Field and Home Exercise Program for Improving Function in Iraqi Rural Women (CRP-Rural)

August 13, 2025 updated by: Munib Abdullah Fathi, University of Mosul

Feasibility a Combining Rehabilitation Program at Field Exercises and Tele-exercises to Enhance Daily Life Activities to Rural Women in Iraq

This study evaluates a 12-week Combined Rehabilitation Program (CRP) designed to reduce musculoskeletal pain and improve physical function among rural women in northern Iraq. The program integrates home-based therapeutic exercises with simple, culturally appropriate games. Sixty-six women from the Hamdaniya district, all with nearly two decades of experience in agricultural labor and chronic musculoskeletal pain in the back, neck, and limbs, participated voluntarily.

The intervention includes two supervised group sessions per week at a local sports field and remote home-based sessions guided via pre-recorded videos shared through WhatsApp. Each session lasts 45 to 60 minutes and incorporates rest periods. The program is designed to strengthen weakened muscles, improve daily function, and promote social engagement among participants.

Rural women engaged in long-term agricultural labor are at increased risk of chronic musculoskeletal pain, particularly in the back, neck, and limbs.

What is already known on this subject:

  • Rural women engaged in long-term agricultural labor are at increased risk of chronic musculoskeletal pain, particularly in the back, neck, and limbs.
  • Home-based therapeutic exercises are widely used to manage pain and improve physical function.
  • Community-based rehabilitation programs can support better health outcomes in underserved populations.

What this study adds:

  • Introduces a culturally adapted Combined Rehabilitation Program (CRP) that blends home-based exercises with traditional games in a rural Iraqi context.
  • Explores the feasibility of delivering rehabilitation through low-cost mobile technology in resource-limited environments.
  • Provides a community-based model for accessible, flexible rehabilitation tailored to the needs of rural women.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study aims to evaluate the effectiveness of a Combined Rehabilitation Program (CRP) designed to reduce musculoskeletal pain and enhance physical function among rural women in northern Iraq. The CRP integrates home-based therapeutic exercises with culturally relevant physical games and is tailored to the specific needs and social context of the participants.

The study includes 66 women, aged around 46 years, with 18-23 years of experience in agricultural work. All participants reported ongoing muscle and joint pain in the upper and lower limbs, back, and neck, which affects their ability to carry out daily activities. Due to family and work constraints, a flexible intervention was developed that combines in-person and remote elements to ensure accessibility and adherence.

The 12-week program consists of two supervised group sessions per week held at a local field, along with home-based sessions delivered through pre-recorded videos shared via mobile applications. Each session lasts 45-60 minutes and includes walking, stretching, strengthening exercises, and simple games targeting muscle groups commonly affected by physical labor. Rest periods are integrated into each session to promote safety and participation.

Participants are assessed before and after the intervention for muscle strength, flexibility, body composition, and pain levels using standardized tools. The study design emphasizes a community-based and technology-supported approach to rehabilitation, addressing the unique challenges faced by women in rural areas with limited access to conventional services.

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Iraq
    • Nineveh
      • Mosul, Nineveh, Iraq, 00964
        • College of Physical Education and Sport Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Women have experienced Musculoskeletal pain in one or more one of fourth areas of study variables which are : the upper and lower extremities, neck, and lower back.

Exclusion Criteria:

  • Women who suffer from other functional diseases not related to Musculoskeletal pain.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Combined Rehabilitation Program (CRP) - Single Group
This arm received a 12-week Combined Rehabilitation Program (CRP), consisting of both in-person field exercises and remote tele-exercises. The intervention included therapeutic exercises and culturally relevant physical games tailored to improve musculoskeletal function and reduce pain. Exercises were focused on mobility, strength, and flexibility, targeting areas of muscle weakness identified during baseline assessment.
Behavioral: Combined Exercise

Participants engaged in a hybrid exercise program that included:

In-field sessions held twice weekly at a local sports facility (45-60 minutes per session, including rest).

Remote sessions delivered via pre-recorded videos through WhatsApp, with ongoing monitoring and feedback.

Exercises included walking, jogging, full-body stretching, and strength training targeting the trunk, limbs, and weak muscle groups (shoulders, back, knees).

The program aimed to reduce joint and muscle pain, improve strength and flexibility, and support daily functional activities.

Pre- and post-intervention assessments included muscle strength (via hand dynamometer), flexibility tests, BMI, and self-reported pain using the NRS-11 scale.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in musculoskeletal pain level in the lower back, neck, upper extremities, and lower extremities.
Time Frame: Baseline and Week 12
Pain levels will be self-reported using the Numeric Rating Scale (NRS-11), a validated 11-point scale ranging from 0 (no pain) to 10 (worst possible pain). Participants will report pain in four body regions: lower back, neck, upper extremities, and lower extremities. The method of assessment was Numeric Rating Scale (NRS-11), administered in-person and via teleconsultation.
Baseline and Week 12

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in flexibility.
Time Frame: Baseline and Week 12
Flexibility of major joints and muscle groups (especially lower extremities) will be assessed using standard range-of-motion and stretch tests. The method of assessment was manual flexibility tests (sit-and-reach, joint range assessments)
Baseline and Week 12
Change in muscle strength in upper and lower extremities and trunk.
Time Frame: Baseline and Week 12
Muscle strength will be measured using a handheld dynamometer (MicroFET2). Assessments will include trunk flexors/extensors, thigh flexors/extensors, and upper limb muscles (shoulder, elbow, wrist).The method of assessment was Handheld Dynamometer (MicroFET2).
Baseline and Week 12

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Body Weight
Time Frame: Baseline and Week 12
Body weight will be measured using a calibrated digital scale to assess changes over the course of the 12-week intervention. The method of assessment was standard anthropometric measurement tools. The unit of measure: Kilograms per square meter (kg/m²)
Baseline and Week 12
Change in body mass index (BMI).
Time Frame: Baseline and Week 12
BMI will be calculated using measured weight and height, according to the formula: weight (kg) / [height (m)]². This will assess changes in body composition over the course of the 12-week intervention. The method of assessment: was standard anthropometric measurement tools.
Baseline and Week 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Mosul

Investigators

  • Principal Investigator: Munib Fathe, University of Mosul

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 5, 2024

Primary Completion (Actual)

October 15, 2024

Study Completion (Actual)

November 7, 2024

Study Registration Dates

First Submitted

July 23, 2025

First Submitted That Met QC Criteria

August 13, 2025

First Posted (Actual)

August 19, 2025

Study Record Updates

Last Update Posted (Actual)

August 19, 2025

Last Update Submitted That Met QC Criteria

August 13, 2025

Last Verified

August 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • College of Physical Education
  • The corresponding Author (Other Identifier: University of Mosul)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Data availability will be available on request by contact with corresponding author on email : m.a.fathi@uomsul.edu.iq

IPD Sharing Time Frame

Data will be available beginning 6 months after publication and for up to 3 years. Requests will be reviewed by the study's data-sharing committee to ensure alignment with ethical standards and scientific merit.

IPD Sharing Access Criteria

Individual Participant Data (IPD) and related supporting documentation (such as the study protocol, statistical analysis plan, and informed consent form) will be made available to qualified researchers upon reasonable request. Access will be granted to researchers affiliated with academic institutions, non-profit organizations, or other recognized research bodies for the purpose of secondary analysis, meta-analysis, or other ethically approved scientific research.

Requests for access should include a clear research proposal, objectives, and a data use agreement outlining how the data will be protected and used in compliance with applicable ethical and data protection standards.

To request access, researchers may contact the corresponding author via the email address provided in the publication or through the institutional contact listed in the trial registration. Data will be shared in a de-identified format to ensure participant confidentiality.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE
  • CSR

Study Data/Documents

  1. Individual Participant Data Set
    Information identifier: m.a.fathi@uomosul.edu.iq
    Information comments: De-identified individual participant data is available through the provided OSF link

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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