Simple exercise ‘better than physio’ for problem that affects millions of Brits

A recent study has suggested that a specific form of exercise may be more effective than standard physiotherapy when it comes to treating a common hip condition. Researchers found that attending weekly group spin classes could not only help those in pain, but it could also be a more cost-efficient option for the NHS and potentially reduce long waiting times for physiotherapy services.

Hip osteoarthritis, a condition impacting approximately 3.2 million people in the UK, develops when the cartilage in the hip joint breaks down. This can cause severe pain and result in limited movement.

In the study, researchers from Bournemouth University and University Hospitals Dorset (UHD) compared standard physiotherapy with an eight-week programme called CHAIN (Cycling Against Hip Pain), which integrates cycling-based exercise with educational components.

The study, published in The Lancet Rheumatology, included 211 participants who were divided roughly equally between the two treatment groups. Those in the CHAIN programme took part in weekly 30-minute educational sessions led by a physiotherapist, followed by a 30-minute session of static cycling guided by a gym instructor.

Researchers used the Hip Disability and Osteoarthritis Outcome Score (HOOS) for activities of daily living (ADL) to evaluate how hip issues impacted participants’ everyday function. Findings revealed that those who completed the cycling classes experienced a “statistically significant improvement in patient-reported function after treatment”.

According to the researchers, the intervention “showed superior outcomes compared with usual physiotherapy care, and the feasibility of delivering a low-cost, community-based intervention within the NHS was shown”. They noted, however, that the “longer-term benefits and broader generalisability warrant further investigation”.

Professor Tom Wainwright, an orthopaedics expert at Bournemouth University and physiotherapist at UHD, 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.”

Professor Rob Middleton, an orthopaedic surgeon at UHD and fellow Bournemouth University academic, added: “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, commented: “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.”

Launched in 2013, the CHAIN programme currently accepts patients referred to University Hospitals Dorset (UHD) by their GP. To make the programme more widely accessible, Bournemouth University has created a virtual version via its educational app, enabling patients to take part remotely from home or at a nearby gym.