For patients with hip osteoarthritis referred for physiotherapy at a UK hospital, the cycling and education intervention (CLEAT) trial sought to compare the clinical and cost-effectiveness of the group-based cycling and education program known as the Cycling Against Hip Pain (CHAIN) intervention with standard physiotherapy care.
The participants over 18 years with joint discomfort from activities, and no morning stiffness or morning stiffness that lasted not more than 30 minutes, and who met primary-care requirements for exercise referral were included.
Using randomly permuted blocks of sizes 2, 4, and 6, participants were randomized (1:1) to receive either the CHAIN intervention or standard physiotherapy care. The CHAIN intervention group's participants participated in an 8-week group program that included education and static cycling at a nearby recreation center.
Depending on standard care at the time of treatment, participants in the physiotherapy group received their regular one-on-one care from a physiotherapist at the nearby hospital or over the phone. The Hip Disability and Osteoarthritis Outcome Score (HOOS) activities of daily living subscale differences between groups at 10 weeks after therapy (visit 4) were the main outcome.
A parallel economic evaluation from the major viewpoints of personal social services and the UK NHS was part of the study. Data on safety and adverse events were gathered between baseline and visit 4, and the effectiveness analysis included all individuals who submitted data at that point.
Almost, 221 individuals were enrolled in the trial between February 24, 2020, and April 28, 2023, and they were randomized to receive either standard physiotherapy care (111 [50%]) or the CHAIN intervention (110 [50%]).
The mean age of the participants was 64·4 years (SD 9·5), with 126 (57%) being female, 95 (43%) being male, and 217 (98%) being White.
When compared to those in the standard physiotherapy care group, individuals in the CHAIN group showed higher gains in mean HOOS activities of daily living subscale scores.
The primary result indicated that CHAIN was statistically significantly better than standard physiotherapy; however, the between-group difference of 6·9 HOOS points fell short of the minimal clinically meaningful difference of 7·4.
When compared to standard physiotherapy care, CHAIN cost £4092 every quality-adjusted life year gained, which is less than the £20,000–$30,000 National Institute of Health and Care Excellence cost-effectiveness benchmark. There were no significant side effects from the therapy.
Overall, the CHAIN intervention demonstrated better results than standard physiotherapy care, and it is feasible to provide a low-cost, community-based intervention.
Source:
Wainwright, T. W., Immins, T., Docherty, S., Saunders, G., Hawton, A., Goodwin, E., Rees, T., Low, M., Samways, J., Webley, F., Howard, N., Lee, P. H., & Middleton, R. G. (2025). Clinical and cost-effectiveness of a cycling and education intervention versus usual physiotherapy care for the treatment of hip osteoarthritis in the UK (CLEAT): a pragmatic, randomised, controlled trial. The Lancet. Rheumatology. https://doi.org/10.1016/S2665-9913(25)00102-X
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.