Effects of a Warm-up on Immune Response to Exercise

Study Overview
=================
Brief Summary
-----------------
This randomized cross-over study compares two identical cardiorespiratory exercise bouts, differing only in the inclusion or exclusion of a dynamic period of increasing exercise intensity prior to the exercise bout. Planned comparisons include physiological responses and perceived effort during exercise, leukocyte mobilization, and mood between the two exercise sessions.

Detailed Description
-----------------
Physically active adult men and women are asked to complete three study visits to the laboratory. On Visit 1, participants provide informed consent and are screened for study inclusion criteria: being between 18 and 40 years of age, a non-smoker, not pregnant, free of disease impacting exercise performance or immunity, and performing at least one hour per week of vigorous exercise training (any modality) for at least the prior six months. Participants also complete an incremental submaximal exercise test on a stationary bicycle. The results of this test are used to calculate the resistance corresponding to 80% of estimated maximal heart rate. Participants return within 2-14 days for Visits 2 and 3. These visits consist of 30 min of bicycling at this resistance. One visit included a 10 min dynamic warm-up prior to the exercise bout. Participants were stratified by sex and randomized such that half of the men and women completed the exercise trial with warm-up during Visit 2. Heart rate, perceived exertion, and wattage are recorded during each minute of the exercise bouts. Participants donate blood before, immediately after, and 1h after each exercise. Blood is analyzed by flow cytometry to characterize leukocyte subsets. After each exercise session, participants complete surveys assessing mood and affect. Physiological, immunological, and psychological parameters recorded will be compared within participants between the two experimental exercise sessions using appropriate statistical tests. p<0.05 will be accepted as significant.

Official Title
-----------------
The Effects of a Dynamic Warm up on the Immune Response to Exercise in Lower Fit and Higher Fit Adults

Conditions
-----------------
Physiological and Psychological Responses to Exercise

Intervention / Treatment
-----------------
* Behavioral: Exercise


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: identifies as exercising 1-3 hours per week or more than 6 hours per week, on average (last 6 months) meets American College of Sports Medicine criteria for participation in exercise Exclusion Criteria: underlying medical problems that contraindicate supervised high intensity exercise past or present history of autoimmune disease, HIV, hepatitis, stroke, or cardiovascular disease chronic/debilitating arthritis central or peripheral nervous disorders asthma, emphysema, or bronchitis bedridden in the past three months history of blood clotting disorders administration of any medication that might affect physiological response to exercise functional or cognitive impairment that would limit exercise performance or prohibit informed consent having any common-cold or influenza like symptoms (scratchy throat, runny nose, inflamed sinuses, frequent sneezing or coughing) in the last 2 weeks pregnancy tobacco use

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Randomized cross-over study with two conditions. Randomization was stratified by sex
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Warm-up, then no warm-up<br>Participants' visit 2 included 10 minutes of gradually increasing intensity prior to the 30 minute exercise session. Participants' visit 3 consisted of the 30 minute exercise session without a warm-up. | Behavioral: Exercise<br>* 30 minutes of exercise at 80% of maximum predicted heart rate performed on an indoor stationary bicycle. Exercise was preceded by 10 min of gradually increasing cycling intensity in one of two exercise trials<br>* Other names: Cardiorespiratory exercise;|
| Experimental: No warm-up, then warm-up<br>Participants' visit 2 consisted of the 30 minute exercise session without a warm-up. Participants' visit 3 included 10 minutes of gradually increasing intensity prior to the 30 minute exercise session. | Behavioral: Exercise<br>* 30 minutes of exercise at 80% of maximum predicted heart rate performed on an indoor stationary bicycle. Exercise was preceded by 10 min of gradually increasing cycling intensity in one of two exercise trials<br>* Other names: Cardiorespiratory exercise;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate during exercise | Heart rate in beats per minute | Minutes 1-30 of exercise, recordings made each minute | 
| Perceived exertion during exercise | Rating of perceived exertion measured using the Borg 6-20 scale | Minutes 1-30 of exercise, recordings made each minute | 
| Power during exercise | Wattage produced on stationary bicycle | Minutes 1-30 of exercise, recordings made each minute | 
| Monocyte mobilization by exercise | Number of peripheral blood monocytes | Change from resting levels of monocytes after exercise | 
| Natural Killer cell mobilization by exercise | Number of peripheral blood natural killer cells | Change from resting levels of natural killer cells after exercise | 
| CD4 T cell mobilization by exercise | Number of peripheral blood CD4 T cells | Change from resting levels of CD4 T cells after exercise | 
| CD8 T cell mobilization by exercise | Number of peripheral blood CD8 T cells | Change from resting levels of CD8 T cells after exercise | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mood after exercise | Mood dimensions characterized by Profile of Mood Survey | Measured within 10 minute of end of exercise session | 
| Affect after exercise | Affect characterized by Positive and Negative Affect Schedule | Measured within 10 minute of end of exercise session |