Weidner 1998.

Methods	Study design: randomised controlled trial Location, number of centres: School of Physical Education at Ball State University Country: USA Study period: 6 exercise sessions in a 10‐day period Methods of analysis: "all participants reported to the laboratory every 12 hours for 10 consecutive days. Beginning on day 2 (the day of the second inoculation), all participants completed a 13‐item symptom severity checklist for each reporting period for virus detection and quantification. Just before HRV 16 inoculation, a pre‐inoculation nasal wash was taken from all participants. This nasopharyngeal sample, designed to detect most subclinical or incubating respiratory viruses, allowed us to eliminate previously infected participants from the experiment. The cultures were examined by microscope approximately every other day; other standard techniques were used for detection and identification of viruses (e.g. hemadsorption for myxo and paramyxoviruses, acid lability for rhinoviruses, etc.). These cell cultures could not detect all possible viruses (e.g. most coronavirus infections and many coxsackie A viruses). Beginning the day after inoculation (day 2), nasal washings were obtained and virus specimens were quantitated for HRV 16. Instruments included cycling on either the Air‐Dyne bicycle (Schwinn Bicycle Co., Chicago, IL) or Cybex MET 100 cycle (Cybex Metabolic Systems, Ronkonkoma, NY); walking or jogging on a treadmill (Trotter, Millis, MA) or at an indoor track; or stair climbing on the Stepmill (Stair Master Sports and Medical Products, Kirkland, WA). All participants performed the same mode for each training session. HR was monitored continuously via Polar HR telemetry units; rating of perceived exertion via the Borg 6‐20 RPE scale was recorded twice per training session" Statistical analysis: "symptom severity scores from the cold symptom checklist were summed. 3 statistical analysis were performed. A 2 group by 9 measure (2 × 9) repeated measures ANOVA procedure was used to compare the symptom questionnaire mean z‐value scores and the mucous weights for days 2 to 10. A participant's values obtained during the a.m. and p.m. testing were averaged to arrive at a participant's value for a day. The statistical power for comparing the differences between the EX and NEX groups over the 9 days (P value < 0.05) was 0.96 for Cohen's medium‐sized effect (Eta = 0.25) and 0.99 for his large effect (Eta = 0.37). Preliminary analyses of the questionnaire and mucous data suggested an alternative to the usual ANOVA procedure was desirable. The alternative procedure employed for these data was the assignment of ranks to the data values, normalising the ranks (obtaining normal distribution z‐values for percentiles of the ranks) and evaluating the data via conventional ANOVA procedures and F‐tests. The other 2 statistical procedures were a 2 by 5 (2 × 5) repeated measures ANOVA for differences between the EX pre‐ and post‐exercise cold symptom scores and a one‐way ANOVA for differences between the quantity of recreational physical activity performed by the EX and NEX groups. The statistical power for the EX group pre post differences (P value < 0.05) was 0.67 for Cohen's medium‐sized effect (Eta = 0.25) and 0.97 for his large effect (Eta = 0.37). The SPSS MANOVA program (SPSS, Inc., Chicago, IL) was used for these analyses"
Participants	Recruitment means: student volunteers solicited from classes Target participants: healthy adults N screened: 50 adult students N randomised: 50 adults randomised N completed: 50 adults completed the study: 34 (intervention group) and 16 (control group) Gender M = 24: intervention 17, control 7 F = 14: intervention 17, control 9 Age: 19 to 29 years old Baseline details: age, gender, physical activity profile, symptom checklist, health history, immune deficiency, medications
Interventions	Setting of intervention: Ball State University, School of Physical Education laboratory Description of intervention: "2 standardised incremental treadmill protocols, 1 for men and 1 for women, were used in this study. Both protocols consisted of 1‐minute stages (1‐MET increments) and began with 5 to 6 minutes of graded walking and then progressed to running speeds. All participants were encouraged to give a maximal effort and were provided with strong verbal prompts throughout the testing sessions. HR and RPE were recorded during the last 10 seconds of each stage. Exercise training. Within 18 hours of the first inoculation, EX participants began the supervised exercise training programme previously described. Participants were scheduled for 1 of 2 possible exercise times, either morning or evening. Participants who were assigned to exercise in the morning were expected to exercise at the same time for the entire 6 days of training; likewise, participants assigned to exercise in the evening did so regularly. Exercise consisted of training at 70% of HR reserve for 40 minutes, with the mode of exercise designed to match each participant's regular form of workout. Choices included cycling on either the Air‐Dyne bicycle (Schwinn Bicycle Co., Chicago, IL) or Cybex MET 100 cycle (Cybex Metabolic Systems, Ronkonkoma, NY); walking or jogging on a treadmill (Trotter, Millis, MA) or at an indoor track; or stair climbing on the Stepmill (StairMaster Sports and Medical Products, Kirkland, WA). All participants performed the same mode for each training session. HR was monitored continuously via Polar HR telemetry units; rating of perceived exertion via the Borg 6‐20 RPE scale was recorded twice per training session" Delivered by: supervised by the researchers Intervention period: 10 days Co‐interventions: rhinovirus‐induced disease
Outcomes	Cold symptom, upper respiratory infection and severity of disease measured by questionnaire and facial tissues Follow‐up period: 10 days
Notes	Study funding: this research was supported by NIH HL 50123
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	No description of how allocation was concealed. "Fifty subjects who tested negative to the HRV 16 antibody were randomly assigned to the exercise (EX) group or the non‐exercise (NEX) group"
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	Low risk	There were no losses to follow‐up.
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.