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IRCT20260624069940N7 IRCT 2026-08-22 Tarbiat Modares University Comparison of Combined, Blood Flow Restriction, and Hypoxic Training on Physical Fitness and Recovery in Boxers Investigating the Effect of Combined Training with Blood Flow Restriction and Hypoxia Compared to Each Alone on Selected Indicators of Physical Fitness and Recovery in Boxing Athletes 2026-09-01 anticipated 44 Recruiting https://irct.ir/trial/92596 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: After initial screening and confirmation of eligibility, eligible participants will be randomly assigned to four groups (Combined, BFR, Hypoxic, and Control) using randomization software. The randomization method is simple randomization with individual as the unit of randomization. No stratification is used. The random sequence is generated by software. Allocation concealment is ensured using sealed envelopes, Blinding description: In this study, due to the nature of the exercise intervention, complete blinding is not possible. However, outcome assessors who are responsible for administering the physical fitness and recovery tests will be blinded to participants' group allocation. Participants, the principal investigator, and trainers are aware of the intervention type. Outcome assessors are blinded through participant coding and lack of access to group allocation information. N/A Boxing. Intervention 1: Intervention group 1 (Combined): Combined training (blood flow restriction and hypoxia) for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) with BFR cuffs applied to proximal limbs (pressure 50 to 80% of arterial occlusion pressure) in a hypoxic chamber (simulated altitude 2500 to 3000 meters with approximately 15 to 15.5% oxygen), and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Intervention 2: Intervention group 2 (Blood Flow Restriction): Blood flow restriction training for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) with BFR cuffs applied to proximal limbs (pressure 50 to 80% of arterial occlusion pressure) in normoxic conditions, and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Intervention 3: Intervention group 3 (Hypoxic): Hypoxic training for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) in a hypoxic chamber (simulated altitude 2500 to 3000 meters with approximately 15 to 15.5% oxygen) without BFR cuffs, and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Intervention 4: Control group: Participants in this group receive no structured training intervention outside their routine boxing training and are asked to continue their normal daily activities and boxing training throughout the 8‑week study period. After the study completion, if the interventions prove effective, the beneficial training program will be offered to this group as well. Yes - There is a plan to make this available What will be shared: De-identified individual participant data, study protocol, statistical analysis plan, informed consent form, clinical study report, and data dictionary: All collected data related to outcome variables (physical fitness and recovery indices) will be shared completely without identifying information. Documentation regarding methodology, forms used, and analysis plan will also be provided. When: Six months after publication of study results To whom: Researchers affiliated with reputable academic and scientific institutions who have an approved research proposal by their institutional ethics committee. Conditions: Data may be used solely for research purposes and secondary analyses related to exercise physiology and sports performance. Commercial use of the data is not permitted. All users must adhere to ethical requirements and maintain data confidentiality, and must report any findings from their analyses to the primary authors. Requests must include a detailed description of the project and its objectives. Where to obtain: To request data, please contact the corresponding author, Mr. Moustafa Hamed Hadi, via email at Moustafa.hadi@modares.ac.ir. Requests may also be submitted through the Department of Exercise Sciences at Tarbiat Modares University. How to obtain: Upon submission of a request via email, the corresponding author will review the application. After approval by the university ethics committee, the request will be forwarded to the research team. If finally approved, de-identified data will be provided within two to four weeks via email or a secure data-sharing platform. Comments: Data will be provided solely for non-commercial purposes, with full adherence to ethical principles and confidentiality of participant information.
public Moustafa Hadi
Shahid Chamran Blvd.
Tehran Iran (Islamic Republic of) 1411713116 +98 21 8288 5063 Moustafa.hadi@modares.ac.ir Tarbiat Modares University scientific Dr. Shahnaz Shahrbanian
Shahid Chamran Blvd.
Tehran Iran (Islamic Republic of) 1411713116 +98 21 8288 5063 sh.shahrbanian@modares.ac.ir Tarbiat Modares University Iran (Islamic Republic of) Male professional boxers aged 18 to 30 years At least 3 years of boxing competition experience Complete general health and no medical restrictions or injuries No use of medications affecting muscle or respiratory function No use of anticoagulants, corticosteroids, or strong stimulant supplements at least 4 weeks prior to the study No history of seizures, migraine with aura, or chronic pulmonary disease (for hypoxia) No history of deep vein thrombosis, grade 3 or higher varicose veins, renal failure, or uncontrolled hypertension (for BFR) Ability to understand and cooperate in performing tests and exercises Signed written informed consent to participate in the study 18 years 30 years Male Presence of any chronic cardiac, pulmonary, or neurological disease History of severe injury in the past six months preventing exercise History of head trauma resulting in unconsciousness in the past 6 months or any unresolved concussion symptoms Blood oxygen saturation drop below 88% for more than 1 minute despite rest Systolic blood pressure above 180 or diastolic above 110 during exercise Y93.71 Activity, boxing Behavior Behavior Behavior Other Intervention group 1 (Combined): Combined training (blood flow restriction and hypoxia) for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) with BFR cuffs applied to proximal limbs (pressure 50 to 80% of arterial occlusion pressure) in a hypoxic chamber (simulated altitude 2500 to 3000 meters with approximately 15 to 15.5% oxygen), and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Intervention group 2 (Blood Flow Restriction): Blood flow restriction training for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) with BFR cuffs applied to proximal limbs (pressure 50 to 80% of arterial occlusion pressure) in normoxic conditions, and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Intervention group 3 (Hypoxic): Hypoxic training for 8 weeks, three sessions per week, each session lasting 45 minutes. Each session includes 10 minutes of warm-up (light running, dynamic stretching, and shadow boxing), 30 minutes of main exercise (controlled-intensity bag punching, mitt work for reaction speed and accuracy, and plyometric exercises such as depth jumps and medicine ball throws) in a hypoxic chamber (simulated altitude 2500 to 3000 meters with approximately 15 to 15.5% oxygen) without BFR cuffs, and 5 minutes of cool-down (static stretching and breathing exercises). Exercise intensity will gradually increase over the 8 weeks. Control group: Participants in this group receive no structured training intervention outside their routine boxing training and are asked to continue their normal daily activities and boxing training throughout the 8‑week study period. After the study completion, if the interventions prove effective, the beneficial training program will be offered to this group as well. Aerobic Capacity. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Cooper Test (12-minute run at maximum effort); calculating maximal oxygen consumption based on distance covered using formula: (22.351 × distance in km) - 11.288 (ml/kg/min). Anaerobic Power. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Running-based Anaerobic Sprint Test (six 35-meter sprints at maximum speed with 10 seconds rest between repetitions); calculating peak power, mean power, and fatigue index using standard formulas. Speed. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: 20-Meter Sprint Test with quick start; recording time using digital stopwatch (in seconds). Muscular Strength. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Bench Press Test; determining the maximum weight that can be lifted in one repetition maximum (in kilograms). Muscular Endurance. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Plank Test; recording the time maintaining the plank position (in seconds). Fatigue. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Multidimensional Fatigue Inventory (20 items in five dimensions: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue; scored on a 5-point Likert scale; range 20-100, higher score indicates greater fatigue). Sleep Quality. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Pittsburgh Sleep Quality Index (seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction; scored 0-21, score >5 indicates poor sleep quality). Delayed Onset Muscle Soreness. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Visual Analog Scale for pain (10 cm line from 0 = no pain to 10 = worst possible pain). Post-Exercise Heart Rate Recovery. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: Calculating the difference between heart rate immediately after exercise and heart rate one minute after exercise (in beats per minute). Perceived Recovery Status. Timepoint: Before the intervention and after 8 weeks of intervention. Method of measurement: 0-10 scale (0 = not recovered at all, 10 = fully recovered). Tarbiat Modares University Approved 2026-07-18 Research Ethics Committee of Tarbiat Modares University Shahid Chamran Blvd. Tehran Tehran Iran (Islamic Republic of)