No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
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At a Glance
Age
50 – 95
Sex
Any
Trial phase
Early Phase 1
Study type
Interventional
Purpose
Treatment
Participants needed
30 (estimated)
Sponsor
University of California, Los Angeles · Other
Who this trial is looking for
This trial is looking for people aged 50 or older who have chronic knee pain and depression. Participants will attend Tai Chi sessions and receive rTMS treatment twice a week for three months.
Are You a Good Fit for This Trial?
Rules you outDementiaNeurological diseaseCancerCardiovascular diseaseMetabolic diseaseRenal diseaseLiver diseasePsychotic disorder
You may be able to join if
I am 50 years old or older.
I have chronic pain in my body for 6 months or more.
I have knee pain for at least 3 months on most days.
I have a pain interference score of 40 or higher.
I have internet access.
I can walk without assistance.
I have depression with a score over 20 on the Beck Depression Inventory.
I am willing to complete the 3-month study with follow-ups.
You may not be able to join if
I have changed my psychotropic or pain medication in the past four months.
I am currently diagnosed with mania, hypomania, or a psychotic disorder.
I have a serious medical condition like cancer or heart disease.
I cannot safely participate in moderate exercise.
I have had alcohol or drug dependence in the past three months.
I am currently practicing Tai Chi.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer three quick questions written from this study's own rules to see if you may qualify. No account needed to find out.
Osteoarthritis (OA) is a major public health problem, and involvement of the knee is especially disabling. Symptomatic knee OA has an incidence rate between 40 to 1,020 per 100,000 person years1 and is among the most common causes of disability worldwide. Knee arthritis pain and disability are highly comorbid wiht depression (30-50%). Currently available treatments offer only limited relief. The P…
Osteoarthritis (OA) is a major public health problem, and involvement of the knee is especially disabling. Symptomatic knee OA has an incidence rate between 40 to 1,020 per 100,000 person years1 and is among the most common causes of disability worldwide. Knee arthritis pain and disability are highly comorbid wiht depression (30-50%). Currently available treatments offer only limited relief. The Pilot project aims to establish feasibility of the rTMS neuromodulation of response to Tai Chi and improvement in pain and comorbid depression in patients with knee OA. There are several ways in which the pilot project will improve scientific knowledge, and clinical practice: 1) The sequential stimulation of two targets (M1 and l-DLPFC) has not been systematically examined for the treatment of comorbid MDD and knee OA. We hypothesize that using a multi-target rTMS strategy combining M1 and l-DLPFC- active targets will be well tolerated and more effective to treat comorbid symptoms than single site rTMS to M1+l-DLPFCsham. This hypothesis will be tested in Aim 1 of this proposal by comparing two experimental conditions: A) M1active and l-DLPFCactive; and B) M1active and l-DLPFCsham. 2) Identifying the relationship between improvement in pain and depression to improvement in pro-inflammatory cytokines would be novel. Adding an rTMS as a neuromodulation technique with novel stimulation sites to assist in the reduction of symptoms of pain and depression is another scalable to clinical use opportunity that will provide pilot data for future clinical trials. We will perform a pilot feasibility trial of rTMS for those presenting with knee osteoarthritis related pain and moderate to severe depression in 30 volunteers who are undergoing Tai Chi intervention. Tolerability and safety of rTMS added to Tai Chi will be assessed along with changes in symptoms of pain and depression, in preparation to future R-01 applications.
Trial Locations
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Eligibility Criteria
Inclusion Criteria:
* • Age 50 or years older.
* Chronic pain as indicated by complaints of pain in one or more body regions for 6 months or more. Participants who meet at least one of the following criteria for Osteoarthritis (OA)
* Fulfills the American College of Rheumatology (ACR) crite…
Inclusion Criteria:
* • Age 50 or years older.
* Chronic pain as indicated by complaints of pain in one or more body regions for 6 months or more. Participants who meet at least one of the following criteria for Osteoarthritis (OA)
* Fulfills the American College of Rheumatology (ACR) criteria for symptomatic knee OA and had radiographic evidence of tibiofemoral or patellofemoral OA (defined as the presence of a definite osteophyte in the tibiofemoral compartment and/or the patellofemoral compartment.
* Knee pain for \>- 3 months and on most days of the past month
* Patient PROMIS Pain Interference score \>=40 (100 mm VAS);
* Access to computer or device for telehealth delivery;
* Able to walk without cane or assistance.
* Psychological distress expressed as depression: Persistent depressive symptomatology (Beck Depression Inventory)\>20 in two consecutive screenings within 2-3 weeks.
* Willingness to complete the 3-month study, including twice-a-week Tai Chi sessions and rTMS, with additional 6 and 12 month follow up
* Approval to participate in program by patient's primary care provider or another member of their medical team (e.g. cardiologist).
* Ability to pass the Physical Activity Readiness Questionnaire (PAR-Q) administered in the telephone screening.
* Internet access \>No contraindications to rTMS
Exclusion Criteria:
* • Change in psychotropic or pain medication during the past four months. This will minimize the amount of symptom change due to medication alterations.
* A current diagnosis of mania, hypomania, unstable bipolar disorder, psychotic disorder or a history of psychosis, as noted in electronic medical record.
* Dementia, neurological disease, cancer, cardiovascular disease, metabolic disease, renal disease, liver disease, or other serious medical conditions limiting ability to participate in the Tai Chi or Exercise programs, as determined by primary care physicians.
* No current medical conditions that limit ability to participate safely in moderate exercise.
* Meets criteria for alcohol or drug dependence within the past three months.
* Currently practicing Tai Chi
Contacts
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