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Lyu H, Cao X, Wang J. Comparative Effects of Fatiguing Exercise on Anticipatory and Compensatory Postural Adjustments between Trained and Untrained Individuals. Life (Basel) 2024; 14:943. [PMID: 39202685 PMCID: PMC11355520 DOI: 10.3390/life14080943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/06/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024] Open
Abstract
This study evaluates the effects of general fatiguing exercises on anticipatory postural adjustments (APAs), compensatory postural adjustments (CPAs), and standing stability between 18 individuals with comprehensive training experience (TR) and 18 untrained individuals (UT). Assessments were conducted before and after a 20-min fatiguing exercise using surface electromyography and a force platform during self-initiated perturbation and postural stability tests. Key findings include that, irrespective of fatigue, the APAs onsets in the TrA/IO (p = 0.004), LMF (PRE p = 0.003, POST p < 0.001), and ST (PRE p = 0.001, POST p = 0.006) muscles activated earlier in the TR group than in the UT group. Additionally, the APA co-contraction indices of the TrA/IO-LMF (PRE p = 0.011, POST p = 0.029), TrA/IO-ST (p = 0.014), and LMF-ST (PRE p = 0.002, POST p = 0.005) muscle pairs were higher in the TR group. After fatigue, the UT group significantly increased CPA co-contraction indices for the TrA/IO-LMF (p = 0.035) and LMF-ST (p = 0.005) muscle pairs. This research highlights the importance of comprehensive training in facilitating feedforward control strategies, particularly for individuals facing challenging postural conditions, such as fatigue or disturbances.
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Affiliation(s)
- Hui Lyu
- Ningbo Innovation Center, Zhejiang University, Ningbo 315100, China;
| | - Xueying Cao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Jian Wang
- Department of Sports Science, Zhejiang University, Hangzhou 310058, China
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Moon SH, Doshi KB, Lockhart T. Assessing fall risk in osteoporosis patients: a comparative study of age-matched fallers and nonfallers. Front Digit Health 2024; 6:1387193. [PMID: 39049820 PMCID: PMC11266042 DOI: 10.3389/fdgth.2024.1387193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/20/2024] [Indexed: 07/27/2024] Open
Abstract
This study aimed to investigate sway parameters and physical activity level of the age/gender-matched older adults with osteoporosis faller and nonfaller patients. By examining these factors, our objective was to understand how these faller and nonfaller groups with osteoporosis differed particularly in terms of balance capabilities and their impact on physical activity levels. We recruited 24 patients with osteoporosis: 12 who reported a fall within a year before recruitment (fallers) and 12 without falls (nonfallers). Given the close association between biochemical markers of musculoskeletal health such as serum calcium, parathyroid hormone (PTH), Vitamin D, and renal function, we compared these markers in both groups. As a result, elderly individuals with osteoporosis and with a history of falls within the preceding year indicated significantly higher sway velocity (P = 0.012*), sway area (P < 0.001*), and sway path length (P = 0.012*). Furthermore, fallers had significantly lower calcium (P = 0.02*) and Parathyroid hormone (PTH) (P = 0.02*), as well as higher Alkaline Phosphatase (ALP) (P = 0.02*) as compared to nonfallers despite similar vitamin D and creatinine levels. In conclusion, diminished biochemical factors in the osteoporosis faller group could possibly cause postural instability resulting in lower physical activity levels in the osteoporosis fall group and increasing the risk of falls.
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Affiliation(s)
- Seong Hyun Moon
- Locomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Krupa B. Doshi
- Division of Endocrinology, Mayo Clinic, Scottsdale, AZ, United States
| | - Thurmon Lockhart
- Locomotion Research Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
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Hejazi HS, Khanmohammadi R, Olyaei G, Qanbari S. The effects of combining sensorimotor training with transcranial direct current stimulation on the anticipatory and compensatory postural adjustments in patients with chronic low back pain. Disabil Rehabil 2024:1-13. [PMID: 38982892 DOI: 10.1080/09638288.2024.2375756] [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: 11/06/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE To investigate the effects of concurrent sensorimotor training (SMT) and transcranial direct current stimulation (tDCS) on the anticipatory and compensatory postural adjustments (APAs and CPAs) in patients with chronic low back pain (CLBP). METHOD The interventions included (1) SMT plus tDCS and (2) SMT plus sham tDCS. Outcome measures were the normalized integrals of electromyography activity (NIEMG) during the phases of anticipatory and compensatory, and muscle onset latency. The investigated muscles were ipsilateral and contralateral multifidus (MF), transversus abdominus/internal oblique (TrA/IO), and gluteus medius (GM). RESULTS Between-group comparisons demonstrated that ipsilateral TrA/IO NIEMG during CPA1 (p = 0.010) and ipsilateral GM NIEMG during CPA1 (p = 0.002) and CPA2 (p = 0.025) were significantly lower in the SMT combined with tDCS than in the control group. Furthermore, this group had greater NIEMG for contralateral GM during APA1 than the control group (p = 0.032). Moreover, the onset latency of contralateral TrA/IO was significantly earlier after SMT combined with tDCS (p = 0.011). CONCLUSIONS Both groups that received SMT showed positive effects, but anodal tDCS had an added value over sham stimulation for improving postural control strategies in patients with CLBP. Indeed, SMT combined with tDCS leads to stronger APA and less demand for CPA. RCT REGISTRATION NUMBER IRCT20220228054149N1. REGISTRATION DATE 2022-04-04.
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Affiliation(s)
- Hanie Sadat Hejazi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Olyaei
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Qanbari
- Physical Therapy Department, Tehran University of Medical Sciences, Tehran, Iran
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Muthukrishan R, Badr Ul Islam FM, Shanmugam S, Arulsingh W, Gopal K, Kandakurti PK, Rajasekar S, Malik GS, S G G. Perturbation-based Balance Training in Adults Aged Above 55 Years with Chronic Low Back Pain: A Comparison of Effects of Water versus Land Medium - A Preliminary Randomized Trial. Curr Aging Sci 2024; 17:156-168. [PMID: 38111118 DOI: 10.2174/0118746098254991231125143735] [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: 03/31/2023] [Revised: 07/16/2023] [Accepted: 10/23/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND 'Rapid balance reaction' or 'perturbation' training is an emerging paradigm in elderly back pain rehabilitation due to its connection to postural stability. OBJECTIVE This study aimed to inform the feasibility and practicality of perturbation-based balance training (PBT) using a stratification approach and to determine the effectiveness of land versus water-based PBT in elderly individuals with chronic low back pain (CLBP). METHODS Elderly CLBP participants (n=24) received exercise interventions as per treatmentbased classification (TBC) and were randomly allotted into water-based perturbation exercises (WBPE, Mean age=63.0±2.6years, n=12) and land-based perturbation exercise group (LBPE, 62.3±2.6 years, n=12). Pain intensity, disability, scores of fear-avoidance beliefs, fall efficacy, and rate of perceived exertion (RPE) were assessed before and at the end of 6 weeks. RESULTS WBPE group reported a significant reduction in pain score (median difference(MD)):2, p<0.03), fear avoidance behaviour for work (MD:9, p<0.01) and fear avoidance behaviour for physical activity (MD:10, p< 0.05), improved straight leg raise right (SLR) (MD:37.5°, p<0.05), and improved modified fall efficacy scores (MFES, MD:25, p<0.05) compared to the LBPE group at post-intervention. Within-group analysis in both groups revealed significant improvement in clinical outcomes except for fear-avoidance beliefs related to physical activity in the LBPE group. Subgroup analysis revealed that the high BMI elderly CLBP group of LBPE had significant improvements similar to the WBPE group except for scores of FABQ physical activity scores and SLR. CONCLUSION Possible key factors for future research are discussed in the realms of perturbation exercise in the elderly with CLBP.
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Affiliation(s)
| | | | - Sukumar Shanmugam
- Department of Physiotherapy, Gulf Medical University, Ajman, United Arab Emirates
| | - Watson Arulsingh
- Department of Physiotherapy, Gulf Medical University, Ajman, United Arab Emirates
| | | | | | - Sannasi Rajasekar
- Srinivas College of Physiotherapy and Research Centre, Karnataka, 575001, India
| | - Gulshan Shahzadi Malik
- Thumbay Physical Therapy and Rehabilitation Hospital, Ajman, United Arab Emirates
- Khalifa Hospital, Umm Al Quwain, United Arab Emirates
| | - Geovinson S G
- Thumbay Physical Therapy and Rehabilitation Hospital, Ajman, United Arab Emirates
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Ehsani F, Masoudi M, Hedayati R, Jaberzadeh S. Transcranial direct current stimulation over dorsolateral prefrontal cortex improves postural stability in non-specific chronic low back pain patients with high fear of pain: A randomized sham-controlled trial. Eur J Neurosci 2023; 58:3315-3329. [PMID: 37519282 DOI: 10.1111/ejn.16090] [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: 04/29/2022] [Revised: 05/14/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023]
Abstract
Deficits in postural stability in response to environmental challenges are seen in chronic low back pain (CLBP) patients with high fear of pain (HFP). Hence, it is essential to follow effective approaches to treat postural stability deficits and improve the health status of these patients. The current study aimed to compare the effects of cathodal and anodal transcranial direct current stimulation (c-tDCS and a-tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on postural stability in non-specific CLBP patients with HFP. In this randomized clinical trial study, 75 patients were randomly assigned to left DLPFC a-tDCS, left DLPFC c-tDCS and sham stimulation groups (n = 25 in each group). All groups received a single-session 2 mA tDCS for 20 min, but the stimulation was slowly turned off after 30 s in the sham group. Before, immediately, 24 h and 1 week after the interventions, postural stability indices were assessed using a Biodex Balance System. A significant reduction in most indices was shown in both a-tDCS and c-tDCS groups after interventions (immediately, 24 h and 1 week follow-up) during static and dynamic postural tasks compared with the sham tDCS group (p < .01). In addition, some tests showed a significant difference between a-tDCS and c-tDCS (p < .05). The findings indicated positive effects of both a-tDCS and c-tDCS on the left DLPFC, with more efficacy of a-tDCS on postural stability in LBP patients with HFP.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mona Masoudi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity, Department of Physiotherapy, Nursing and Health Sceinces, Monash University, Melbourne, Australia
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Nishi Y, Osumi M, Morioka S. Anticipatory postural adjustments mediate the changes in fear-related behaviors in individuals with chronic low back pain. Scand J Pain 2023; 23:580-587. [PMID: 36437116 DOI: 10.1515/sjpain-2022-0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/10/2022] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The role(s) of anticipatory postural adjustments (APAs) in changes in subsequent motor and postural controls in response to movement perturbations are unclear in individuals with chronic low back pain (CLBP). This study aimed to clarify the relationships among kinesiophobia, APAs, lumbar kinematic output, and postural control associated with lumbar movement in individuals with CLBP. METHODS CLBP participants (n=48) and healthy controls (HCs) without CLBP (n=22) performed a bend-forward task using their lumbar region on a force platform and returned upright. Each participant's lumbar movements were recorded using an electrogoniometer. We calculated the APA duration, the duration of lumbar direction changes from forward to backward, and the center of pressure (COP) position after lumbar movement tasks completion. RESULTS Compared with the HCs, the duration of direction changes in lumbar movement and the APA duration in CLBP participants were prolonged, and the COP position was shifted forward. The mediation analysis revealed that the duration of lumbar direction changes in the CLBP group was subjected to a significant indirect effect of APAs and a direct effect of kinesiophobia, and the COP position was subjected to a significant indirect effect of kinesiophobia through APAs. CONCLUSIONS APAs partially mediate the relationship between kinesiophobia and changes in lumbar motor control and mediate the relationship between kinesiophobia and postural control in response to movement perturbations. These findings expand our understanding of APAs in altered subsequent movement and postural controls due to kinesiophobia in individuals with CLBP.
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Affiliation(s)
- Yuki Nishi
- Institute of Biomedical Sciences (Health Sciences) , Nagasaki University , Nagasaki, Japan
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Michihiro Osumi
- Neurorehabilitation Research Center, Kio University, Nara, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara, Japan
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Funao H, Igawa T, Matsuzawa M, Isogai N, Ishii K. Comparative Study of Anticipatory Postural Adjustments between Normal and Cervical Myelopathy Patients. J Clin Med 2023; 12:jcm12103584. [PMID: 37240690 DOI: 10.3390/jcm12103584] [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: 04/26/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Patients with cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament have been considered to be prone to falls due to lower extremity dysfunction and gait instability. Anticipatory postural adjustments (APAs) are unconscious muscular activities to counterbalance perturbation. To date, there are no reports on APAs in cervical myelopathy patients, and quantification of postural control remains difficult. Thirty participants were enrolled, of which 15 were cervical myelopathy patients and 15 were normal age- and sex-matched controls. A three-dimensional motion capture system with force plates was used, and the APA phase was defined as the time between start of movement at the center of pressure and heel-off of the step leg. The APA phase (0.47 vs. 0.39 s, p < 0.05) and turning time (2.27 vs. 1.83 s, p < 0.01) were significantly longer, whereas step length tended to be shorter (305.18 vs. 361.04 mm, p = 0.06) in cervical myelopathy patients. There was a significant correlation between Japanese Orthopaedic Association lower extremity motor dysfunction scores and step length (p < 0.01). Cervical myelopathy patients are prone to falls due to longer APA phases with shorter step lengths. Analysis of the APA phase aids the visualization and quantification of postural control during initial gait in cervical myelopathy patients.
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Affiliation(s)
- Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Chiba 286-0124, Japan
| | - Tatsuya Igawa
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan
| | - Masaru Matsuzawa
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi 324-8501, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Tokyo 108-8329, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
- Society for Minimally Invasive Spinal Treatment (MIST), Tokyo 101-0063, Japan
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Postural Adjustments in HTLV-1 Infected Patients during a Self-Initiated Perturbation. Viruses 2022; 14:v14112389. [PMID: 36366487 PMCID: PMC9695886 DOI: 10.3390/v14112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 (HTLV-1) infection can be associated with tropical spastic paraparesis (TSP/HAM), which causes neurological myelopathy and sensory and muscle tone alterations, leading to gait and balance impairments. Once trunk perturbation is predicted, the motor control system uses anticipatory and compensatory mechanisms to maintain balance by recruiting postural muscles and displacement of the body's center of mass. METHODS Twenty-six participants (control or infected) had lower limb muscle onset and center of pressure (COP) displacements assessed prior to perturbation and throughout the entire movement. RESULTS Semitendinosus (ST) showed delayed onset in the infected group compared to the control group. The percentage of trials with detectable anticipatory postural adjustment was also lower in infected groups in the tibialis anterior and ST. In addition, COP displacement in the infected group was delayed, had a smaller amplitude, and took longer to reach the maximum displacement. CONCLUSIONS HTLV-1 infected patients have less efficient anticipatory adjustments and greater difficulty recovering their postural control during the compensatory phase. Clinical assessment of this population should consider postural stability during rehabilitation programs.
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Quijoux F, Nicolaï A, Chairi I, Bargiotas I, Ricard D, Yelnik A, Oudre L, Bertin‐Hugault F, Vidal P, Vayatis N, Buffat S, Audiffren J. A review of center of pressure (COP) variables to quantify standing balance in elderly people: Algorithms and open-access code. Physiol Rep 2021; 9:e15067. [PMID: 34826208 PMCID: PMC8623280 DOI: 10.14814/phy2.15067] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Postural control is often quantified by recording the trajectory of the center of pressure (COP)-also called stabilogram-during human quiet standing. This quantification has many important applications, such as the early detection of balance degradation to prevent falls, a crucial task whose relevance increases with the aging of the population. Due to the complexity of the quantification process, the analyses of sway patterns have been performed empirically using a number of variables, such as ellipse confidence area or mean velocity. This study reviews and compares a wide range of state-of-the-art variables that are used to assess the risk of fall in elderly from a stabilogram. When appropriate, we discuss the hypothesis and mathematical assumptions that underlie these variables, and we propose a reproducible method to compute each of them. Additionally, we provide a statistical description of their behavior on two datasets recorded in two elderly populations and with different protocols, to hint at typical values of these variables. First, the balance of 133 elderly individuals, including 32 fallers, was measured on a relatively inexpensive, portable force platform (Wii Balance Board, Nintendo) with a 25-s open-eyes protocol. Second, the recordings of 76 elderly individuals, from an open access database commonly used to test static balance analyses, were used to compute the values of the variables on 60-s eyes-open recordings with a research laboratory standard force platform.
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Affiliation(s)
- Flavien Quijoux
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- ORPEA GroupPuteauxFrance
| | - Alice Nicolaï
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Ikram Chairi
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Groupe MSDAUniversité Mohammed VI PolytechniqueBenguerirMaroc
| | - Ioannis Bargiotas
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Damien Ricard
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Service de Neurologie de l’Hôpital d’Instruction des Armées de PercySSAClamartFrance
- Ecole du Val‐de‐GrâceEcole de Santé des ArméesParisFrance
| | - Alain Yelnik
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- PRM DepartmentGH Lariboisière F. WidalAP‐HPUniversité de ParisUMR 8257ParisFrance
| | - Laurent Oudre
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | | | - Pierre‐Paul Vidal
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
- Institute of Information and ControlHangzhou Dianzi UniversityZhejiangChina
| | - Nicolas Vayatis
- Centre Borelli UMR 9010/Université Paris‐SaclayENS Paris‐SaclayCNRSSSA, InsermUniversité de ParisParisFrance
| | - Stéphane Buffat
- Laboratoire d’accidentologie de biomécanique et du comportement des conducteursGIE Psa Renault GroupesNanterreFrance
| | - Julien Audiffren
- Department of NeuroscienceUniversity of FribourgFribourgSwitzerland
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