Acupoint TENS vs Resistance Training for Iron Deficiency Anemia

Effect of Transcutaneous Electrical Acupoint Stimulation Versus Resistance Exercise on Hemoglobin Level in Women With Iron Deficiency Anemia

The current study is designed to compare between the effect of transcutaneous electrical acupoint stimulation and resistance exercises on hemoglobin level in women with iron deficiency anemia.The design of this study will be a randomized controlled trial (RCT) pretest post-test assessment.Sixty women diagnosed with iron deficiency anemia will be recruited in this study from Kafrelshiekh University Hospital, Kafrelshiekh Governorate, Egypt. Their ages will be ranged from 20 to 30 years old, and they will be randomly divided into three equal (n= 20) groups. Change in hemoglobin concentration (g/dL) after the intervention period and changes in RBC count, MCV, MCH, RDW, serum ferritin, fatigue level, and functional exercise capacity after treatment will be measured.

Iron deficiency anemia (IDA) is one of the most common nutritional disorders among women and is associated with fatigue, weakness, reduced physical performance, and impaired quality of life. Non-pharmacological interventions such as Transcutaneous Electrical Nerve Stimulation (TENS) applied on acupuncture points such as gall bladder 39 and spleen 6 and resistance exercise may help improve circulation, stimulate physiological responses, and support hemoglobin production.This study is randomized controlled trial (RCT) pretest post test assessment aimed to compare the effects of acupoint TENS and resistance exercise on hemoglobin levels in women with iron deficiency anemia.Sixty women diagnosed with iron deficiency anemia will be recruited in this study . Their ages will be ranged from 20 to 30 years old, and they will be randomly divided into three equal (n= 20) groups as following:

1. Study group (A) includes 20 women who will receive acupuncture transcutaneous electrical nerve stimulation (Acu-TENS) in addition to routine medical treatment program.
2. Study group (B) includes 20 women who will undergo resistance exercise training in addition to routine medical treatment program.
3. Control group (C) includes 20 women who will receive routine medical treatment program only.

The treatment program will be applied once per day, three times per week for 12 consecutive weeks.

Inclusion Criteria:

• Sixty women diagnosed with iron deficiency anemia within ≤6 months.
• Their hemoglobin concentrations ranging from 8.0 to 10.9 g/dL that classified as moderate anemia in accordance with the World Health Organization (WHO) criteria.
• The iron deficiency anemia resulted from the heavy monthly bleeding of menstrual cycle as reported by the women.
• Their age will be ranged from 20 and 30 years old.
• Their BMI will be ranged from 18.5 to 24.9 kg/m².
• They will have the same level of functional capacity assessed by 6-minute walking test.
• They will be receiving the same medical treatment programme.

Exclusion Criteria:

• Other causes of anemia (e.g., hemolytic anemia, anemia of chronic disease, megaloblastic anemia, thalassemia, or sickle cell disease).
• Severe anemia (hemoglobin < 8.0 g/dL)
• History of chronic kidney disease, liver disease, or malignancy.
• Current pregnancy or lactation, due to altered iron metabolism and hemoglobin thresholds.
• Recent blood transfusion or iron therapy (oral or intravenous) within the past 3 months.
• Use of hematopoietic agents (e.g., erythropoietin).
• Acute infection or inflammatory conditions at the time of enrollment.
• Inability or unwillingness to provide informed consent or comply with study procedures.
• Previous participation in complementary treatments/research within the last six months.