JAMA Netw Open

Does testosterone enhance mobility recovery after hip fracture in older women?

May 26, 2025

Combining testosterone therapy with supervised exercise doesn't provide additional benefits for long-distance mobility in older women recovering from hip fracture compared with exercise alone.

Study details: STEP-HI (NCT02938923) was a phase 3 double-blind, placebo-controlled randomized trial conducted at eight U.S. sites from December 2018 to August 2023. It included 129 women ≥65 years of age with recent surgical repair of a nonpathologic femur fracture and persistent mobility impairments. Participants were randomized into three groups: exercise plus topical testosterone gel, exercise plus placebo gel, and enhanced usual care. The exercise groups underwent a 24-week supervised, multimodal high-intensity exercise program, while the enhanced usual care group received a low-intensity home-based exercise program and monthly health education sessions. The primary outcome was the change in the 6-minute walking distance (6MWD) from baseline to 24 weeks.

Results: The mean change in 6MWD wasn't significantly different between the exercise plus testosterone group (42.7 m), the exercise plus placebo group (40.5 m), and the enhanced usual care group (37.7 m). The addition of testosterone therapy didn't result in a significant improvement in long-distance mobility compared with exercise alone.

Source:

Binder EF, et al. (2025, May 1). JAMA Netw Open. Combining Exercise Training and Testosterone Therapy in Older Women After Hip Fracture: The STEP-HI Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/40372752/