Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Increasing age and decreasing estrogen levels in postmenopausal women cause obesity, increased body fat, and decreased skeletal muscle mass due to hormonal changes and body composition. Physical activity as a potential intervention strategy can improve muscle strength and reduce obesity in preventing and overcoming postmenopausal complications. It was shown that low– to moderate–intensity exercise could decrease hs–CRP blood levels and improve postmenopausal women's cardiorespiratory endurance. On the other hand, menopause increases the risk of muscle damage and oxidative stress, which leads to chronic inflammatory diseases, so antioxidant compounds can help prevent and treat inflammatory disorders and reduce creatine–phosphokinase secretion. Exercise with Tribulus supplement may be an effective method to control menopausal complications in overweight women. The present study aimed to determine the effect of a combined aerobic–resistance exercise with Tribulus supplement on creatine–phosphokinase (CPK), lactate–dehydrogenase (LDH), and high–sensitivity C–reactive protein (hs–CRP) in overweight postmenopausal women.
Methods: The present quasi–experimental study employed a pretest–posttest and follow–up design with a control group. The statistical sample comprised 60 eligible postmenopausal women aged 50–65 from Rasht City, Iran. After the call, 109 volunteers participated in the study. G–Power software was used to determine the sample size. The statistic used was analysis of covariance with an effect size of 0.40, test power of 0.80, and alpha error of 5%. Finally, the proposed sample size was sixty people randomly assigned to four groups of 15 people. The inclusion criteria were overweight, cessation of menstruation for more than 12 consecutive months, age range between 55 and 65 years, not using hormone therapy in the past year, not smoking in the previous 6 months, and complaining of some menopausal complications. The exclusion criteria were any injury during the research, unwillingness, or absenteeism in training sessions for three consecutive sessions. They were randomly divided into four equal groups: inactive control, moderate intensity training, supplement group, and combined (moderate intensity training with supplement consumption) groups. Groups 2 and 4 performed an exercise training program for 10 weeks. Moderate–intensity training included walking and running on a treadmill, and resistance training was performed with an elastic band, including 9 movements: bench press, squat, biceps curl, seated row, knee bend, sit–up, knee extension, overhead press, and bench press. The supplement was taken as 500 mg capsules in groups 3 and 4 twice a day. Research variables were measured before and after 10 weeks. Data analysis was performed using 1–way ANOVA, repeated measures ANOVA, Bonferroni post hoc test, and LSD post hoc test in SPSS software version 25 at a significance level of 0.05.
Results: The results showed a significant difference between the four groups in fat percentage, CPK, LDH, and hs–CRP (p<0.001). The follow–up test results showed a significant difference between the training and supplement groups in the CPK indices (p<0.001) and between the supplement and combination groups in the LDH (p=0.005). In addition, the hs–CRP variable showed a significant difference between the experimental and control groups (p<0.001).
Conclusion: The results of the present study showed that 10 weeks of combined exercises with Tribulus supplement decreased LDH, CPK, and hs–CRP in overweight postmenopausal women. So, postmenopausal women who are overweight could utilize combined exercises with Tribulus supplements to improve muscle and inflammatory indicators.