Effects of eight weeks of functional training with blood flow restriction on biochemical, cognitive, and functional outcomes in postmenopausal women: protocol for a single-blind randomized controlled trial

Introduction Aging in women is accompanied by impaired muscle and cognitive function, reduced anabolic activity, and chronic low-grade inflammation. Blood flow restriction (BFR) may enhance adaptations to low-load exercise, but its effects when combined with functional training in postmenopausal women are unclear. This trial will examine the effects of eight weeks of functional training with BFR on biochemical, cognitive, and functional outcomes in postmenopausal women. Methods This protocol describes a single-blind, assessor-masked, randomized controlled trial that will recruit 45 eligible postmenopausal women, defined as having experienced no menstrual bleeding for at least 24 consecutive months before screening, without another identifiable physiological or pathological cause. After health screening and physician-confirmed examination, participants will be randomly assigned (1:1:1) to functional training with BFR (FTBFR; n = 15), functional training alone (FT; n = 15), or non-exercise control (CON; n = 15) using web-based randomization. Exercise groups will complete supervised sessions three times weekly for eight weeks. Primary outcomes are plasma/serum concentrations of growth hormone, insulin-like growth factor-binding protein-3, interleukin-6, C-reactive protein, vascular endothelial growth factor, testosterone, and cortisol, measured by ELISA; the testosterone-to-cortisol ratio will also be calculated. Cognitive outcomes include the Mini-Mental State Examination, Montreal Cognitive Assessment, Stroop test, and Corsi block-tapping test. Secondary outcomes are handgrip strength, upper- and lower-body muscle strength, Timed Up and Go five-times-sit-to-stand performance, quality of life (SF-36), and pain. Conclusions This trial will clarify whether adding BFR to functional training provides additional biochemical, cognitive, and functional benefits in Postmenopausal women and may inform safe, low-intensity exercise strategies for healthy aging. Clinical Trial Registration https://en.irct.ir/trial/89951 , IRCT20191123045478N4.