Pain relief for osteoarthritis through combined treatment (PROACT): Protocol for a randomized controlled trial of mindfulness meditation combined with transcranial direct current stimulation in non-Hispanic black and white adults with knee osteoarthritis.
Study Goal
The researchers aimed to determine whether combining mindfulness (Breathing and Attention Training) with transcranial direct current stimulation (tDCS) could enhance pain modulation, reduce clinical pain, and attenuate ethnic disparities in pain outcomes among adults with knee osteoarthritis.
Results Summary
The abstract does not report specific results, as the study is a proposed clinical trial. The outcomes to be measured include pain modulatory balance, pain-related brain function, clinical pain reduction, and ethnic differences in these effects.
Population
Non-Hispanic black (NHB) and non-Hispanic white (NHW) adults with knee osteoarthritis.
Effective Dosage
Not specified (intervention involves five 20-minute sessions of combined BAT and tDCS).
Duration
One week (five sessions).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) | increase | pain modulatory balance | NHBs and NHWs with knee OA | - | will test whether will enhance | #1 |
mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) | increase | pain-related brain function | NHBs and NHWs with knee OA | - | will test whether will enhance | #2 |
mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) | decrease | clinical pain | NHBs and NHWs with knee OA | - | will test whether will reduce | #3 |
mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) | decrease | ethnic differences | NHBs and NHWs with knee OA | - | will test whether will attenuate | #4 |
mindfulness and tDCS treatments | increase | additive or synergistic effects when combined | - | - | will determine whether will show | #5 |
mindfulness and tDCS treatments | neutral | across ethnic/race groups | - | - | will determine whether treatment effects differ | #6 |
Knee osteoarthritis (OA) is a leading cause of late life pain and disability, and non-Hispanic black (NHB) adults experience greater OA-related pain and disability than non-Hispanic whites (NHWs). Recent evidence implicates psychosocial stress, cognitive-attentional processes, and altered central pain processing as contributors to greater OA-related pain and disability among NHBs. To address these ethnic/race disparities, this clinical trial will test whether a mindfulness intervention (Breathing and Attention Training, BAT) combined with transcranial direct current stimulation (tDCS) will enhance pain modulatory balance and pain-related brain function, reduce clinical pain, and attenuate ethnic differences therein, among NHBs and NHWs with knee OA. Participants will complete assessments of clinical pain, function, psychosocial measures, and quantitative sensory testing (QST), including mechanical temporal summation and conditioned pain modulation. Neuroimaging will be performed to examine pain-related brain structure and function. Then, participants will be randomized to one of four groups created by crossing two BAT conditions (Real vs. Sham) with two tDCS conditions (Real vs. Sham). Participants will then undergo five treatment sessions during which the assigned BAT and tDCS interventions will be delivered concurrently for 20 min over one week. After the fifth intervention session, participants will undergo assessments of clinical pain and function, QST and neuroimaging identical to the pretreatment measures, and monthly follow-up assessments of pain will be conducted for three months. This will be the first study to determine whether mindfulness and tDCS treatments will show additive or synergistic effects when combined, and whether treatment effects differ across ethnic/race groups.