Klentrou 2002.

Methods	Study design: parallel‐group randomised controlled trial Location, number of centres: Brock University Country: Canada Study period: February to May 2000 Methods of analysis: "to monitor the effectiveness of the exercise programme, both groups were administered a continuous incremental exercise test on an electrically braked cycle ergometer (Ergociser EC‐1600, Cateyer Co. Ltd., Japan) for the determination of maximal aerobic power (VO₂ max) at 3 separate times during the course of the study: T1 – at the onset of the study (before any activity by the exercise group began), T2 – at the mid‐point of training (6 weeks) and T3 – at the conclusion of training (12 weeks). A volume of 1 ml of unstimulated whole mixed saliva was collected from each participant at T1 and T3 using cylinder‐shaped swabs placed in the mouth for 1 minute. Each participant was provided with a Health and Sickness Logbook to record symptoms, as exhibited, daily" "Participants were asked not to take any over‐the‐counter or prescription medication that might mask their symptoms since the daily sickness log was based on symptoms that the participant experienced or felt" Statistical analysis: "all statistical analyses were performed using SPSS (SPSS Inc., Chicago Ill.). Comparison of inter‐group differences was done using an ANOVA. Changes in maximal [IgAs], [Albs] and [IgAs]:[Albs] with training were analysed using a repeated measurements ANOVA. The accepted level of significance was set at P < 0.05. The experimental power was more than 99%. Pearson correlation analysis was used to examine the strength of the relationship which existed between URTI and the salivary variables"
Participants	Recruitment means: not stated Target participants: healthy men and women N screened: 20 healthy men and women N completed: 19 completed: 9 (exercise) and 10 (control) Gender: not stated Age: 25 to 50 years Inclusion criteria: "adult men or women (aged 25 to 50 years) having a sedentary lifestyle, non‐smokers, free of asthma, no recent influenza immunisation, free from URTI at entry to the study and the women not being pregnant or planning on becoming so. Furthermore, the majority of participants were only indirectly exposed to young children and they all resided in the same area" Baseline details: age, VO₂ max, IgA
Interventions	Setting of intervention: Exercise Assessment and Research Centre Description of intervention: "the exercise programme consisted of 3 exercise sessions a week. Each exercise session was 45 minutes long. During the exercise period, the participants performed a 30‐minute aerobic protocol at 75% of heart rate reserve using stationary bicycles, treadmills, stair climbers or combined/cross‐training using more than 1 device. At the end of the aerobic activities, participants spent an additional 15 minutes doing stretching exercises involving the lower body, trunk and arms. More specifically, each participant performed approximately 10 muscle stretches including: quadriceps, calves, gluteal, lower back, triceps, biceps, shoulder, trapezius and pectoralis. During the aerobic protocol, each participant's heart rate was recorded at 3 different points: prior to starting exercise, mid‐point of exercise and completion of exercise (before cool‐down) using a Polar heart rate monitor. All exercise sessions were conducted in a group format in the Exercise Assessment and Research Center to ensure that participants exercised at the prescribed duration and intensity" Delivered by: not stated Follow‐up period: 12 weeks Co‐interventions: none
Outcomes	Influenza symptoms, cold symptoms, total sickness days, VO₂ max, symptom record, IgA concentrations, salivary albumin concentration (Albs) and minimum concentration ratio ([IgAs]:[Albs]) Follow‐up period: 12 weeks
Notes	Study funding: Faculty of Health Sciences, Brock University
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	The authors do not explain how the random sequence was generated.
Allocation concealment (selection bias)	Unclear risk	"After signing the informed consent, participants were randomly assigned to either the control group or the exercise group." Insufficient information provided to permit an assessment.
Blinding of participants and personnel (performance bias) All outcomes	High risk	The participants could not be blinded due to the characteristics of the intervention.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcomes measured by participant self‐report.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	1 participant of 9 in the exercise group was not included, with no reasons given.
Selective reporting (reporting bias)	Low risk	The outcomes prespecified in the methods were reported in the results.
Other bias	Low risk	The study seems to be free of other sources of bias.