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Sousa MV, Goethel M, Becker KM, Diefenthaeler F, Fernandes RJ, de Santana Toro Batista I, Vilas-Boas JP, Ervilha U. Effect of experimentally induced muscle pain on neuromuscular control of force production. Hum Mov Sci 2024; 95:103219. [PMID: 38636393 DOI: 10.1016/j.humov.2024.103219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE Neural and peripheral effects of induced muscle pain on explosive force production were investigated. METHODS Nine participants performed two maximal, six explosive, and six electrical stimulations induced (twitches and octets) isometric knee extensions before and after (15 min of rest) receiving an intramuscular injection of hypertonic saline (pain inducer) or isotonic (placebo) infusions in two laboratory visits separated by 7 days. RESULTS It was observed a reduction of peak torque production in maximal voluntary contraction in both conditions (9.3 and 3.3% for pain and placebo, respectively) and in the rate of torque development in placebo (7%). There was an increase in the rate of torque development for twitch and octets (10.5 and 15.8%, respectively) in the pain condition and peak torque for twitch (12%) in both conditions (as did the total rate of torque development for octets). CONCLUSION Force production decreases and increases during voluntary and involuntary contractions, respectively, suggesting that acute pain impairs force production via central mechanisms.
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Affiliation(s)
- Manoela Vieira Sousa
- Porto Biomechanics Laboratory, University of Porto, Porto 4200-450, Portugal; Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal.
| | - Márcio Goethel
- Porto Biomechanics Laboratory, University of Porto, Porto 4200-450, Portugal; Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| | - Klaus M Becker
- Porto Biomechanics Laboratory, University of Porto, Porto 4200-450, Portugal; Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| | - Fernando Diefenthaeler
- Biomechanics Laboratory, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Ricardo J Fernandes
- Porto Biomechanics Laboratory, University of Porto, Porto 4200-450, Portugal; Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| | - Isabella de Santana Toro Batista
- Laboratory of Physical Activity Sciences, School of Arts, Sciences, and Humanities, University of São Paulo, 03828-000 São Paulo, Brazil
| | - João Paulo Vilas-Boas
- Porto Biomechanics Laboratory, University of Porto, Porto 4200-450, Portugal; Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal
| | - Ulysses Ervilha
- Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto 4200-450, Portugal; Laboratory of Physical Activity Sciences, School of Arts, Sciences, and Humanities, University of São Paulo, 03828-000 São Paulo, Brazil
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Sato Y, Takanaka S, Izumi SI. Alteration of Interhemispheric Inhibition in Patients With Lateral Epicondylalgia. THE JOURNAL OF PAIN 2024; 25:104440. [PMID: 38065465 DOI: 10.1016/j.jpain.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024]
Abstract
Patients with lateral epicondylalgia (LE) show alterations in the primary motor cortex (M1) contralateral to the affected side. Cortical alterations have been investigated by measuring intracortical facilitation/inhibition; however, their association with pain remains controversial. Furthermore, no studies have investigated changes in interhemispheric inhibition (IHI). IHI can be assessed using the ipsilateral silent period (iSP) known as the temporary inhibition of electromyographic activity evoked by transcranial magnetic stimulation in the ipsilateral M1 of the contracting muscle. To better understand the relationship between cortical alterations and pain in LE, this observational study investigated the relationship between iSP and pain in LE. Twenty-seven healthy volunteers and 21 patients with LE were recruited. The duration of iSP in the extensor carpi radialis brevis was measured. The IHI asymmetry ratio was calculated to determine the IHI balance. Pain and disability were scored using the Japanese version of the patient-rated elbow evaluation. We observed increased inhibitory input from the ipsilateral M1 on the affected side to the contralateral M1 in LE. Additionally, the IHI balance correlated with pain severity. Hence, regulating imbalanced IHI can potentially decrease lateral elbow pain in LE. PERSPECTIVE: Patients with lateral epicondylalgia (LE) experience persistent pain and cortical alterations. However, there is no established relationship between cortical alterations and pain. This study demonstrated that the interhemispheric inhibition (IHI) balance is correlated with pain. Regulating imbalanced IHI can potentially decrease lateral elbow pain in patients with LE.
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Affiliation(s)
- Yosuke Sato
- Course of Rehabilitation, Department of Health Sciences, Tohoku Fukushi University, Aoba-ku, City, Miyagi, Japan; Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Shun Takanaka
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan; Graduate School of Biomedical Engineering, Tohoku University, Sendai City, Miyagi, Japan
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Suhood AY, Summers SJ, Opar DA, Astill T, An WW, Rio E, Cavaleri R. Bilateral Corticomotor Reorganization and Symptom Development in Response to Acute Unilateral Hamstring Pain: A Randomized, Controlled Study. THE JOURNAL OF PAIN 2024; 25:1000-1011. [PMID: 37907112 DOI: 10.1016/j.jpain.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/08/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
Accumulating evidence demonstrates that pain induces adaptations in the corticomotor representations of affected muscles. However, previous work has primarily investigated the upper limb, with few studies examining corticomotor reorganization in response to lower limb pain. This is important to consider, given the significant functional, anatomical, and neurophysiological differences between upper and lower limb musculature. Previous work has also focused on unilateral corticomotor changes in response to muscle pain, despite an abundance of literature demonstrating that unilateral pain conditions are commonly associated with bilateral motor dysfunction. For the first time, this study investigated the effect of unilateral acute hamstring pain on bilateral corticomotor organization using transcranial magnetic stimulation (TMS) mapping. Corticomotor outcomes (TMS maps), pain, mechanical sensitivity (pressure pain thresholds), and function (maximal voluntary contractions) were recorded from 28 healthy participants at baseline. An injection of pain-inducing hypertonic (n = 14) or pain-free isotonic (n = 14) saline was then administered to the right hamstring muscle, and pain ratings were collected every 30 seconds until pain resolution. Follow-up measures were taken immediately following pain resolution and at 25, 50, and 75 minutes post-pain resolution. Unilateral acute hamstring pain induced bilateral symptom development and changes in corticomotor reorganization. Two patterns of reorganization were observed-corticomotor facilitation and corticomotor depression. Corticomotor facilitation was associated with increased mechanical sensitivity and decreased function bilaterally (all P < .05). These effects persisted for at least 75 minutes after pain resolution. PERSPECTIVE: These findings suggest that individual patterns of corticomotor reorganization may contribute to ongoing functional deficits of either limb following acute unilateral lower limb pain. Further research is required to assess these adaptations and the possible long-term implications for rehabilitation and reinjury risk in cohorts with acute hamstring injury.
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Affiliation(s)
- Ariane Y Suhood
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Simon J Summers
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David A Opar
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia; School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Tom Astill
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Winko W An
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Ebonie Rio
- School of Allied Health, La Trobe University Melbourne, Melbourne, Victoria, Australia; The Victorian Institute of Sport, Albert Park, Victoria, Australia
| | - Rocco Cavaleri
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
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Paired corticomotoneuronal stimulation of the preactivated ankle dorsiflexor: an open-label study of magnetic and electrical painless protocols. Exp Brain Res 2023; 241:629-647. [PMID: 36637488 DOI: 10.1007/s00221-022-06534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 12/20/2022] [Indexed: 01/14/2023]
Abstract
Paired corticomotoneuronal stimulation (or electrical PCMS: ePCMS) is the repetitive pairing of an electrical stimulus to a nerve with a transcranial magnetic stimulation of the primary motor cortex (TMS-of-M1) to noninvasively influence spinal plasticity. We compared ePCMS with the new painless PCMS protocol pairing a magnetic stimulus to the nerve with TMS-of-M1 (mPCMS) in the preactivated tibial anterior muscle (TA). Sixteen healthy adults participated in two sessions (mPCMS, ePCMS), each with 180 pairs of [low-intensity TMS-of-M1 + nerve stimulation] at 0.2 Hz. TA motor-evoked potentials (MEP) to single-pulse TMS at pre-PCMS, immediately and 30 min after PCMS, were cluster-analyzed to discriminate responders and non-responders. Paired-pulse TMS-of-M1 and F-waves were also tested and BDNF polymorphism influence was explored. Both PCMS protocols significantly increased MEP amplitudes (n = 9 responders each), but the time-course differed with mPCMS inducing larger MEP increase over time. The number of BDNF-methionine carriers tended to be larger than Val66Val in mPCMS and the reverse in ePCMS, thus warranting further investigations. The MEP changes of the preactivated TA likely occurred at the pre-motoneuronal level and larger mPCMS after-effects over time may be related to the afferents recruited. mPCMS seems relevant to be tested in future studies as a painless noninvasive approach to induce sustained pre-motoneuronal plasticity in spinal cord injury.
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Mouth rinsing and ingesting salty or bitter solutions does not influence corticomotor excitability or neuromuscular function. Eur J Appl Physiol 2023; 123:1179-1189. [PMID: 36700971 DOI: 10.1007/s00421-023-05141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To explore the effect of tasting unpleasant salty or bitter solutions on lower limb corticomotor excitability and neuromuscular function. METHODS Nine females and eleven males participated (age: 27 ± 7 years, BMI: 25.3 ± 4.0 kg m-2). Unpleasant salty (1 M) and bitter (2 mM quinine) solutions were compared to water, sweetened water, and no solution, which functioned as control conditions. In a non-blinded randomized cross-over order, each solution was mouth rinsed (10 s) and ingested before perceptual responses, instantaneous heart rate (a marker of autonomic nervous system activation), quadricep corticomotor excitability (motor-evoked potential amplitude) and neuromuscular function during a maximal voluntary contraction (maximum voluntary force, resting twitch force, voluntary activation, 0-50 ms impulse, 0-100 impulse, 100-200 ms impulse) were measured. RESULTS Hedonic value (water: 47 ± 8%, sweet: 23 ± 17%, salt: 71 ± 8%, bitter: 80 ± 10%), taste intensity, unpleasantness and increases in heart rate (no solution: 14 ± 5 bpm, water: 18 ± 5 bpm, sweet: 20 ± 5 bpm, salt: 24 ± 7 bpm, bitter: 23 ± 6 bpm) were significantly higher in the salty and bitter conditions compared to control conditions. Nausea was low in all conditions (< 15%) but was significantly higher in salty and bitter conditions compared to water (water: 3 ± 5%, sweet: 6 ± 13%, salt: 7 ± 9%, bitter: 14 ± 16%). There was no significant difference between conditions in neuromuscular function or corticomotor excitability variables. CONCLUSION At rest, unpleasant tastes appear to have no influence on quadricep corticomotor excitability or neuromuscular function. These data question the mechanisms via which unpleasant tastes are proposed to influence exercise performance.
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Chowdhury NS, Chang WJ, Millard SK, Skippen P, Bilska K, Seminowicz DA, Schabrun SM. The Effect of Acute and Sustained Pain on Corticomotor Excitability: A Systematic Review and Meta-Analysis of Group and Individual Level Data. THE JOURNAL OF PAIN 2022; 23:1680-1696. [PMID: 35605763 DOI: 10.1016/j.jpain.2022.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
Pain alters motor function. This is supported by studies showing reduced corticomotor excitability in response to experimental pain lasting <90 minutes. Whether similar reductions in corticomotor excitability are present with pain of longer durations or whether alterations in corticomotor excitability are associated with pain severity is unknown. Here we evaluated the evidence for altered corticomotor excitability in response to experimental pain of differing durations in healthy individuals. Databases were systematically searched for eligible studies. Measures of corticomotor excitability and pain were extracted. Meta-analyses were performed to examine: (1) group-level effect of pain on corticomotor excitability, and (2) individual-level associations between corticomotor excitability and pain severity. 49 studies were included. Corticomotor excitability was reduced when pain lasted milliseconds-seconds (hedges g's = -1.26 to -1.55) and minutes-hours (g's = -0.55 to -0.9). When pain lasted minutes-hours, a greater reduction in corticomotor excitability was associated with lower pain severity (g = -0.24). For pain lasting days-weeks, there were no group level effects (g = -0.18 to 0.27). However, a greater reduction in corticomotor excitability was associated with higher pain severity (g = 0.229). In otherwise healthy individuals, suppression of corticomotor excitability may be a beneficial short-term strategy with long-term consequences. PERSPECTIVE: This systematic review synthesised the evidence for altered corticomotor excitability in response to experimentally induced pain. Reduced corticomotor excitability was associated with lower acute pain severity but higher sustained pain severity, suggesting suppression of corticomotor excitability may be a beneficial short-term adaptation with long-term consequences.
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Affiliation(s)
- Nahian S Chowdhury
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia
| | - Wei-Ju Chang
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Samantha K Millard
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia
| | - Patrick Skippen
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Katarzyna Bilska
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia
| | - David A Seminowicz
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland; Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, Maryland
| | - Siobhan M Schabrun
- Center for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia.
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Rohel A, Desmons M, Leonard G, Desgagnés A, da Silva R, Simoneau M, Mercier C, Massé-Alarie H. The influence of experimental low back pain on neural networks involved in the control of lumbar erector spinae muscles. J Neurophysiol 2022; 127:1593-1605. [PMID: 35608262 DOI: 10.1152/jn.00030.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) often modifies spine motor control, but the neural origin of these motor control changes remains largely unexplored. This study aimed to determine the impact of experimental low back pain on the excitability of cortical, subcortical, and spinal networks involved in the control of back muscles. METHOD Thirty healthy subjects were recruited and allocated to Pain (capsaicin and heat) or Control (heat) groups. Corticospinal excitability (motor-evoked potential-MEP) and intracortical networks were assessed by single- and paired-pulse transcranial magnetic stimulation, respectively. Electrical vestibular stimulation was applied to assess vestibulospinal excitability (vestibular MEP-VMEP), and the stretch reflex for excitability of the spinal or supraspinal loop (R1 and R2, respectively). Evoked back motor responses were measured before, during and after pain induction. Nonparametric rank-based ANOVA determined if pain modulated motor neural networks. RESULTS A decrease of R1 amplitude was present after the pain disappearance (p=0.01) whereas an increase was observed in the control group (p=0.03) compared to the R1 amplitude measured at pre-pain and pre-heat period, respectively (Group x Time interaction - p<0.001). No difference in MEP and VMEP amplitude was present during and after pain (p>0.05). CONCLUSION During experimental LBP, no change in cortical, subcortical, or spinal networks was observed. After pain disappearance, the reduction of the R1 amplitude without modification of MEP and VMEP amplitude suggest a reduction in spinal excitability potentially combined with an increase in descending drives. The absence of effect during pain needs to be further explored.
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Affiliation(s)
- Antoine Rohel
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Mikaël Desmons
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Guillaume Leonard
- Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Canada
| | - Amélie Desgagnés
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Rubens da Silva
- BioNR Research Lab, Université du Québec à Chicoutimi, Chicoutimi, Quebec, Canada
| | - Martin Simoneau
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Catherine Mercier
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Hugo Massé-Alarie
- Cirris research centre, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada.,Faculty of Medicine, Université Laval, Quebec City, Canada
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Neige C, Lebon F, Mercier C, Gaveau J, Papaxanthis C, Ruffino C. Pain, No Gain: Acute Pain Interrupts Motor Imagery Processes and Affects Mental Training-Induced Plasticity. Cereb Cortex 2021; 32:640-651. [PMID: 34313709 DOI: 10.1093/cercor/bhab246] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Pain influences both motor behavior and neuroplastic adaptations induced by physical training. Motor imagery (MI) is a promising method to recover motor functions, for instance in clinical populations with limited endurance or concomitant pain. However, the influence of pain on the MI processes is not well established. This study investigated whether acute experimental pain could modulate corticospinal excitability assessed at rest and during MI (Exp. 1) and limit the use-dependent plasticity induced by MI practice (Exp. 2). Participants imagined thumb movements without pain or with painful electrical stimulations applied either on digit V or over the knee. We used transcranial magnetic stimulation to measure corticospinal excitability at rest and during MI (Exp. 1) and to evoke involuntary thumb movements before and after MI practice (Exp. 2). Regardless of its location, pain prevented the increase of corticospinal excitability that is classically observed during MI. In addition, pain blocked use-dependent plasticity following MI practice, as testified by a lack of significant posttraining deviations. These findings suggest that pain interferes with MI processes, preventing the corticospinal excitability facilitation needed to induce use-dependent plasticity. Pain should be carefully considered for rehabilitation programs using MI to restore motor function.
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Affiliation(s)
- Cécilia Neige
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France
| | - Florent Lebon
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Laval University, Québec, QC G1M 2S8, Canada
| | - Jérémie Gaveau
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France
| | - Charalambos Papaxanthis
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France
| | - Célia Ruffino
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, F-21078 Dijon, France
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