Effects of Aerobic Versus Combined Aerobic-Resistance Exercise on Physiological Variables among Female University Students: An Eight-Week Experimental Study

Background : Physical inactivity among university students is associated with adverse cardiovascular and body composition outcomes. Although both aerobic exercise and combined aerobic–resistance exercise improve physiological health, evidence comparing their effectiveness among female university students remains limited. Methods : A randomized pretest–posttest experimental study was conducted among 32 non-athlete female undergraduate students at Bahir Dar University, Ethiopia. Participants were randomly assigned to a moderate-intensity aerobic exercise group (MIAE; n = 16) or a combined aerobic–resistance exercise group (CEX; n = 16). Both groups participated in supervised exercise sessions three times per week for eight weeks. Resting systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), body fat percentage (BF%), and lean body mass (LBM) were measured before and after the intervention. Data were analyzed using paired-samples t-tests and multivariate analysis of variance (MANOVA). Results : Significant within-group improvements were observed in both interventions. The MIAE group demonstrated significant reductions in SBP (p < 0.001), DBP (p = 0.002), RHR (p < 0.001), and BF% (p < 0.001). The CEX group showed significant reductions in SBP (p < 0.001), DBP (p = 0.002), RHR (p < 0.001), BF% (p < 0.001), and a significant increase in LBM (p < 0.001). MANOVA revealed a significant overall intervention effect on the combined physiological variables (Wilks’ Λ = 0.411, F(10,21) = 3.003, p = 0.016, partial η² = 0.589). Follow-up analyses indicated significant between-group differences in RHR (p = 0.019) and LBM (p = 0.037), whereas SBP, DBP, and BF% did not differ significantly between groups. Conclusion : Both exercise modalities improved cardiovascular and body composition outcomes. However, moderate-intensity aerobic exercise produced greater reductions in resting heart rate, whereas combined aerobic–resistance exercise was superior for increasing lean body mass. Combined exercise may therefore provide broader physiological benefits among female university students. Trial registration: Pan African Clinical Trial Registry (PACTR; pactr.samrc.ac.za), PACTR202607782571116, registered on 31 July 2026. Retrospectively registered.