The Effect of Hand Exercise Hoops on Labour Pain

The Effect of Hand Exercise Hoops on Labour Pain: A Randomized Controlled Single-Blind Study

This randomized, single-blind controlled trial aims to evaluate the effect of using a hand exercise ring combined with breathing exercises on labor pain, anxiety, and childbirth satisfaction in primiparous women during the active phase of labor. Labor pain is a complex, multidimensional experience that intensifies as labor progresses and may lead to adverse physiological, psychological, and emotional consequences for both the mother and the fetus if not effectively managed. While pharmacological pain relief methods are effective, they may be associated with maternal and neonatal side effects and are not always accessible. Therefore, safe, low-cost, and non-pharmacological pain management strategies are of growing interest in maternity care.

The study will be conducted in a hospital labor ward and will include low-risk primiparous women aged 18-35 years who are admitted for vaginal birth. A total of 86 participants will be randomly assigned to either an intervention group or a control group. Women in the intervention group will receive a soft hand exercise ring and will be instructed to use it in conjunction with guided breathing exercises during uterine contractions, starting at 4-5 cm cervical dilation and continuing throughout the active phase of labor. During each contraction, participants will squeeze the hand exercise ring while exhaling and release it during relaxation periods between contractions. This intervention is designed to reduce pain perception through distraction, activation of the gate control mechanism, increased endorphin release, and regulation of the autonomic nervous system via controlled breathing.

The control group will receive routine intrapartum care without any additional pain management intervention. Outcome measures include labor pain intensity assessed using the Visual Analog Scale (VAS), anxiety levels measured with the State Anxiety Inventory (STAI Form TX-1), and childbirth satisfaction evaluated using the Maternal Satisfaction with Childbirth Scale. Pain and anxiety will be assessed at three stages of cervical dilation (4-5 cm, 6-7 cm, and 8-9 cm), while childbirth satisfaction will be assessed six hours postpartum.

The findings of this study are expected to contribute evidence regarding the effectiveness of a simple, non-invasive, and easily applicable intervention for labor pain management, potentially supporting its integration into routine midwifery care to improve women's childbirth experiences.

Study Overview

• Status: Not yet recruiting
• Conditions: Midwifery; Labour Pain
• Intervention / Treatment: Device: Hand Exercise Hoop

• Study Type: Interventional
• Enrollment (Estimated): 86
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Elif DOGAN; Phone Number: +90 539 601 15 88; Email: elifdogann18@gmail.com

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Istanbul University - Cerrahpasa
    • Contact: Elif DOGAN; Phone Number: +90 539 601 15 88; Email: elifdogann18@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Primiparous women with low-risk pregnancies

Exclusion Criteria:

• Women with high-risk pregnancies (such as preeclampsia, placenta previa)
• Women who will use any pharmacological or non-pharmacological pain management method
• Women who cannot be contacted or who are not amenable to referral

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group
Experimental: Hand Exercise Hoop Group	Device: Hand Exercise Hoop; Participants assigned to the intervention group will use a soft hand exercise hoop in combination with guided breathing exercises during the active phase of labor. The intervention will begin at 4-5 cm cervical dilation and continue throughout the active phase. During each uterine contraction, participants will be instructed to inhale deeply at the onset of the contraction and to squeeze the hand exercise hoop while slowly exhaling as the contraction intensifies. As the contraction subsides, participants will release the hoop and return to normal breathing. The hand exercise hoop will be used continuously during contractions as a mechanical distraction and sensory stimulus. The intervention aims to reduce pain perception through activation of the gate control mechanism, distraction from pain stimuli, increased endorphin release, and regulation of the autonomic nervous system via controlled breathing. Participants will receive verbal guidance and support from healthcare staff throughout

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Labor Pain Intensity	Labor pain intensity will be assessed using the Visual Analog Scale (VAS), a validated tool consisting of a 10-cm horizontal line ranging from "no pain" (0) to "worst imaginable pain" (10). Participants will indicate their perceived pain intensity at each assessment point, with higher scores indicating greater pain severity.	During the active phase of labor at 4-5 cm, 6-7 cm, and 8-9 cm cervical dilation (up to 24 hours)
Maternal Anxiety During Labor	Maternal anxiety levels will be measured using the State Anxiety Inventory, a 20-item self-report questionnaire assessing situational anxiety. Total scores range from 20 to 80, with higher scores indicating higher levels of anxiety.	During the active phase of labor at 4-5 cm, 6-7 cm, and 8-9 cm cervical dilation (up to 24 hours)
Maternal Satisfaction with Childbirth	Maternal satisfaction with the childbirth experience will be evaluated using the Maternal Satisfaction with Childbirth Scale, a validated instrument assessing women's satisfaction with various aspects of the childbirth process. This study will use the vaginal birth version, which contains 43 items and 10 subscales to assess maternal satisfaction during childbirth. The subscales evaluate different areas of satisfaction related to the birth process (e.g., pain management, communication with healthcare personnel, birth environment). The total score range is 43-215. Higher total scores indicate greater satisfaction with the birth experience.	Within 6 hours after vaginal birth.

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa

Study record dates

Study Major Dates

• Study Start (Estimated): May 15, 2026
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): January 15, 2027

Study Registration Dates

• First Submitted: January 18, 2026
• First Submitted That Met QC Criteria: January 28, 2026
• First Posted (Actual): January 30, 2026

Study Record Updates

• Last Update Posted (Actual): January 30, 2026
• Last Update Submitted That Met QC Criteria: January 28, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Labor Pain
• Other Study ID Numbers: 2025/727

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No