Exercise for Hip Arthritis Has Modest Impact; PT Homework Skipped by Most; Rehab Access Unequal
A Cochrane review finds exercise for hip osteoarthritis reduces pain by 7 points on a 100-point scale, below the 12-point threshold for noticeable benefit. A survey shows 76% of physical therapy patients skip home exercises, citing forgetfulness and time constraints. A study reports only 22% of stroke and brain injury survivors receive intensive inpatient rehab, with disparities by race, insurance, and income.
A new evidence review concludes that exercise provides only modest pain relief for hip osteoarthritis, likely not enough for patients to notice a meaningful difference in their daily lives. Meanwhile, a national survey finds that more than three in four physical therapy patients fail to complete their prescribed home exercises, and a study shows that only 22% of stroke and brain injury survivors receive intensive inpatient rehabilitation.
The review, published July 22 in the Cochrane Database of Systematic Reviews, analyzed 18 clinical trials involving nearly 1,400 people aged 53 to 74. Exercise programs tested included strength training, aerobics, and mind-body practices like yoga. Compared to no treatment or usual care, exercise likely reduces pain by around 7 points on a 100-point scale. However, an improvement of at least 12 points is needed for patients to perceive a meaningful benefit. Results may be inflated because participants self-reported their pain and function. Researchers emphasize that exercise is still recommended as a primary treatment and provides broad health benefits beyond pain relief, with little risk of harm. They call for larger, better-designed trials to identify which patients and exercise types yield the most benefit.
A separate survey from the Ohio State University Wexner Medical Center, conducted in September 2025 among 1,006 Americans, found that only 24% of patients assigned physical therapy exercises at home complete all of them. Another 28% complete more than three-quarters, while 27% do half to three-quarters, 11% do a quarter to half, 8% do less than a quarter, and 2% do none. Older adults are more adherent: 30% of those 65 and older complete all homework versus 12% of those under 30. Common reasons for non-completion include forgetting (40%), lack of time or scheduling conflicts (33%), finding exercises boring (22%), not seeing quick results (19%), and experiencing pain or fear of making things worse (18%). Physical therapists note that the one to three hours per week spent in clinic are insufficient without at-home follow-through.
Research published June 10 in Neurology Open Access examined health records from 2016–2019 across five states and found that only 22% of nearly 445,000 adults hospitalized for stroke, traumatic brain injury, or spinal cord injury were discharged to inpatient rehabilitation facilities, which provide more than three hours of daily therapy. Among stroke patients, just 22% received such care; for brain injury, 14%; and for spinal cord injury, 44%. The study also uncovered disparities: Black patients had 29% higher odds of inpatient rehab compared to home discharge versus white patients, but 10% lower odds when compared to skilled nursing facilities after excluding home discharges. Those with private insurance had 35% lower odds than Medicare beneficiaries, and residents of high-income areas had 12% lower odds than those from lower-income areas. Researchers stress the need for equitable access to intensive rehabilitation to improve long-term outcomes.