Exercise for Mental Health in Medical Students: The UNSW MedEx Project

Arm 1: Supervised high intensity aerobic interval training participants randomized to the aerobic interval group will attend the CSEP labs 2 x per week for 15 minutes for 8 weeks. Participants in this group will complete an aerobic training session on the stationary bike incorporating 5 x 1 minute maximum effort (rate of perceived exertion 15- 18/20) cycling bouts, with one minute active low intensity (RPE 8-9) recovery between each bout. Each session will be preceded by a warm up and followed by a cool down. Sessions will be supervised an Accredited Exercise Physiologist (AEP). Sessions will be one-on-one. Arm 2: Progressive resistance training (PRT) Participants randomised to the PRT group will attend the university training laboratory located on Ground Floor of the Wallace Wurth Building, University of NSW. Participants will exercise 2 times per week for approximately 15 minutes each visit for 8 weeks. Training will be fully supervised by an AEP to maintain proper intensity and progression, as well as to ensure correct technique. All PRT participants will receive weight lifting exercises of 5 major muscle groups using resistance equipment located in the CSEP lab. Exercises chosen include the large muscle groups of the chest, upper back and upper leg and include the cable chest press, standing cable row and leg press. These are symmetrical exercises and functionally relevant to activities of daily living (ADLs). Participants will perform 3 sets of 8 repetitions of each exercise, with controlled concentric and eccentric phases. The initial intensity for this treatment group will be set at 50% of the participant’s peak strength determined at baseline (1 repetition maximum or 1RM). Intensity will then be increased by 10% each session over 4 sessions until 80% 1RM has been reached, as we have done in previous trials of adults. Repetition maximum testing will be repeated at 2-week intervals to ascertain progress and intensity will be adjusted accordingly (usually ˜3% per session) and fine-tuned by a rating of between 15-18 on the BORG Rating of Perceived Exertion Scale. This will ensure maintenance of an intensity of 80% of the subject’s current 1RM on a continuous basis throughout the 8 week training program. Sessions will be one-on-one. Arm 3: Active control Participants who are randomised to the active control will be given the current National Physical Activity guidelines of completing 10,000 steps per day. Steps will be measured by a Jawbone or similar physical activity device and recorded/synced at a twice weekly visit with an AEP located in the Clinical Skills Exercise Physiology (CSEP) Lab. This will ensure equal contact exposure to the supervised intervention groups. Face-to-face contact will be one-on-one.