Core training and neuromuscular electrical stimulation as non-pharmacological strategies to improve health in sedentary middle-aged men with desk-based occupations: A quasi-experimental controlled health promotion trial
Shokoofeh Samouei, Khosro Jalali Dehkordi, Farzaneh TaghianBACKGROUND AND AIM:
Sedentary lifestyle among middle-aged men is associated with adverse metabolic, hormonal, and functional health outcomes. This study examined the individual and combined effects of core stability training and neuromuscular electrical stimulation (NMES) on hormonal regulation, body composition, physical performance, fatigue, and health-related quality of life in sedentary men with desk-based occupations.
MATERIALS AND METHODS:
Forty-eight sedentary men (aged 35-55 years) were non-randomly assigned to four groups: control (no intervention), core training (8 weeks, 3 sessions/week of progressive trunk exercises), NMES (6 sessions over 3 weeks plus a week-8 booster) targeting abdominal muscles via TruSculpt Flex), and combined group (NMES in weeks 1-3 with a week-8 booster, followed by core training in weeks 4-8). The pre- and post-intervention assessments included: (1) serum hormones (testosterone, cortisol, IGF-1 by CLIA), the calculated testosterone-to-cortisol (T/C) ratio, (2) body composition (weight, BMI, waist-to-hip ratio, body-fat percentage, and skeletal muscle mass via InBody 270 BIA), (3) core endurance via static (plank) and dynamic (crunch) tests, and (4) fatigue (MFI-20), and health- related quality of life (SF-36). Given acceptable normality and variance homogeneity, within-group changes were evaluated using a paired T-Test, and between-group differences were assessed with one-way ANOVA (
RESULTS:
Testosterone levels significantly increased in the core training and combined groups, while IGF-1 rose across all the intervention groups. Cortisol and the testosterone-to-cortisol ratio improved within groups, but did not differ between groups. Anthropometric outcomes showed significant within-group improvements, with between-group differences only for skeletal muscle mass, where the combined group achieved the greatest gains. Core endurance, fatigue, and quality of life improved in all intervention arms, with superior effects observed in the combined and core training groups compared to NMES alone. Overall, the combined protocol produced the most consistent and comprehensive benefits across hormonal, physiological, and psychological domains.
CONCLUSION:
Both core training and NMES effectively improved hormonal profiles, body composition, physical performance, fatigue, and quality of life in sedentary middle-aged men. Among the tested protocols, the combined intervention (NMES followed by core training) yielded the most consistent and comprehensive benefits, suggesting a synergistic effect. While NMES primarily enhanced IGF-1 levels and muscle–fat ratio, core training demonstrated broader effects on hormonal balance, functional capacity, and psychological outcomes. These findings highlight combined protocols as a promising non-pharmacological strategy to mitigate age-related decline and promote overall health in inactive middle-aged men.