Physical fitness influences stress reactions to extreme military training

Background: Physical fitness and physical conditioning have long been valued by the military for their roles in enhancing mission-specific performance and reducing risk of injury in the warfighter. It is not known whether physical fitness plays a causal role in attenuating acute military stress reactions or the evolution of post-traumatic stress disorder. Objective: The objective of this study was to determine whether physical fitness influences the impact of stressful events during military survival training in 31 men. Methods: Participants self-reported their most recent Physical Readiness Test scores and completed a trait anxiety measure before survival training. Participants also completed the Impact of Events Scale (IES) 24 hours after training. Results: Aerobic fitness was inversely associated with the total IES score (p < 0.01, adjusted R-2 = 0.19). When adjusted for trait anxiety, this relationship was substantially attenuated and no longer significant (p = 0.11). Trait anxiety was inversely associated with aerobic fitness (p < 0.05) and positively related to IES (p < 0.001). Conclusions: Physical fitness may buffer stress symptoms secondary to extreme military stress and its effects may be mediated via fitness-related attenuations in trait anxiety.