Effects of Music During Walking on Pain and Muscle Activation in People With Chronic Pain Due to Knee Osteoarthritis

Effects of Music-Based Rhythmic Auditory Stimulation During Walking on Nociceptive Signaling and Muscle Activation in People With Chronic Pain Due to Knee Osteoarthritis

The purpose of this research study is to compare muscle activation, changes in pain sensitivity, and brain function, between different walking conditions, including walking to music, walking to metronome, and walking without music or metronome.

Study Overview

• Status: Not yet recruiting
• Conditions: Knee Osteoarthritis
• Intervention / Treatment: Behavioral: Rhythmic Auditory Stimulation with music; Behavioral: Rhythmic Auditory Stimulation with metronome; Behavioral: Control

Detailed Description

Participants with knee osteoarthritis (OA) will complete a single study visit which will include three walking tasks, each being 25 minutes in duration. The walking tasks will include walking without music or metronome, walking to metronome, and walking with music. Participants muscle activity, brain activity, and movements will be recorded during these tasks. Participant's pressure pain threshold will be recorded at the beginning and after each task.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Deepak Kumar, PT, PhD; Phone Number: 617-358-3037; Email: kumard@bu.edu
• Study Contact Backup: Name: Yiwen Yang, DPT; Email: ywyang@bu.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Have activity related pain
• Experience morning knee stiffness ≤ 30 minutes
• Knee pain on most days for 3 months or more
• Able to walk at least 20 minutes with assistance
• Average overall knee pain severity of ≥= 4 on a 11-point numeric rating scale during previous week
• BMI ≤ 40
• Able to communicate using English at a level to understand the study procedures and informed consent

Exclusion Criteria:

• Contraindications to exercise
• Joint replacement in either hip, knee, or ankle
• History of other disease that may involve the index joint including inflammatory joint disease such as rheumatoid arthritis, seronegative spondyloarthropathy (eg, ankylosing spondylitis, psoriatic arthritis, inflammatory bowel disease related arthropathy), crystalline disease (eg, gout or pseudogout), lupus erythematosus, knee joint infections, Paget's disease affecting the knee, or knee joint tumors.
• Previous knee osteotomy in either knee
• Other health conditions that impact motor functioning or prevent participation (e.g., stroke, Parkinson's disease, Alzheimer's disease, Multiple Sclerosis, diabetic neuropathy, etc.)
• Corticosteroid or hyaluronic acid injections in either knee in the previous 3 months
• Pregnancy (self-report)
• Suspected or known drugs or alcohol abuse
• Mini-mental State Examination (MMSE) score < 24
• Hearing impairments
• Pain in lower back or legs that is greater than knee pain

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Rhythmic auditory stimulation during walking; All participants will be exposed to different walking conditions including music, metronome, and no music or metronome	Behavioral: Rhythmic Auditory Stimulation with music; Walking to rhythmic Auditory Stimulation with music; Behavioral: Rhythmic Auditory Stimulation with metronome; walking to rhythmic Auditory Stimulation with metronome; Behavioral: Control; Walking to no music or metronome

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exercise-Induced Hypoalgesia (EIH)	Change in pressure pain threshold (PPT) from baseline to after each walking task	Baseline
medial quadriceps - medial hamstrings muscle coactivation	Medial quadriceps-medial hamstrings muscle co-activation in each walking task will be assessed using surface electromyography	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Medial quadriceps- medial gastrocnemius muscle coactivation	Medial quadriceps-medial gastrocnemius muscle co-activation in each walking task will be assessed using surface electromyography	Baseline
lateral quadriceps- lateral hamstrings muscle coactivation	Lateral quadriceps-lateral hamstrings muscle co-activation in each walking task will be assessed using surface electromyography	Baseline
lateral quadriceps - lateral gastrocnemius muscle coactivation	Lateral quadriceps-lateral gastrocnemoius muscle co-activation in each walking task will be assessed using surface electromyography	Baseline

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Auditory-motor synchronization	difference between actual cadence and target cadence in each walking ask (except walking to no music or metronome)	Baseline
physical activity enjoyment	Modified Physical Activity Enjoyment Scale (PACES) score after each walking task. Range is 7-49 with higher scores indicating greater enjoyment.	Baseline
Prefrontal cortex activation	Prefrontal cortex (PFC) brain activation during each walking task will be assessed using functional near-infrared spectroscopy (fNIRS)	Baseline
Supplementary Motor Area activation	Supplementary Motor Area (SMA) brain activation during each walking task will be assessed using functional near-infrared spectroscopy (fNIRS)	Baseline

Collaborators and Investigators

• Sponsor: Boston University Charles River Campus
• Investigators: Principal Investigator: Deepak Kumar, PT, PhD, Boston University Charles River Campus

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): July 1, 2027

Study Registration Dates

• First Submitted: April 6, 2026
• First Submitted That Met QC Criteria: April 12, 2026
• First Posted (Actual): April 17, 2026

Study Record Updates

• Last Update Posted (Actual): April 22, 2026
• Last Update Submitted That Met QC Criteria: April 17, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: music; knee pain; rhythmic auditory stimulation
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee
• Other Study ID Numbers: 8399

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Requests will be considered on an individual basis

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No