اثربخشی تمرینات مقاومتی بر شاخص های عملکردی قلبی-عروقی و استرس ادراک شده در افراد سالمند

Abstract
Background: This study aimed to examine the effects of a resistance training program on cardiovascular functional indices and perceived stress in older women.
Method: A quasi-experimental design with a pretest–posttest and control group was employed. The sample consisted of 30 women aged 60 to 75 years who were randomly assigned to either the experimental or control group. The experimental group participated in a 6‑week resistance training program, three sessions per week, at an intensity of 60–70%, while the control group continued their usual daily activities without any exercise intervention. Cardiovascular indices, including systolic blood pressure, diastolic blood pressure, mean arterial pressure, resting heart rate, and rate–pressure product, were measured 48 hours before and after the intervention. Perceived stress was assessed using Cohen’s Perceived Stress Scale. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS 25.
Results: Systolic blood pressure, diastolic blood pressure, mean arterial pressure, resting heart rate, and rate–pressure product decreased significantly in the resistance training group compared with the control group (p ≤ .05). Perceived stress scores also showed a significant reduction in the resistance training group (p ≤ .05).
Conclusion: The findings indicate that moderate‑intensity resistance training can serve as a safe and effective intervention for improving cardiovascular functional indices and reducing perceived stress in older women. These results highlight the important role of resistance training in promoting physical and psychological well‑being in older adults, as well as its potential application in preventive and cardiac rehabilitation programs.
EXTENDED ABSTRACT
 Introduction
Aging is accompanied by extensive physiological, psychological, and functional changes that may increase the risk of chronic conditions, including hypertension and elevated perceived stress. Cardiovascular functional indices such as systolic and diastolic blood pressure, heart rate, mean arterial pressure, and rate–pressure product are recognized as major determinants of cardiovascular health in older adults. Moreover, perceived stress is directly associated with exacerbated physiological responses and increased cardiac workload. Given the mobility limitations and adverse effects associated with long-term pharmacological treatment in later life, non-pharmacological approaches such as resistance training using TheraBand elastic bands may serve as safe, cost-effective, and feasible interventions for improving cardiovascular indices and reducing perceived stress. Although previous studies have supported the beneficial effects of this type of exercise, limited research has simultaneously examined its impact on both hemodynamic indices and perceived stress among Iranian older women. Therefore, the present study aimed to determine the effects of a six-week TheraBand resistance training program on cardiovascular functional indices and perceived stress in older women.
Method
The present study employed a quasi-experimental pretest–posttest design with a control group. The study population consisted of women aged 60–75 years residing in Eyvan City during the first half of 2025. Thirty eligible volunteers were selected through convenience sampling and randomly assigned to either the experimental group (n = 15) or the control group (n = 15). Inclusion criteria were: age between 60 and 75 years, obtaining a score above the mean on the Perceived Stress Scale, absence of medications affecting cardiovascular function, and physical capability to perform the exercise protocol. Exclusion criteria included cardiovascular disease, diabetes mellitus, renal, respiratory, neurological, psychological, or musculoskeletal disorders, as well as participation in regular physical activity.
Research instruments consisting of Cohen’s Perceived Stress Scale (1983), consisting of 14 items with a reported reliability coefficient of 0.84 in Iranian populations, and an Omron digital sphygmomanometer for measuring systolic blood pressure, diastolic blood pressure, and heart rate. Mean arterial pressure was calculated using the standard formula. The experimental group participated in a six-week TheraBand resistance training program conducted three times per week. The training protocol consisted of six exercises, including chest press, rowing, military press, knee flexion, knee extension, and calf raises, performed in three sets of 10 repetitions at an intensity of 60–70% of one-repetition maximum (1RM). The control group received no intervention during the study period. Prior to statistical analyses, assumptions of normality and homogeneity of variances were assessed using the Shapiro–Wilk and Levene’s tests, respectively. Data were analyzed using ANCOVA in SPSS version 25, with the significance level set at p < .05.
Results
Preliminary analyses confirmed the assumptions of normality and homogeneity of variances, supporting the use of parametric statistical procedures. The results of ANCOVA controlling for pretest effects are presented in Table 1.
The results demonstrated that, after controlling for pretest effects, significant differences were observed between the resistance training and control groups across all study variables, including systolic blood pressure, diastolic blood pressure, mean arterial pressure, resting heart rate, perceived stress, and rate–pressure product (p ≤ .05). Effect size values (η²) ranged from .18 to .20, indicating moderate to large intervention effects. Overall, resistance training exerted significant beneficial effects on cardiovascular functional indices and perceived stress among older women.
Conclusion
The findings of the present study indicated that six weeks of TheraBand resistance training resulted in significant reductions in systolic and diastolic blood pressure, mean arterial pressure, resting heart rate, rate–pressure product, and perceived stress among older women. These results suggest that TheraBand resistance training, as a safe and low-cost non-pharmacological intervention, may effectively improve cardiovascular functional indices and reduce psychological stress in this population. From a physiological perspective, the reductions in blood pressure and heart rate following resistance training may be attributed to improved endothelial function and enhanced nitric oxide release, leading to decreased peripheral vascular resistance. Furthermore, increased parasympathetic tone and reduced sympathetic activity resulting from autonomic adaptations may contribute to improved regulation of heart rate and blood pressure. The simultaneous reduction in systolic blood pressure and heart rate directly explains the decrease in rate–pressure product as an indicator of cardiac workload. These adaptations suggest that resistance training may exert cardioprotective effects by reducing myocardial oxygen demand. Regarding the reduction in perceived stress, resistance training may modulate psychological stress responses through increased levels of anti-inflammatory cytokines such as interleukin-10, improved sleep quality, and enhanced social interaction. Group-based exercise may also foster self-efficacy and social support, thereby reducing feelings of loneliness and improving mood among older adults. Collectively, these findings underscore the importance of resistance exercise as a safe, accessible, and effective strategy for promoting both physical and psychological well-being in later life.
Ethical Consideration
Ethical Code
This article was derived from a Master’s thesis in Exercise Physiology at the University of Ilam and was approved by the Ethics Committee of the University of Ilam (IR.ILAM.REC.1403.018).
Funding
 This study received no external funding.
Authors’ Contributions
F.E.: Software, Validation, Formal analyses, Data Curation; M.N.: Conceptualization, Methodology, Writing - Review & Editing, Project administration, Supervision; H.Sh.: Conceptualization, Writing - Review & Editing.
Conflict of Interest
The authors had no conflicts of interest.
Acknowledgments
The authors sincerely appreciate all participants for their valuable cooperation in this study.
References
Abbasi, s. (2024). The effectiveness of aerobic and resistance exercises on improving balance and walking in the elderly with memory impairment. Journal of Motor and Behavioral Sciences, 7(2), e197203. https://doi.org/10.22034/jmbs.2024.197203. [Persian]
Afshari, A. (2024). The Relationship Between Indestructible Healthy Lifestyle Patterns, Levels of Sensation-Seeking and Perceived Stress with Cognitive Performance in Older Adults with Hypertension. Aging Psychology, 10(4), 429-448. doi:10.22126/jap.2025.11352.1813. [Persian]
Bartholomew, J. B., Stults-Kolehmainen, M. A., Elrod, C. C., & Todd, J. S. (2008). Strength gains after resistance training: the effect of stressful, negative life events. The Journal of Strength & Conditioning Research, 22(4), 1215–1221. DOI: 10.1519/JSC.0b013e318173d0bf.
Boeno, F. P., Ramis, T. R., Munhoz, S. V., Farinha, J. B., Moritz, C. E., Leal-Menezes, R., Ribeiro, J. L., Christou, D. D., & Reischak-Oliveira, A. (2020). Effect of aerobic and resistance exercise training on inflammation, endothelial function and ambulatory blood pressure in middle-aged hypertensive patients. Journal of Hypertension, 38(12), 2501–2509. DOI: 10.1097/HJH.0000000000002581.
Carcelén-Fraile, M. d. C., Déniz-Ramírez, N. d. P., Sabina-Campos, J., Aibar-Almazán, A., Rivas-Campo, Y., González-Martín, A. M., & Castellote-Caballero, Y. (2024). Exercise and nutrition in the mental health of the older adult population: a randomized controlled clinical trial. Nutrients, 16(11), 1741. DOI: 10.3390/nu16111741.
Caruso, F. R., Bonjorno Jr, J. C., Arena, R., Phillips, S. A., Cabiddu, R., Mendes, R. G., Arakelian, V. M., Bassi, D., & Borghi-Silva, A. (2017). Hemodynamic, autonomic, ventilatory, and metabolic alterations after resistance training in patients with coronary artery disease: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 96(4), 226–235.
Chen, M.-L., Burgess, E., Chao, Y.-Y., Gardenhire, D., & Luo, R. (2020). Effects of Resistance Exercise on Mental Health in Older Chinese Americans: A Randomized Controlled Trial. Innovation in Aging, 4(Suppl 1), 187. doi: 10.1093/geroni/igaa057.605.
de Sá Souza, H., de Melo, C. M., Piovezan, R. D., Miranda, R. E. E. P. C., Carneiro-Junior, M. A., Silva, B. M., Thomatieli-Santos, R. V., Tufik, S., Poyares, D., & D’Almeida, V. (2022). Resistance training improves sleep and anti-inflammatory parameters in sarcopenic older adults: a randomized controlled trial. International journal of environmental research and public health, 19(23), 16322. DOI: 10.3390/ijerph192316322.
Delavar, A. (2016). Research methods in psychology and educational sciences. Tehran: Roshd, 100-99.‏
Eghbali, F., & Moradi, M. (2017). The Effect of A Course of Pilates Exercise on Hypertension, Nitric Oxide, and Resting Heart Rate in the Eldrly Men with Hypertension [Original Atricle]. Journal of Arak University of Medical Sciences, 19(11), 1–10. [Persian]
Emamimoghaddam, Z., Khosh Raftar Roudi, E., Ildarabadi, E., & Behnam Vashani, M. (1970). Quality of life in hypertention elderly patients that referred to health centers in Mashhad. Journal of Sabzevar University of Medical Sciences, 22(2), 444–452. [Persian]
Ferreira Mendes, B., Improta-Caria, A. C., Diniz e Magalhães, C. O., Dias Peixoto, M. F., Cardoso Cassilhas, R., de Oliveira, E. M., & De Sousa, R. A. L. (2024). Resistance training reduces blood pressure: putative molecular mechanisms. Current Hypertension Reviews, 20(1), 52–56. DOI: 10.2174/0115734021277791240102041632.
Gerage, A. M., Forjaz, C., Nascimento, M., Januário, R., Polito, M., & Cyrino, E. S. (2013). Cardiovascular adaptations to resistance training in elderly postmenopausal women. International journal of sports medicine, 34(09), 806–813. DOI: 10.1055/s-0032-1331185.
Gobel, F. L., Norstrom, L., Nelson, R. R., Jorgensen, C. R., & Wang, Y. (1978). The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris. Circulation, 57(3), 549–556. DOI: 10.1161/01.cir.57.3.549.
Hadi Toroghi, H., & Masoudi, S. (2019). The effectiveness of acceptance and commitment therapy on the reduction of perceived stress in the elderly afflicted by chronic pain. Aging Psychology, 5(1), 1–11. doi: 10.22126/jap.2019.1123. [Persian]
Hosseini, S.S., Azimkhani, A., Hosseini Abrishami, L. (2024). Effect of a course of selected cawthorne-cooksey and frankel exercises on balance, coordination and walking speed of elderly men with dementia. Journal of Toloo-e-Behdasht; 22 (6), 103-116. URL: http://tbj.ssu.ac.ir/ article-1-3560-fa.html. [Persian]
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., Ogedegbe, O. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5).
Janipourmofrad, K., Momeni, L., Hassanpour Hashtijani, E. (2025). The Effectiveness of Aerobic Exercise on Resilience and Life Expectancy in the Older Women. Aging Psychology, 11(3), 311-330. doi:10.22126/jap.2026.13097.1888. [Persian]
Kakavand Alireza, M. B., Farhad Shirmohammadi. (2016). The Effectiveness of Acceptance and Commitment Therapy on Stress Reductionin Afflicted Elderly Men to Heart Diseases. Aging Psychology, 1(3), 169–178. [Persian]
Kanegusuku, H., Queiroz, A., Chehuen, M., Costa, L., Wallerstein, L., Mello, M., Ugrinowitsch, C., & Forjaz, C. (2011). Strength and power training did not modify cardiovascular responses to aerobic exercise in elderly subjects. Brazilian Journal of Medical and Biological Research, 44, 864–870. DOI: 10.1590/s0100-879x2011007500100.
Karami, S., & Rajabi, H. (2024). Effects of Resistance Training on Selected Hemodynamic and Functional Factors in Older Men. Salmand: Iranian Journal of Ageing, 19(3), 382–397. doi:10.32598/sija.2024.2548.1. [Persian]
Kavandi, sh., Bagheri, B., Haroonrashidi, H. (2025). The Effectiveness of Pilates Training on Psychological Capital and Body Image in Older Women. Aging Psychology, 11(3), 275–292. doi:10.22126/jap.2025.12225.1856.
Kazeminasab, F., Mahboobi, M. H., & Azali Alamdari, K. (2024). The Combined Effect of Aerobic Exercise and Vegetarian Diet on Blood Pressure in Adults with Overweight and Obesity: A Meta-Analysis Systematic Review [Research]. Research in Sport Medicine and Technology, 22(27), 240–274. [Persian]
Kelley, G. A., & Kelley, K. S. (2018). Brief report: Exercise and blood pressure in older adults—an updated look. International Journal of Hypertension, 2018(1), 6548659. DOI: 10.1155/2018/6548659.
Kwag, K. H., Martin, P., Russell, D., Franke, W., & Kohut, M. (2011). The impact of perceived stress, social support, and home-based physical activity on mental health among older adults. The International Journal of Aging and Human Development, 72(2), 137–154. DOI: 10.2190/AG.72.2. c.
Li, Z., Lv, M., Li, Z., Gao, W., & Li, M. (2024). Physiological characteristics of blood pressure responses after combined exercise in elderly hypertensive patients: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 11, 1404127. DOI: 10.3389/fcvm.2024.1404127.
Lin, L. L.-C., Chen, Y.-J., Lin, T.-Y., & Weng, T.-C. (2022). Effects of resistance training intensity on heart rate variability at rest and in response to orthostasis in middle-aged and older adults. International journal of environmental research and public health, 19(17), 10579. DOI: 10.3390/ijerph191710579.
Mahmoudi, S. A. A., Madani, Z., Torabizadeh, J., Amouzad Mahdirejei, H., Nadi Ghara, A. A., Shafie, S. I., Sadati, S. J., & Sedaghatizadeh, S. (2022). Comparison of the Effect of 8 Weeks of Aerobic and Resistance Training on Lipid Profile and Blood Pressure of Inactive Obese Women with Hypertension [Research]. Razi Journal of Medical Sciences, 29(10), 87–101. [Persian]
Mohaqeqi Kamal, S. H., & Basakha, M. (2022). Prevalence of Chronic Diseases Among the Older Adults in Iran: Does Socioeconomic Status Matter? Salmand: Iranian Journal of Ageing, 16(4), 468–481. doi:10.32598/sija.2022.16.4.767.2. [Persian]
Molavi, P., Salvat Ghojehbeiglou, H., Nadr Mohammadi, M., & Ghalaei, S. M. (2019). Effectiveness of Stress Management Training on Reducing Perceived Stress in Veterans with PTSD [Original Research]. Iranian Journal of War and Public Health, 11(2), 67–72. [Persian]
Movaghar, F., Samadi, A., Isanezhad, A., & Khahesi, M. (2024). The effect of eight-week total-body resistance training (TRX) on hemodynamic parameters and body composition in overweight and obese pre-hypertensive women. Journal of Sport and Exercise Physiology, 17(3), 56–70. https://doi.org/10.48308/joeppa.2024.235981.1266 [Persian]
Naseri, M. B. A. (2024). Isometric Exercise for Blood Pressure and Endothelial Function in Metabolic Syndrome: A Review. Asian Journal of Sports Medicine, 15(4).
Nasiri, S., Isanezhad, A., & Nasiri, E. (2018). The Effects of 8 Week Theraband Resistance Training on Serum Level of IL-1β and Quality of Sleep in Elderly Women. Journal of Applied Exercise Physiology, 14(27), 183–194. https://doi.org/10.22080/jaep.2018.1805. [Persian]
nazari, s., sharifi, f., & gashtili, n. (2021). Investigating the relationship between aging perception with stress, anxiety and depression in the elderly members of the Tehran's social security retirees in 2020 [Original research]. Journal of Gerontology, 6(3), 78–88. [Persian]
Nemati, R., Banitalebi, E., & Rahimi, M. (2020). The Comparison of Traditional and Cluster Resistance Band Training on Hepato-metabolic Indices and Physical Performance of Elderly Woman. Journal of Gerontology, 5(2), 50–60. Retrieved from http://joge.ir/article-1-372-fa.html. [Persian]
Sadeghzadeh R, e. a. (2020). Effects of regular exercise on psychosocial stress in rat model of heart failure induced by isoproterenol. Daneshvar Medicine, 24(5), 11–24. [Persian]
Sheykh, M., Mansour Jozan, Z., & Amini, M. M. (2020). The effect of physical activity and training of progressive muscle relaxation on the level of anxiety and perceived stress in patients with Covid-19. Sport Psychology Studies, 9(32), 227–248. [Persian]
Silva, E., Bernardi, N., de Souza Marques, M. G., de Morais, S. R. L., Júnior, J. R. N., Branco, B. H. M., & de Oliveira, D. V. (2024). Effects of 12 weeks of functional and resistance training on stress perception and sleep quality in Brazilian older people. Retos: nuevas tendencias en educación física, deporte y recreación (56), 690–698.
Stewart, K. J., Bacher, A. C., Turner, K. L., Fleg, J. L., Hees, P. S., Shapiro, E. P., Tayback, M., & Ouyang, P. (2005). Effect of exercise on blood pressure in older persons: a randomized controlled trial. Archives of internal medicine, 165(7), 756–762.
Taaffe, D., Galvao, D., Sharman, J., & Coombes, J. (2007). Reduced central blood pressure in older adults following progressive resistance training. Journal of human hypertension, 21(1), 96–98.
Tanna, K., & KhaTri, S. (2024). Effect of Yoga Nidra on Perceived Stress in Individuals with High Blood Pressure: A Quasi-experimental Study. Journal of Clinical & Diagnostic Research, 18(1).