical exercise. The increase in vital lung capacity and oxygen uptake by the lungs and oxygen
utilized by the body will be quickly replaced by regular physical exercise, so the oxygen saturation
value will increase or remain after completing physical activity because if the oxygen supply to the
muscles is sufficient, energy needs will be more easily met.6
There is also a study from Pamungkas and Nidomuddin in 2019 on soccer athletes at Unibraw
Malang which stated that even though they were in a tired condition, they could still focus on their
game well because oxygen in their blood remained normal, which means if someone does a good
intensity and exercise program. then diagnostically his physical condition will get better too.3

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The heart rate will increase when the intensity of the exercise is increased. If the heart rate
starts to be constant without increasing when the intensity of exercise is increased, it means that the
maximum volume of oxygen is said to have reached its maximum.29,30 Everyone has different
oxygen consumption and can be increased with appropriate exercise. People who have a good
maximum oxygen volume value will use oxygen more optimally and cause better cardiorespiratory
endurance and affect a person's physical fitness.31 By implementing systematic and programmed
exercise, the maximum volume of oxygen can be increased. This measurement of the maximum
amount of oxygen determines fitness levels by calculating how efficiently cells use oxygen to
produce energy. In people who are trained or untrained after physical activity, generally will
experience a decrease in oxygen saturation according to the Hb-O2 dissociation curve, but in people
who are not trained in sports will experience a greater decrease than people who are not trained in
sports.32,33

4. CONCLUSIONS
The results of a review of 8 literatures related to differences in oxygen saturation before and
after physical activity, both in people who are trained in sports and in people who are not trained in
sports. Of the 8 articles, there are 4 articles that show that there is an increase in oxygen saturation
after physical activity in both people who are trained in sports and those who are not. Meanwhile, the
other 4 articles showed that there was a decrease in oxygen saturation after physical activity in both
people who were trained in sports and those who were not. It can be concluded that oxygen
saturation after doing physical activity in both trained and untrained people will decrease. The
decline was greater in the untrained than in the exercise-trained.

Recommendations
Cardiorespiratory endurance can be increased with certain exercises, for example, sports
athletes do better than untrained people. In this literature review, it can be seen that people who are
trained will have better cardiorespiratory resistance than people who are not trained, therefore we can
start getting used to exercising regularly to maintain body fitness.

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