A new study by Bournemouth University (BU) and University Hospitals Dorset (UHD) has revealed the benefits of static cycling for patients with hip osteoarthritis.The study was funded by the National Institute for Health Research (NIHR) and will be published in Lancet Rheumatology at 23:30 UK time on Thursday 31st July 2025.
Participants within the study who took part in the weekly cycling and education sessions reported better recovery outcomes compared to participants who undertook regular physiotherapy. The results reveal that better outcomes for patients can be achieved in a group setting using the cycling and education classes, and that less clinical time is needed to deliver this compared to one-to-one standard physiotherapy treatment.
Tom Wainwright, Professor of Orthopaedics at BU and a physiotherapist at UHD, was the chief investigator of the study. He said: “For the time it takes to treat one patient using standard physiotherapy, we can treat multiple patients in a group session and provide them with better outcomes. This has proved to be more cost-effective than standard treatment and so we hope this will contribute to reducing NHS waiting times for physiotherapy treatment in the future.”
The “CHAIN” intervention used in this study was first launched in 2013 and is a weekly education session and static cycling class that takes place over eight weeks for patients suffering from hip osteoarthritis (OA). OA is a leading cause of disability in older people. In the UK, 10 million people have OA, with 3.2 million suffering from hip OA.
A five-year follow-up reported a significant improvement in hip function after treatment compared to usual physiotherapy care. The majority of participants were still using self-management strategies to manage their hip pain, and 57 percent had not pursued surgical intervention.
BU’s Professor Rob Middleton and orthopaedic surgeon at UHD said: “Hip replacements cost the NHS over £6,000 per patient, so avoiding surgery for hip problems reduces the burden on the NHS, saves money, and provides better outcomes for patients. Now with this new study we can also see the potential for static cycling to save further money for the NHS by bringing down waiting lists for physiotherapy.”
Dr Peter Wilson, Chief Medical Officer at UHD said: “We are an ageing population and increasingly we are seeing more patients with osteoarthritis that need either surgery or physiotherapy. Finding alternative ways to treat these patients could help reduce waiting times and the financial demand on NHS services.”
Professor Wainwright continued: “We previously knew that CHAIN worked and benefitted patients. What this latest study has shown is that it improves clinical outcomes and is far more cost-effective when compared to usual physiotherapy care.”
Patients taking advantage of CHAIN are referred to the UHD Physio Team via their GP. They are then registered on the eight-week programme.
The researchers have teamed up with BH Live, a local registered charity and a leading leisure centre operator, to deliver the group sessions at BH Live Active, Littledown in Bournemouth.
Viv Galpin, BH Live’s Health & Wellbeing Manager, said: “Studio cycling is a fantastic form of low-impact exercise. Among many other advantages, it helps to improve muscles around joints, maintain bone strength, improve balance, and reduce joint pain and stiffness. It’s great to see so many participants are already benefitting from our programme.”
One of the participants, Sue, was originally referred to her local hospital. She had to give up her two favourite hobbies, walking and dancing, because of painful hip problems. Speaking about her experiences, she said: “My leg would give way and suddenly I couldn’t walk. The first week of the spinning class I could barely manage to get on the bike. By the third week I had already noticed a positive difference in my hip. After the programme I was walking and dancing and grateful to have a good night’s sleep again.”
To help roll out CHAIN on a national level, the BU team have developed a virtual course on their education app. Individuals are able to follow the programme from their home or gym using a static bike.
The future aim of CHAIN is to roll it out nationally by providing other clinical teams across the UK with the knowledge and skills to set up their own interventions.
Professor Wainwright concluded: “By providing an app to help people manage their hip pain virtually and by supporting other clinicians with a toolkit to set up their own CHAIN programmes, the outcomes in the future could change the way we treat hip pain on a national and international level, helping to benefit our patients and improve lives for thousands of people.”
For further information about the CHAIN programme, please visit the BU website.
