{"id":4685,"date":"2024-09-26T07:48:58","date_gmt":"2024-09-26T07:48:58","guid":{"rendered":"https:\/\/microsites.bournemouth.ac.uk\/ori\/?page_id=4685"},"modified":"2025-09-08T08:34:01","modified_gmt":"2025-09-08T08:34:01","slug":"chain-2","status":"publish","type":"page","link":"https:\/\/microsites.bournemouth.ac.uk\/ori\/chain-2\/","title":{"rendered":"CHAIN"},"content":{"rendered":"<div id=\"attachment_5110\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2024\/11\/Tom-and-patient-on-bike.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5110\" class=\"wp-image-5110 size-medium\" src=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2024\/11\/Tom-and-patient-on-bike-300x200.jpg\" alt=\"\" width=\"300\" height=\"200\" srcset=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2024\/11\/Tom-and-patient-on-bike-300x200.jpg 300w, https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2024\/11\/Tom-and-patient-on-bike.jpg 717w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-5110\" class=\"wp-caption-text\">The CHAIN Study<\/p><\/div>\n<p>CHAIN (Cycling against Hip pAIN) was conceived by <a href=\"https:\/\/staffprofiles.bournemouth.ac.uk\/display\/rmiddleton\" target=\"_blank\" rel=\"noopener\">Professor Robert Middleton<\/a> and <a href=\"https:\/\/staffprofiles.bournemouth.ac.uk\/display\/twainwright\" target=\"_blank\" rel=\"noopener\">Professor Thomas Wainwright<\/a> of the Orthopaedic Research Institute (ORI) at Bournemouth University, with the aim of promoting the self-management of osteoarthritic symptoms through lifestyle change. The programme is based on the latest <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng226\" target=\"_blank\" rel=\"noopener\">National Institute for Health and Care Excellence (NICE) guidelines<\/a>\u00a0for the treatment of osteoarthritis, which recommend exercise (local muscle strengthening and aerobic training), education and weight loss where necessary.<\/p>\n<p>The programme was <strong>first launched in 2013<\/strong>. Patients presenting with hip osteoarthritis or other forms of hip pain at a primary care service were referred by their GP. Ninety-six participants completed the course, and demonstrated improvements to pain, function and quality of life. In addition, participants reported an increase in knowledge, confidence, and motivation to exercise. The success of the programme and the partnership with BH Live was <strong>recognised by UK Active in 2014<\/strong>, when the CHAIN programme was a finalist in the national Healthy Partnership Award. CHAIN was also highlighted by SAGA in a publication looking at the best exercise for arthritis.<\/p>\n<div id=\"attachment_6267\" style=\"width: 347px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2025\/08\/CHAIN-class.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-6267\" class=\"wp-image-6267 \" src=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2025\/08\/CHAIN-class-300x200.jpg\" alt=\"\" width=\"337\" height=\"224\" srcset=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2025\/08\/CHAIN-class-300x200.jpg 300w, https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2025\/08\/CHAIN-class-768x511.jpg 768w, https:\/\/microsites.bournemouth.ac.uk\/ori\/files\/2025\/08\/CHAIN-class.jpg 1024w\" sizes=\"auto, (max-width: 337px) 100vw, 337px\" \/><\/a><p id=\"caption-attachment-6267\" class=\"wp-caption-text\">CHAIN class<\/p><\/div>\n<p>Following completion of the initial programme, the local NHS trust (The Royal Bournemouth and Christchurch Hospitals NHS Trust) commissioned the programme to take referrals from secondary care to the CHAIN programme, which <strong>ran between February 2018 and September 2019<\/strong>. 167 participants completed the course, and demonstrated improvements similar to the original cohort in terms of pain, function, quality of life and motivation to exercise. A five year follow up of the original programme found that the majority of participants were still using self-management strategies to manage their hip pain, and 57% had not pursued surgical intervention.<\/p>\n<p>In <strong>February 2020, ORI launched the CLEAT study<\/strong>, a randomised controlled trial to compare the CHAIN programme with usual physiotherapy care in the treatment of hip osteoarthritis. The trial, which was delivered in collaboration with University Hospitals Dorset, recruited 221 participants who were randomised to receive one of two interventions. Participants randomised to receive CHAIN attended a local leisure centre for one hour a week over eight weeks. In each session, they received 30 minutes of education from a physiotherapist on how to manage their arthritis, and a 30 minute cycling session, led by an exercise specialist. Participants randomised to the Physiotherapy group received usual care physiotherapy at their local hospital. To find out more information about the CLEAT trial, click <a href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/chain\/the-cleat-study\/\">here<\/a>.<\/p>\n<p>To hear what patients had to say about their experience of CHAIN, click <a href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/chain\/patient-testimonials\/\">here<\/a>.<\/p>\n<p>To see CHAIN in the media, click <a href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/media\/\">here<\/a>.<\/p>\n<p>A short YouTube video outlining the CHAIN programme &#8211;<\/p>\n<p><iframe loading=\"lazy\" title=\"The CHAIN (Cycling against Hip pAIN) Programme\" width=\"573\" height=\"430\" src=\"https:\/\/www.youtube.com\/embed\/djliEWY_VC0?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\n<h3>CHAIN Research<\/h3>\n<p><b>Since it\u2019s creation, a number of rigorous evaluations have demonstrated the efficacy of the CHAIN programme for improving function and pain in people with hip osteoarthritis. In addition, we have reported the methodology behind the design of the CHAIN programme and CLEAT trial. These reports are summarised below.<\/b><\/p>\n<div id=\"attachment_5405\" class=\"wp-caption alignright\">\n<p id=\"caption-attachment-5405\" class=\"wp-caption-text\">\n<\/div>\n<p><a href=\"https:\/\/www.thelancet.com\/journals\/lanrhe\/article\/PIIS2665-9913(25)00102-X\/fulltext\"><strong>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<\/strong><\/a><\/p>\n<p><em>July 2025 &#8211; The Lancet Rheumatology<\/em><\/p>\n<p>This article reports the findings from the CLEAT randomised controlled trial, comparing an eight-week cycling and education programme (CHAIN), run in groups at a local leisure centre, with usual one-to-one physiotherapy care at a local hospital, for people with hip osteoarthritis.<\/p>\n<p><a href=\"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-023-06456-0\" target=\"_blank\" rel=\"noopener\"><strong>CycLing and EducATion (CLEAT): protocol for a single centre randomised controlled trial of a cycling and education intervention versus standard physiotherapy care for the treatment of hip osteoarthritis<\/strong><\/a><\/p>\n<p><em>May 2023 \u2013 BMC Musculoskeletal Disorders<\/em><\/p>\n<p>The CHAIN (Cycling against Hip pAIN) intervention is a group cycling and education intervention conceived as a way of implementing the NICE guidance. CycLing and EducATion (CLEAT) is a pragmatic, two parallel arm, randomised controlled trial comparing CHAIN with standard physiotherapy care for the treatment of mild-to-moderate hip osteoarthritis. This article describes the protocol of the CLEAT study.<\/p>\n<p><strong><a href=\"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/2050312120946522\" target=\"_blank\" rel=\"noopener\">A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme<\/a><\/strong><\/p>\n<p><em>July 2020 \u2013 SAGE Open Medicine<\/em><\/p>\n<p>This article reports the findings from the second CHAIN programme, delivered in Bournemouth, Dorset between February 2018 and September 2019.<\/p>\n<p><a href=\"https:\/\/www.oarsijournal.com\/article\/S1063-4584(20)30786-X\/fulltext\" target=\"_blank\" rel=\"noopener\"><strong>What are the clinical, methodological, logistical and operational challenges when designing and conducting a randomised controlled trial of a group based intervention for the treatment of osteoarthritis and how can they be managed?<\/strong><\/a><\/p>\n<p><em>April 2020 \u2013 World Congress on Osteoarthritis<\/em><\/p>\n<p>This abstract reports some of the methodological challenges that should be considered in the design of randomised controlled trials of group based versus one-to-one interventions in the treatment of osteoarthritis.<\/p>\n<p><a href=\"https:\/\/www.mdpi.com\/2227-9032\/8\/1\/37\" target=\"_blank\" rel=\"noopener\"><strong>Self-management of hip osteoarthritis five years after a cycling and education treatment pathway<\/strong><\/a><\/p>\n<p><em>February 2020 \u2013 Healthcare<\/em><\/p>\n<p>This article reports the results from a cross-sectional survey, conducted to collect data from participants who completed the CHAIN programme between 2013 and 2015.<\/p>\n<p><a href=\"https:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/21679169.2017.1377764\" target=\"_blank\" rel=\"noopener\"><strong>Snapshot survey of physiotherapy practice for patients with hip osteoarthritis in the public sector<\/strong><\/a><\/p>\n<p><em>April 2017 \u2013 European Journal of Physiotherapy<\/em><\/p>\n<p>This online survey was conducted to gain a snapshot view of physiotherapy practice within the public sector in the UK.<\/p>\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1878124116300053\" target=\"_blank\" rel=\"noopener\"><strong>A cycling and education programme for the treatment of hip osteoarthritis: a quality improvement study<\/strong><\/a><\/p>\n<p><em>November 2016 \u2013 International Journal of Orthopaedic and Trauma Nursing<\/em><\/p>\n<p>This article reports the results of the first CHAIN programme, delivered from 2013 until 2015 at a leisure centre in Bournemouth, Dorset.<\/p>\n<p><a href=\"https:\/\/researchinvolvement.biomedcentral.com\/articles\/10.1186\/s40900-015-0013-8\" target=\"_blank\" rel=\"noopener\"><strong>More than just ticking a box\u2026how patient and public involvement improved the research design and funding application for a project to evaluate a cycling intervention for hip osteoarthritis<\/strong><\/a><\/p>\n<p><em>November 2015 \u2013 Research Involvement and Engagement<\/em><\/p>\n<p>This article reports how patients and members of the public were involved in the design of the CLEAT study, a randomised controlled trial comparing the CHAIN programme to standard care physiotherapy, in the treatment of hip osteoarthritis.<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25678618\" target=\"_blank\" rel=\"noopener\"><strong>Hip osteoarthritis: patients with complex comorbidities can make exceptional improvements following intensive exercise and education.<\/strong><\/a><\/p>\n<p><em>February 2015 \u2013 BMJ Case Reports<\/em><\/p>\n<p>This article reports the significant improvements experienced by a 71-year-old gentleman presenting with hip osteoarthritis, in addition to a complex range of comorbidities, after completing the CHAIN programme.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>CHAIN (Cycling against Hip pAIN) was conceived by Professor Robert Middleton and Professor Thomas Wainwright of the Orthopaedic Research Institute (ORI) at Bournemouth University, with the aim of promoting the self-management of osteoarthritic symptoms through lifestyle change. The programme is based on the latest National Institute for Health and Care Excellence (NICE) guidelines\u00a0for the treatment&#8230;  <a class=\"excerpt-read-more\" href=\"https:\/\/microsites.bournemouth.ac.uk\/ori\/chain-2\/\">Read more &raquo;<span class=\"sr-only\"> about CHAIN<\/span><\/a><\/p>\n","protected":false},"author":3924,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4685","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/pages\/4685","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/users\/3924"}],"replies":[{"embeddable":true,"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/comments?post=4685"}],"version-history":[{"count":14,"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/pages\/4685\/revisions"}],"predecessor-version":[{"id":6289,"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/pages\/4685\/revisions\/6289"}],"wp:attachment":[{"href":"https:\/\/microsites.bournemouth.ac.uk\/ori\/wp-json\/wp\/v2\/media?parent=4685"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}