{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:39:07Z","timestamp":1781278747198,"version":"3.54.1"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,1,26]]},"abstract":"<jats:p>A 71-year-old man presenting with hip osteoarthritis, with a complex range of comorbidities was referred by his general practitioner to CHAIN (Cycling against Hip PAIN), a 6\u2005week programme developed to aid self-management of hip osteoarthritis through exercise, education and advice, as defined by the National Institute for Health and Care Excellence (NICE) guidelines. Significant improvements were seen in Oxford hip score, the Hip disability and Osteoarthritis Outcome Score (HOOS) \u2013 function score, sit-to-stand test, timed up and go test, pain scores and hip flexion. There was also a weight loss of 2.1\u2005kg. The man reported \u2018an amazing difference\u2019 in his affected hip and leg, and improved fitness. Many clinicians would have questioned the man's suitability for the programme due to his coexisting medical conditions. This case study shows that patients may be much more able than we think to achieve significant improvement with exercise.<\/jats:p>","DOI":"10.1136\/bcr-2014-208529","type":"journal-article","created":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T16:45:40Z","timestamp":1423759540000},"page":"bcr2014208529","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Hip osteoarthritis: patients with complex comorbidities can make exceptional improvements following intensive exercise and education"],"prefix":"10.1136","volume":"2015","author":[{"given":"Thomas William","family":"Wainwright","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tikki","family":"Immins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Gordon","family":"Middleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,2,12]]},"reference":[{"key":"2025042705203551000_2015.feb12_1.bcr2014208529.1","unstructured":"Arthritis Research UK. Osteoarthritis in general practice. Data and perspectives. Chesterfield: Arthritis Research UK, 2013."},{"key":"2025042705203551000_2015.feb12_1.bcr2014208529.2","unstructured":"National Institute for Health and Care Excellence (NICE). Osteoarthritis. Care and management in adults. NICE Clinical Guideline 177. http:\/\/www.nice.org.uk\/guidance\/CG177 (accessed 26 Jun 2014)."},{"key":"2025042705203551000_2015.feb12_1.bcr2014208529.3","first-page":"CD007912","article-title":"Exercise for osteoarthritis of the hip","volume":"4","author":"Fransen","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2025042705203551000_2015.feb12_1.bcr2014208529.4","doi-asserted-by":"publisher","DOI":"10.1179\/1743288X12Y.0000000056"},{"key":"2025042705203551000_2015.feb12_1.bcr2014208529.5","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1392-8"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-208529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:20:47Z","timestamp":1745756447000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-208529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,12]]},"references-count":5,"alternative-id":["10.1136\/bcr-2014-208529"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-208529","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,12]]}}}