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BMJ Open Sport Exerc Med. 2018 Aug 21;4(1):e000393. doi: 10.1136/bmjsem-2018-000393. eCollection 2018.

Exercise training and physiological responses to acute stress: study protocol and methodological considerations of a randomised controlled trial.

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The Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.
The Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
The Department of Neuroscience and Physiology, Sahlgrenska Academy and Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.



This paper describes the protocol and methodological prerequisites for a randomised controlled exercise intervention. Selected baseline data from the study are also presented, demonstrating some methodological challenges related to exercise intervention trials. The aim of the trial was to study the effects of exercise training on physiological responses to acute psychosocial stress in untrained individuals.


Individuals with a low level of physical activity were invited to participate in an exercise intervention lasting for 6 months. A total of 119 participants were included and went through a peak oxygen uptake test and a psychosocial stress test at baseline. Adrenocorticotropic hormone (ACTH) and cortisol were measured in connection to the stress test to identify the physiological response.


Almost 90% of the participants reported themselves as untrained, but results from the objectively measured oxygen uptake did not seem to correspond to the reported sedentary lifestyle. The primary outcome measures at baseline varied between individuals. The mean change from pre-test to peak value was 214% for ACTH and 94% for cortisol. Of these, 13 individuals did not respond in ACTH and/or and cortisol.


Supposedly untrained individuals seeking participation in an exercise intervention might not be as untrained as they report, a methodological consideration of importance when evaluating the effects of training. Another important consideration is related to the primary outcome measure, which should be measurable and possible to affect. Absence of reaction at baseline means that changes can only be detected as an increased reaction.


longitudinal study; physical activity; psychosocial stress

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