Effects of short-term resistance training plus whole-body neuromuscular electrical stimulation on blood cardiometabolic biomarkers in sedentary middle-aged women: a parallel-group, randomized trial

BACKGROUND: Middle-aged women are disproportionately affected by cardiometabolic deterioration during the menopausal transition. Resistance training (RT) is an established countermeasure, and whole-body neuromuscular electrical stimulation (WB-NMES) may enhance its physiological effects. However, whether short-term RT combined with WB-NMES further improves blood cardiometabolic biomarkers in this population remains unknown. METHODS: ) were allocated to six weeks of RT combined with WB-NMES (RT + WB-NMES; n = 11) or RT alone (RT; n = 12), performing two supervised sessions per week. Primary outcomes were blood biomarkers related to cardiometabolic risk (total cholesterol, LDL-c, HDL-c, VLDL-c, triglycerides, fasting glucose, liver enzymes, and C-reactive protein). Secondary outcomes comprised anthropometric measures, body composition, and physical fitness. RESULTS: No significant Group × Time interaction was identified for any blood biomarker. A significant main effect of Time was observed for LDL-c (P = 0.002) and total cholesterol (P = 0.001), with post-hoc analyses revealing significant within-group reductions exclusively in the RT + WB-NMES group (LDL-c: P = 0.041, ES = - 1.13; total cholesterol: P = 0.026, ES = - 0.91). No significant Group × Time interaction was found for any anthropometric, body composition, or most physical fitness variables. Lumbar traction strength improved significantly within the RT + WB-NMES group (P = 0.029, ES = 0.99) but not in RT alone (P = 0.569, ES = 0.53). CONCLUSIONS: Six weeks of RT combined with WB-NMES accelerated reductions in LDL-c and total cholesterol in sedentary middle-aged women, although statistical superiority over RT alone was not demonstrated. These preliminary findings support the cardiometabolic relevance of short-term RT + WB-NMES, though larger trials are required. TRIAL REGISTRATION: U111113186998 https://ensaiosclinicos.gov.br/rg/RBR6zx5zcz. Registered on 10/09/2025.