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
Primary result · HOOS activities of daily living subscale, mean scoreResult — go to the resultAdjusted mean difference 6.9 95% CI 2.5–11.2Authors' conclusion
The CHAIN 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.
Study context
- Population
- Patients with hip OA referred for physiotherapy, older than 18 years, with activity-related joint pain; Bournemouth, UK
- Participants
- 221 patients
- Comparison
- CHAIN group-based cycling and education programme vs usual physiotherapy care
- CHAINn = 110
- Usual physiotherapy caren = 111reference
- Primary endpoint
- Difference between groups in HOOS activities of daily living subscale
- Follow-up
- 10 weeks post-treatment (visit 4)
Methodological detailspragmatic, single-centre, parallel economic evaluation, People with lived experience of hip OA were involved in the design and management of the study
- Pragmatic
- Single-centre
- Parallel economic evaluation
- People with lived experience of hip OA were involved in the design and management of the study
Primary result
As reported in the abstract
HOOS activities of daily living subscale, mean score · 10 weeks
Adjusted mean difference
6.9
95% CI 2.5–11.2
P = 0.0023
By group
CHAIN
73.5
mean · SD 20.0
Usual physiotherapy care
65.4
mean · SD 19.9
CHAINvs Usual physiotherapy care
adjusted mean difference 6.9 (95% CI 2.5–11.2); P = 0.0023
Further findings
Cost-effectiveness
- CHAIN cost per quality-adjusted life year gained vs usual physiotherapy care
- £4092
- Below the £20 000 to £30 000 NICE threshold
Safety
Treatment-related serious adverse events · baseline to visit 4
- None
- 0
Original publication
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. Lancet Rheumatol. Published 31 July 2025. doi:10.
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