# Enhancing modulation Effect of Baduanjin through Non-invasive Neuromodulation for knee Osteoarthritis

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $664,353

## Abstract

PROJECT SUMMARY
Knee osteoarthritis (KOA) is a common age-related disorder and a leading cause of long-term pain and
disability, for which there is a substantial therapeutic gap. Baduanjin (BDJ) is a unique mind-body exercise
consisting of eight movements that can be practiced at home with video guidance, thereby making it a suitable
option for older adults with KOA. Our recent study showed that BDJ can significantly reduce pain in patients
with KOA. However, responses to BDJ intervention are heterogeneous, and some individuals demonstrate only
a moderate response. Thus, there is an urgent need for mechanistic research to enhance the modulation effect
of this promising mind-body therapy.
One characteristic of BDJ is the practice of controlled fine body/limb movements and muscle and tendon
strengthening. This property suggests motor learning and control may play an important role in BDJ. Improving
motor performance should enhance the modulation effect of this promising mind-body intervention. The
primary motor cortex (M1) is the principal brain region of the motor system and integrates input from other
cortical brain areas to generate neural impulses that pass down the spinal cord and control the execution of
movement. Thus, M1 may play a crucial role in BDJ practice.
Transcranial direct current stimulation (tDCS) is a safe and clinically applicable neuromodulation tool that can
alter cortical excitability and has been used to investigate the causal relationship between brain and behavior.
Studies have shown that tDCS at M1 can facilitate motor performance. Thus, increasing the excitability of M1
using tDCS should be able to improve performance of BDJ, increasing its modulation effects. Furthermore, M1
is the most commonly used neuromodulation target for pain management. This proposal aims to investigate
whether we can enhance the modulation effects of BDJ mind-body intervention by enhancing the cortical
excitability of bilateral M1 using multifocal tDCS in patients with knee osteoarthritis. Specifically, we will
conduct a randomized study using a 2 x 2 factorial design in which 140 KOA patients will be randomized to one
of four groups: 1) BDJ + real tDCS, 2) BDJ + sham tDCS, 3) stretching + real tDCS, and 4) stretching + sham
tDCS. Multidisciplinary assessments will be evaluated at baseline and 12 weeks, with a follow-up at 24 weeks.
Our expected outcome is significant and highly innovative in that the findings obtained will lead to the
establishment of a new and clinically implementable treatment paradigm for KOA and be broadly applicable to
the management of chronic musculoskeletal pain.

## Key facts

- **NIH application ID:** 10898777
- **Project number:** 5R01AT012173-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** JIAN KONG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $664,353
- **Award type:** 5
- **Project period:** 2023-08-04 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10898777

## Citation

> US National Institutes of Health, RePORTER application 10898777, Enhancing modulation Effect of Baduanjin through Non-invasive Neuromodulation for knee Osteoarthritis (5R01AT012173-02). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10898777. Licensed CC0.

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