Combining Exercise Training and Testosterone Therapy in Older Women After Hip Fracture Article Swipe
Ellen F. Binder
,
Jenna M. Bartley
,
Sarah D. Berry
,
Peter Doré
,
Steven R. Fisher
,
Richard H. Fortinsky
,
Camelia Guild
,
Douglas P. Kiel
,
George A. Kuchel
,
Robin L. Marcus
,
Christine M. McDonough
,
Kelly Monroe
,
Denise Orwig
,
Rocco A. Paluch
,
Dominic N. Reeds
,
Jennifer E. Stevens‐Lapsley
,
Elena Volpi
,
Kenneth B. Schechtman
,
Jay Magaziner
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1001/jamanetworkopen.2025.10512
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1001/jamanetworkopen.2025.10512
Importance Despite receiving postacute rehabilitation services, many older women with a recent hip fracture repair are unable to return to their prefracture level of function. Whether testosterone therapy can enhance recovery after hip fracture in older women with persistent mobility impairments has not been fully examined. Objective To evaluate the effects of a supervised exercise program combined with topical testosterone therapy on functional outcomes in older women with a recent hip fracture. Design, Setting, and Participants This phase 3 double-blind, placebo-controlled randomized clinical trial, Starting a Testosterone and Exercise Program After Hip Injury (STEP-HI), was conducted at 8 US sites between December 2018 and August 2023. Participants were women aged 65 years or older with a recent surgical repair of a nonpathologic femur fracture, met objective criteria for mobility impairment, and were community dwelling after discharge from rehabilitation. During the first 14 months of the trial, participants were randomly assigned to 1 of 3 treatment groups: exercise plus topical testosterone gel, exercise plus placebo gel, or enhanced usual care. Statistical analysis, using a modified intention-to-treat approach, was performed from November 2023 to November 2024. Interventions For 24 weeks, the 2 exercise groups underwent a supervised, multimodal high-intensity exercise program that included progressive resistance training with trained and certified exercise interventionists. Testosterone was provided in the form of a topical gel (generic 1.0% testosterone), and the placebo gel was chemically identical but without testosterone. The enhanced usual care group was prescribed a self-administered low-intensity home-based exercise program and a staff-led monthly health education session. Main Outcomes and Measures The primary outcome was the between-group difference in the change in the 6-minute walking distance (6MWD) from baseline to 24 weeks. Results Among the 129 women randomized (54 to the exercise plus testosterone group, 55 to the exercise plus placebo group, and 20 to the enhanced usual care group; mean [SD] age, 79.3 [8.4] years) included in the STEP-HI trial (122 (94.6%) provided primary outcome data for baseline and at least 1 time point (12 or 24 weeks). The mean (SD) change in the 6MWD between baseline and 24 weeks was not significantly different for exercise plus topical testosterone gel (n = 53; 42.7 [8.2] m) compared with exercise plus placebo gel (n = 51; 40.5 [8.4] m) and enhanced usual care (n = 18; 37.7 [14.8] m). Conclusions and Relevance In the STEP-HI randomized clinical trial, supervised exercise training combined with testosterone therapy conducted in older women recovering from a hip fracture did not lead to significant improvement in 6MWD compared with supervised exercise alone. Adding testosterone therapy to exercise may not provide further benefits for long-distance mobility. Whether it can improve physical performance and mobility for short distances in this patient population warrants further study. Trial Registration ClinicalTrials.gov Identifier: NCT02938923
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1001/jamanetworkopen.2025.10512
- https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2834116/binder_2025_oi_250373_1746730722.31834.pdf
- OA Status
- gold
- Cited By
- 4
- References
- 33
- Related Works
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- OpenAlex ID
- https://openalex.org/W4410398895
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4410398895Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1001/jamanetworkopen.2025.10512Digital Object Identifier
- Title
-
Combining Exercise Training and Testosterone Therapy in Older Women After Hip FractureWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-05-15Full publication date if available
- Authors
-
Ellen F. Binder, Jenna M. Bartley, Sarah D. Berry, Peter Doré, Steven R. Fisher, Richard H. Fortinsky, Camelia Guild, Douglas P. Kiel, George A. Kuchel, Robin L. Marcus, Christine M. McDonough, Kelly Monroe, Denise Orwig, Rocco A. Paluch, Dominic N. Reeds, Jennifer E. Stevens‐Lapsley, Elena Volpi, Kenneth B. Schechtman, Jay MagazinerList of authors in order
- Landing page
-
https://doi.org/10.1001/jamanetworkopen.2025.10512Publisher landing page
- PDF URL
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https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2834116/binder_2025_oi_250373_1746730722.31834.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2834116/binder_2025_oi_250373_1746730722.31834.pdfDirect OA link when available
- Concepts
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Medicine, Placebo, Physical therapy, Hip fracture, Testosterone (patch), Rehabilitation, Randomized controlled trial, Physical medicine and rehabilitation, Internal medicine, Osteoporosis, Alternative medicine, PathologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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4Total citation count in OpenAlex
- Citations by year (recent)
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2025: 4Per-year citation counts (last 5 years)
- References (count)
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33Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.multimodal | 195 |
| abstract_inverted_index.persistent | 38 |
| abstract_inverted_index.population | 450 |
| abstract_inverted_index.prescribed | 239 |
| abstract_inverted_index.randomized | 81, 283, 391 |
| abstract_inverted_index.recovering | 405 |
| abstract_inverted_index.resistance | 202 |
| abstract_inverted_index.supervised | 53, 394, 420 |
| abstract_inverted_index.Conclusions | 385 |
| abstract_inverted_index.Identifier: | 457 |
| abstract_inverted_index.NCT02938923 | 458 |
| abstract_inverted_index.Statistical | 169 |
| abstract_inverted_index.impairment, | 129 |
| abstract_inverted_index.impairments | 40 |
| abstract_inverted_index.improvement | 415 |
| abstract_inverted_index.performance | 441 |
| abstract_inverted_index.prefracture | 21 |
| abstract_inverted_index.progressive | 201 |
| abstract_inverted_index.significant | 414 |
| abstract_inverted_index.supervised, | 194 |
| abstract_inverted_index.Participants | 75, 106 |
| abstract_inverted_index.Registration | 455 |
| abstract_inverted_index.Testosterone | 86, 210 |
| abstract_inverted_index.participants | 146 |
| abstract_inverted_index.testosterone | 26, 59, 159, 289, 355, 399, 424 |
| abstract_inverted_index.Interventions | 184 |
| abstract_inverted_index.between-group | 262 |
| abstract_inverted_index.double-blind, | 79 |
| abstract_inverted_index.long-distance | 434 |
| abstract_inverted_index.low-intensity | 242 |
| abstract_inverted_index.nonpathologic | 121 |
| abstract_inverted_index.significantly | 349 |
| abstract_inverted_index.testosterone. | 232 |
| abstract_inverted_index.high-intensity | 196 |
| abstract_inverted_index.rehabilitation | 4 |
| abstract_inverted_index.testosterone), | 222 |
| abstract_inverted_index.rehabilitation. | 137 |
| abstract_inverted_index.interventionists. | 209 |
| abstract_inverted_index.self-administered | 241 |
| abstract_inverted_index.ClinicalTrials.gov | 456 |
| abstract_inverted_index.intention-to-treat | 174 |
| abstract_inverted_index.placebo-controlled | 80 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 97 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 19 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6100000143051147 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.99101995 |
| citation_normalized_percentile.is_in_top_1_percent | True |
| citation_normalized_percentile.is_in_top_10_percent | True |