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.

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.

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.

The study involved only female gender (N=66) women

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

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.

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.