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A randomized trial of a digitally delivered, home-based neuromodulation and mindfulness intervention for pain management in older adults with knee osteoarthritis
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  • Published: 31 March 2026

A randomized trial of a digitally delivered, home-based neuromodulation and mindfulness intervention for pain management in older adults with knee osteoarthritis

  • Juyoung Park1,2,
  • Chiyoung Lee1,
  • Lifeng Lin3,
  • Mindy J. Fain4,5,
  • Ilknur Telkes6,
  • Stephen Dahmer7,
  • Lindsey Park1,
  • Jason Hoang1,
  • Hongyu Miao8,9,10 &
  • …
  • Hyochol Ahn1 

npj Digital Medicine , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research
  • Neuroscience

Abstract

Knee osteoarthritis (OA) is a major cause of chronic pain and disability in older adults, yet scalable home-based interventions remain limited, partly due to the lack of clinically effective digital solutions. This study is the first fully powered randomized, double-blind, sham-controlled trial to test a digitally delivered, home-based protocol combining transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM) for knee OA pain. A total of 208 participants were randomized to active tDCS + MBM, active tDCS + sham MBM, sham tDCS + active MBM, or double sham; they completed ten 20-min sessions over 2 weeks. Knee pain intensity was measured at baseline, post treatment, and monthly for 3 months. Although both active tDCS groups improved, the difference between the combined tDCS + MBM intervention and tDCS alone was not statistically significant. Benefits were not sustained at 3 months. These findings offer the first evidence that a remotely supervised, digitally delivered tDCS + MBM intervention can rapidly reduce knee OA pain, supporting future personalized and extended treatment studies. Clinical trial registration: ClinicalTrials.gov NCT04375072 (registered May 7, 2020).

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Data availability

All data supporting the findings of this study are summarized in this published article. Requests for additional de-identified data will be reviewed by the corresponding author on a case-by-case basis and may require institutional and ethical approval.

Code availability

No custom code was used in this study.

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Acknowledgements

We thank Dr. Alejandro Chaoul for his valuable contributions as a consultant on the meditation component of this project. His expertise in mind -body practices informed the development and implementation of the intervention. This work was supported by the National Institute of Nursing Research (R01 NR019051-01, 2020 -2025; R01NR019051-03S1, 2022 -2025), the National Institute on Aging (R03 AG093555-01, 2025 -2027), and the University of Arizona College of Nursing.

Author information

Authors and Affiliations

  1. The University of Arizona College of Nursing, Tucson, AZ, USA

    Juyoung Park, Chiyoung Lee, Lindsey Park, Jason Hoang & Hyochol Ahn

  2. Department of Electrical & Computer Engineering, The University of Arizona College of Engineering, Tucson, AZ, USA

    Juyoung Park

  3. Department of Epidemiology and Biostatistics, The University of Arizona College of Public Health, Tucson, AZ, USA

    Lifeng Lin

  4. Geriatrics and Palliative Medicine, The University of Arizona College of Medicine, Division of General Internal Medicine, Tucson, AZ, USA

    Mindy J. Fain

  5. University of Arizona Center on Aging, Tucson, AZ, USA

    Mindy J. Fain

  6. Department of Neurosurgery, The University of Arizona College of Medicine, Tucson, AZ, USA

    Ilknur Telkes

  7. Andrew Weil Center for Integrative Medicine, The University of Arizona, Tucson, AZ, USA

    Stephen Dahmer

  8. College of Nursing, Florida State University, Tallahassee, FL, USA

    Hongyu Miao

  9. Department of Statistics, Florida State University, Tallahassee, FL, USA

    Hongyu Miao

  10. Department of Computer Science, Florida State University, Tallahassee, FL, USA

    Hongyu Miao

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Contributions

J.P. designed the study, developed the research questions, and drafted the manuscript. C.L. reviewed and edited the full manuscript, with particular attention to statistical analysis and reporting of results. L.L., M.J.F., I.T., S.D., L.P., and J.H. reviewed the draft and provided constructive feedback throughout the revision process. H.M. conducted the data analyses and contributed to the statistical interpretation and reporting of findings. HA contributed to the study design, conceptual framework, and secured the R01 funding that supported the project.

Corresponding author

Correspondence to Juyoung Park.

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Park, J., Lee, C., Lin, L. et al. A randomized trial of a digitally delivered, home-based neuromodulation and mindfulness intervention for pain management in older adults with knee osteoarthritis. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-02577-7

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  • Received: 07 August 2025

  • Accepted: 14 March 2026

  • Published: 31 March 2026

  • DOI: https://doi.org/10.1038/s41746-026-02577-7

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