An interventional study of Resistance Training and Electrical Muscle Stimulation in Obesity & Overweight, sponsored by Birjand University of Medical Sciences. Not yet recruiting at 1 site in Iran. Open to female participants aged 35 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-26.
Sponsored by Birjand University of Medical Sciences · Not applicable, Interventional, and Basic science
This study aims to compare the effects of eight weeks of resistance training versus electrical muscle stimulation (EMS) on oxidative stress indicators and cellular health index in overweight and obese women aged 35-45 years. Forty-two participants will be randomly assigned to three groups: resistance training, EMS, and control. The resistance training group will perform progressive resistance exercises three times per week for eight weeks. The EMS group will receive electrical muscle stimulation on biceps, abdominal, back, and quadriceps muscles three times per week for eight weeks. The control group will receive no intervention. Oxidative stress markers including superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT), glutathione, protein carbonyl (PC), and total antioxidant capacity (TAC) will be measured from blood samples. Cellular health will be assessed using phase angle (PhA) derived from bioelectrical impedance analysis. Upper and lower body muscular strength and endurance will also be evaluated. All measurements will be taken at baseline and 48 hours after the last training session. The primary outcome is change in phase angle. Secondary outcomes include changes in oxidative stress markers and physical performance.
This is a quasi-experimental, pretest-posttest, parallel-group clinical trial with three arms: resistance training, electrical muscle stimulation (EMS), and control. Forty-two overweight and obese women (BMI 25-35 kg/m², aged 35-45 years) will be randomly assigned to the three groups (n=14 each). Participants must meet the inclusion criteria including no history of cardiovascular disease, no pregnancy or lactation, no use of medications affecting muscle or fat mass, and no recent lower/upper extremity injuries.
Intervention details:
Resistance training group: 8 weeks, 3 sessions/week, 50 minutes each session. Exercises include upper body, back, abdominal, and lower body movements. Training intensity will progress from 60% of 1RM in week 1 to 85% of 1RM in week 8.
EMS group: 8 weeks, 3 sessions/week, 30 minutes each session. EMS will be applied to biceps brachii, abdominals, back, and quadriceps muscles using frequency of 35-70 Hz, pulse duration 100 μs, and pulse period 50 ms. Electrode size: 150 × 240 mm. Intensity will be progressively increased over the 8 weeks.
Control group: No exercise intervention during the study period.
Outcome measurements:
Primary outcome: Phase angle (PhA) measured using bioelectrical impedance analysis (Inbody770).
Secondary outcomes: Serum levels of SOD, GPX, CAT, glutathione, PC, and TAC measured using ELISA kits. Upper body strength (bench press) and lower body strength (squat) measured via 1RM testing. Upper body endurance (push-up test) and lower body endurance (bodyweight squat test) measured in 60-second tests.
Statistical analysis: Data will be analyzed using ANCOVA with pretest scores as covariates. Correlation between phase angle changes and oxidative stress markers will be assessed using Pearson's correlation coefficient. All analyses will be performed using SPSS, with significance set at p \< 0.05.
Body mass index (BMI) between 25 and 35 kg/m²
Similar menstrual cycle pattern
No pregnancy or lactation
No continuous medication affecting fat or muscle mass (based on health and fitness questionnaire)
No history of cruciate ligament injury or other upper/lower extremity injuries in the past 6 months
No history of heart attack or acute cardiovascular disease
No use of medications (glucocorticoids, beta-blockers, alcohol) or antioxidant supplements that could interfere with study results
Exclusion Criteria:
Absence from more than three consecutive training sessions
Failure to comply with the study protocol
Development of any medical condition during the study period that contraindicates continued participation
Eight weeks of progressive resistance training, 3 sessions per week. Each session includes upper body, back, abdominal, and lower body exercises. Training intensity progresses from 60% of 1RM in week 1 to 85% of 1RM in week 8.
Other: Resistance Training
Eight weeks of electrical muscle stimulation training, 3 sessions per week. EMS applied to biceps brachii, abdominals, back, and quadriceps muscles using frequency of 35-70 Hz, pulse duration 100 μs, and pulse period 50 ms. Electrode size: 150 × 240 mm. Intensity progressively increased over 8 weeks.
Device: Electrical Muscle Stimulation
No exercise intervention during the 8-week study period. Participants are asked to maintain their usual lifestyle and physical activity levels.
Other: No Intervention
Progressive resistance training program including upper body (chest press), back (lat pulldown), abdominal (crunch), and lower body (squat) exercises. Performed 3 times per week for 8 weeks. Each session includes warm-up (10 min), main exercises (30 min), and cool-down (10 min). Intensity: 60-85% of 1RM, progressing weekly.
Electrical muscle stimulation applied to biceps brachii, abdominals, back, and quadriceps muscles using a commercial EMS device. Parameters: frequency 35-70 Hz, pulse duration 100 μs, pulse period 50 ms, electrode size 150 × 240 mm. Performed 3 times per week for 8 weeks, 15 minutes per session. Intensity progressively increased based on participant tolerance.
Participants in the control group receive no exercise intervention during the 8-week study period.
Change in Phase Angle (PhA) as a Cellular Health Index
Phase angle (PhA) measured using bioelectrical impedance analysis (Inbody770). PhA is calculated as the ratio of reactance (Xc) to resistance (R) and serves as an indicator of cellular health, membrane integrity, and cell function.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week 8).
Change in Serum Superoxide Dismutase (SOD)
Serum SOD level measured using ELISA kit. SOD is an antioxidant enzyme that catalyzes the dismutation of superoxide radical into oxygen and hydrogen peroxide.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week 8).
Change in Upper Body Strength (Bench Press 1RM)
Maximum strength of the upper body measured using the bench press 1-repetition maximum (1RM) test.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week 8).
Change in Lower Body Strength (Squat 1RM)
Maximum strength of the lower body measured using the squat 1-repetition maximum (1RM) test.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week 8).
Change in Upper Body Muscular Endurance (Push-Up Test)
Upper body muscular endurance assessed using the push-up test. The number of correct push-ups performed within 60 seconds is recorded.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week 8).
Change in Serum Glutathione Peroxidase (GPX)
Serum GPX level measured using ELISA kit. GPX is a selenium-containing enzyme that catalyzes the reduction of hydroperoxides.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week
Change in Serum Catalase (CAT)
Serum CAT level measured using ELISA kit. CAT is an enzyme that catalyzes the decomposition of hydrogen peroxide to water and oxygen.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week
Change in Serum Glutathione (GSH)
Serum glutathione level measured using ELISA kit. GSH is a major intracellular antioxidant that protects cells against oxidative damage.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week
Change in Serum Protein Carbonyl (PC)
Serum PC level measured using ELISA kit. PC is a marker of protein oxidation and oxidative damage to proteins.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week
Change in Serum Total Antioxidant Capacity (TAC)
Serum TAC level measured using ELISA kit. TAC reflects the overall capacity of the antioxidant system to neutralize free radicals.
Time frame: Measured at baseline (before intervention) and 48 hours after the last training session (week
Plan to share: No — There is no plan to share individual participant data (IPD) due to ethical and privacy restrictions, as the data contain sensitive personal and physiological information of the participants. Additionally, informed consent was obtained only for the primary study objectives and does not cover secondary data sharing
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Birjand University of Medical Sciences