Study reveals spinning could reduce NHS waiting lists for physiotherapy
New research indicates that group-based stationary cycling programmes improve recovery outcomes for hip osteoarthritis patients and increase cost-efficiency.
A new strategy to address current strain on NHS services has emerged from a clinical trial, suggesting that group-based stationary cycling may outperform traditional one-to-one physiotherapy for patients suffering from hip osteoarthritis. The findings, which indicate improved patient recovery and increased cost-efficiency, were published in Lancet Rheumatology on 31 July 2025.
The research was conducted by Bournemouth University and University Hospitals Dorset, with funding provided by the National Institute for Health Research. It focused on a programme known as CHAIN, which was originally established in 2013. The intervention combines weekly education sessions with static cycling classes over an eight-week period. According to the study, this group-based model requires less clinical time than standard physiotherapy, allowing medical teams to treat multiple patients simultaneously while delivering superior recovery outcomes.
Media additions
Tom Wainwright, Professor of Orthopaedics at Bournemouth University and a physiotherapist at University Hospitals Dorset, served as the chief investigator. He emphasised the potential for this approach to help alleviate the current pressure on waiting lists.
"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."
Tom Wainwright, Professor of Orthopaedics at Bournemouth University and physiotherapist at University Hospitals Dorset, via MedicalUpdateOnline
The scale of the challenge regarding hip osteoarthritis is significant, with 10 million people in the UK affected by osteoarthritis, including 3.2 million who suffer specifically from the hip-related condition. Orthopaedic experts note that the financial and clinical burden of surgical interventions is substantial. Professor Rob Middleton, an orthopaedic surgeon at University Hospitals Dorset, highlighted the fiscal implications of the findings.
"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."
Rob Middleton, Professor at Bournemouth University and orthopaedic surgeon at University Hospitals Dorset, via EurekAlert
Participants in the trial reported notable improvements in mobility. One participant, identified as Sue, described a marked return to daily activities including walking and dancing after completing the programme, despite initial difficulties. Viv Galpin, Health and Wellbeing Manager at BH Live—the charity partnering to deliver the sessions at the Littledown centre in Bournemouth—noted that the low-impact nature of studio cycling helps improve muscle strength, balance, and joint stiffness. A five-year follow-up of the programme showed a significant improvement in hip function, with 57 percent of participants avoiding surgical intervention.
Dr Peter Wilson, Chief Medical Officer at University Hospitals Dorset, underlined that the ageing population necessitates a shift toward these alternative treatments.
To support a national rollout, the research team has developed a virtual course on their education app. Individuals are able to follow the programme from their home or gym using a static bike. Patients interested in the service are typically referred to the University Hospitals Dorset physiotherapy team via their GP before being registered on the eight-week programme.
Future Outlook for Service Delivery
- Clinical Expansion: The CHAIN programme aims to roll it out nationally by providing other clinical teams across the UK with the knowledge and skills to set up their own interventions.
- Digital Accessibility: A virtual course is available on their education app to enable remote participation, allowing patients to manage hip pain from home or at local fitness facilities.
The project, titled the CLEAT trial, marks a continued effort to integrate leisure centre resources and digital patient education into standard NHS rehabilitative pathways.
