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This scoping review aimed to synthetize personal and environmental facilitators and barriers to participation in physical activities among youths living with cerebral palsy.A systematic literature search was performed in five databases: CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane, WEB OF SCIENCE. The studies were selected by two independent researchers based on inclusion and exclusion criteria. A semi-quantitative evaluation assessed the consistency of results for a given variable. Variables displaying consistent associations were classified based on the Physical Activity for people with Disability Model.The electronic search yielded 10 795 articles, of which 57 were included. The main barriers to physical activity identified were motor impairments (30 studies), older age (15 studies), pain (6 studies), attendance in regular school (6 studies), and communication problems (4 studies). Barriers such as upper limb impairment and visual deficit were less frequently studied, while cognitive attributes, adapted physical environments and positive attitude, and family support were identified as facilitators.Personal and environmental factors influencing physical activities behaviors among youths living with cerebral palsy are multiple and complex since they interact with each other. Rehabilitation interventions need to adopt a person-based approach to address barriers and reinforce facilitators.IMPLICATIONS FOR REHABILITATION:Physical activity participation among youths with cerebral palsy is a multidimensional phenomenon, dependent on different personal and environmental factors.Gross motor impairments, communication problems, and pain were the most common personal factors limiting physical activity participation.Environmental factors consistently associated with physical activity participation were school settings, physical environment such as transportation, and social and family support and attitude.Rehabilitation interventions to promote an active lifestyle should consider not only personal factors but their interaction with the child's environment.

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. 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. A decrease of R1 amplitude was present after the pain disappearance (

The Children's Assessment of Participation and Enjoyment (CAPE) is the most widely used questionnaire for the assessment of children participation. While several cultural adaptations and translations exist, the quality of the methods used to produce them, as well as their psychometric properties, remains unclear. The aim of this systematic review was to evaluate the different translated and/or culturally adapted versions of the CAPE for children and youth with and without disabilities.A search was performed in five electronic databases CINAHL (EBSCO), MEDLINE (OVID), EMBASE (ELSEVIER), PSYCINFO (OVID), and WEB OF SCIENCE Core Collection (CLARIVATE), for articles available in French or English with the last update in July 2022. All studies related to a cultural adaptation and/or translation of the CAPE were retained and evaluated based on established guidelines for cross-cultural adaptations and measurement properties. The extraction was done independently by two authors. A critical appraisal of translation and psychometric properties methods was performed. Critical appraisal of the articles was done using the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures tool and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology.The search identified 642 studies (321 duplicates removed), 16 of which underwent full-text review. Nine studies met all inclusion criteria and underwent analysis. According to the recommended steps for cross-cultural adaptations, one study performed 100% of the steps and two others performed 80%. None of the studies met all the recommendations for the evaluation of psychometric properties. A full evaluation of reliability and internal consistency were reported by 74% of studies. None of the studies reported a full evaluation of responsiveness, agreement and/or construct validity.This review demonstrated limitations in the robustness of the methods used to develop and evaluate translated and culturally adapted versions of CAPE. To ensure valid and reliable results when conducting future research using the CAPE, it is recommended to fully evaluate the psychometric properties of the existing versions and to produce other translated and culturally adapted versions of the questionnaire.

The corticospinal tract has been shown to be involved in normal walking in humans. However, its contribution during more challenging locomotor tasks is still unclear. As the corticospinal tract can be a potential target to promote gait recovery after neurological injury, it is of primary importance to quantify its use during human walking. The aims of the current study were to: (1) quantify the effects of precision walking on corticospinal excitability as compared to normal walking; (2) assess if corticospinal modulation is related to task difficulty or participants’ performance. Sixteen healthy participants walked on a treadmill during 2 tasks: regular walking (simple task) and stepping onto virtual targets (precision task). Virtual targets appeared randomly at 3 different step lengths: preferred, and ±20%. To assess corticospinal excitability, 25 motor evoked potentials (MEPs) were recorded from the tibialis anterior muscle in each task during walking. Performance for each participant (global success score; % of target hit) and task difficulty related to step length adjustments (success score for each step length) were also calculated. MEP size was larger during the precision task in all participants (mean increase of 93% ± 72%; P .05). In conclusion, corticospinal excitability exhibits a large increase during the precision task. This effect needs to be confirmed in neurological populations to potentially provide a simple and non-invasive approach to increase corticospinal drive during gait rehabilitation.

International audience; In epidemiology, left-truncated data may bias exposure effect estimates. We analyzed the bias induced by left truncation in estimating breast cancer risk associated with exposure to airborne dioxins. Simulations were run with exposure estimates from a Geographic Information System (GIS)-based metric and considered two hypotheses for historical exposure, three scenarios for intra-individual correlation of annual exposures, and three exposure-effect models. For each correlation/model combination, 500 nested matched case–control studies were simulated and data fitted using a conditional logistic regression model. Bias magnitude was assessed by estimated odds-ratios (ORs) versus theoretical relative risks (TRRs) comparisons. With strong intra-individual correlation and continuous exposure, left truncation overestimated the Beta parameter associated with cumulative dioxin exposure. Versus a theoretical Beta of 4.17, the estimated mean Beta (5%; 95%) was 73.2 (67.7; 78.8) with left-truncated exposure and 4.37 (4.05; 4.66) with lifetime exposure. With exposure categorized in quintiles, the TRR was 2.0, the estimated ORQ5 vs. Q1 2.19 (2.04; 2.33) with truncated exposure versus 2.17 (2.02; 2.32) with lifetime exposure. However, the difference in exposure between Q5 and Q1 was 18× smaller with truncated data, indicating an important overestimation of the dose effect. No intra-individual correlation resulted in effect dilution and statistical power loss. Left truncation induced substantial bias in estimating breast cancer risk associated with exposure with continuous and categorical models. With strong intra-individual exposure correlation, both models detected associations, but categorical models provided better estimates of effect trends. This calls for careful consideration of left truncation-induced bias in interpreting environmental epidemiological data.

BACKGROUND AND OBJECTIVE Pain influences motor control. Previous reviews observed that pain reduces the excitability of corticospinal projections to muscles tested with transcranial magnetic stimulation. However, the independent effect of the type of pain models (tonic, phasic), pain location and tissues targeted (e.g. muscle, skin) remains unexplored. The objective of this review was to determine the influence of experimental pain and of different methodological factors on the corticospinal excitability. DATABASES AND DATA TREATMENT Three electronic databases were searched: Embase, Pubmed and Web of Science. Meta-analyses were conducted in three consecutive steps to reduce methodological variability: (a) all studies; (b) same pain location; (c) same tissues, pain location and muscle state. Strength of evidence was assessed for each analysis performed. RESULTS Forty studies were included in the review and 26 in the meta-analysis as it focused only on studies using tonic pain. Overall, there was conflicting/moderate evidence of a diminution of corticospinal excitability during and after tonic pain. When considering only pain location, tonic hand and face pain induced a reduction in corticospinal excitability (limited evidence). Both muscle and cutaneous hand pain reduced corticospinal excitability (limited/conflicting evidence). Similar results were observed for phasic pain (limited evidence). CONCLUSIONS Our results confirm the inhibitory effect of pain on corticospinal excitability for both tonic and phasic pain. This reduction was specific to hand and face pain. Also, both cutaneous and muscle hand pain reduced excitability. The strength of evidence remains limited/conflicting. More high-quality studies are needed to confirm our conclusions. SIGNIFICANCE This study adds evidence on the effect of specific factors on the modulation of corticospinal excitability during/after experimental pain. The reduction in corticospinal excitability was driven by hand and face pain. We confirmed previous results that muscle pain reduces corticospinal excitability and provided evidence of a similar effect for cutaneous pain. Both models may inform on the influence of different types of pain on motor control. Future studies are needed to determine the origin of the effect of pain.

Physical interactions within virtual environments are often limited to visual information within a restricted workspace. A new system exploiting a cable-driven parallel robot to combine visual and haptic information related to environmental physical constraints (e.g. shelving, object weight) was developed. The aim of this study was to evaluate the impact on user movement patterns of adding haptic feedback in a virtual environment with this robot. Twelve healthy participants executed a manual handling task under three conditions: 1) in a virtual environment with haptic feedback; 2) in a virtual environment without haptic feedback; 3) in a real physical environment. Temporal parameters (movement time, peak velocity, movement smoothness, time to maximum flexion, time to peak wrist velocity) and spatial parameters of movement (maximum trunk flexion, range of motion of the trunk, length of the trajectory, index of curvature and maximum clearance from the shelf) were analysed during the reaching, lowering and lifting phases. Our results suggest that adding haptic feedback improves spatial parameters of movement to better respect the environmental constraints. However, the visual information presented in the virtual environment through the head mounted display appears to have an impact on temporal parameters of movement leading to greater movement time. Taken together, our results suggest that a cable-driven robot can be a promising device to provide a more ecological context during complex tasks in virtual reality.

Nombreuses sont les recherches développées en sciences de gestion pour permettre aux grandes entreprises d’appréhender le risque à l’international et d’identifier le mode d’entrée le plus approprié pour pénétrer un marché étranger. En revanche à ce jour, il n’existe pas de cadre théorique ni de méthodologie adaptée aux petites et moyennes entreprises (PME) pour le faire. Or, pour les PME, la bonne connaissance des risques à l’international et le choix du mode d’entrée sont particulièrement importants, car une erreur de décision peut remettre en cause la pérennité de l’entreprise. Ainsi, dans le prolongement des recherches sur le choix du mode d’entrée dépendant du degré d’engagement souhaité et de contrôle voulu par la PME, nous intégrerons le risque perçu par le dirigeant. L’objectif de cet article est de développer un cadre d’analyse global et systémique qui permettrait d’aider les PME et de les conseiller pour optimiser le choix de leur mode d’entrée dans les marchés étrangers., Many analyses are developed in Management Science to help large corporations anticipate international risks and identify the best ways to penetrate a foreign market. Today, there are no theoretical cases or methodologies that allow small and medium-sized companies to enter these markets or predict risks correlated to their implementation. However, for SMEs, gaining knowledge on international risks and different implementation strategies is particularly important because an error can rapidly jeopardize the company’s performance. Thus, in the continuation of the research on the entry mode code depending on the degree of desired engagement and control wanted by the SME, we will integrate the risk perceived by the company’s executive. The objective of this article is to develop a global and systemic framework for analysis that would help SMEs and advise them to optimize the choice of their entry modes into foreign markets., Muchas investigaciones se desarrollan en Ciencias de gestion para permitir a las grandes empresas entender el riesgo a nivel internacional e identificar el modo de entrada más adecuado para ingresar a un mercado extranjero. Sin embargo, hasta la fecha, no existe un marco teórico o metodología adaptada a las pequeñas y medianas empresas (PyME) para hacerlo. Sin embargo, para las PyME, un buen conocimiento de los riesgos internacionales y la elección del modo de entrada son particularmente importantes porque un error de decisión puede poner en peligro la durabilidad de la empresa. Por lo tanto, en la continuación de la investigación sobre la elección del modo de entrada en función del grado deseado de compromiso y control deseado por la PyME, integraremos el riesgo percibido por el líder. El objetivo de este artículo es desarrollar un marco global y sistémico para el análisis que ayude a las PyME y aconsejarles que optimicen la elección de su modo de entrada en los mercados extranjeros.

BackgroundThe COVID-19 pandemic and the isolation measures taken to control it has caused important disruptions in economies and labour markets, changed the way we work and socialize, forced schools to close and healthcare and social services to reorganize in order to redirect resources on the pandemic response. This unprecedented crisis forces individuals to make considerable efforts to adapt and can have serious psychological and social consequences that are likely to persist once the pandemic has been contained and restrictive measures lifted. These impacts will be significant for vulnerable individuals and will most likely exacerbate existing social and gender health and social inequalities. This crisis also puts a toll on the capacity of our healthcare and social services structures to provide timely and adequate care. In order to minimize these consequences, there is an urgent need for high-quality, real-time information on the psychosocial impacts of the pandemic. The MAVIPAN (Ma vie et la pandémie/My life with the pandemic) study aims to document how individuals, families, healthcare workers, and health organisations that provide services are affected by the pandemic and how they adapt.MethodsThe MAVIPAN study is a 5-year longitudinal prospective cohort study that was launched on April 29th, 2020 in the province of Quebec which, at that time, was the epicenter of the pandemic in Canada. Quantitative data is collected through online questionnaires approximately 5 times a year depending on the pandemic evolution. Questionnaires include measures of health, social, behavioral and individual determinants as well as psychosocial impacts. Qualitative data will be collected with individual and group interviews that seek to deepen our understanding of coping strategies.DiscussionThe MAVIPAN study will support the healthcare and social services system response by providing the evidence base needed to identify those who are most affected by the pandemic and by guiding public health authorities’ decision making regarding intervention and resource allocation to mitigate these impacts. It is also a unique opportunity to advance our knowledge on coping mechanisms and adjustment strategies.Trial registrationNCT04575571 (retrospectively registered)

Cystic fibrosis-related diabetes (CFRD) is a common complication of cystic fibrosis (CF), and restoring metabolic control in these patients may improve their management after lung transplantation. In this multicenter, prospective, phase 1-2 trial, we evaluate the feasibility and metabolic efficacy of combined pancreatic islet-lung transplantation from a single donor in patients with CFRD, terminal respiratory failure, and poorly controlled diabetes. Islets were infused via the portal vein under local anesthesia, 1 week after lung transplantation. At 1 year, the primary outcome was transplant success as evaluated by a composite score including four parameters (weight, fasting glycemia, HbA1c, and insulin requirements). Ten participants (age: 24 years [17-31], diabetes duration: 8 years [4-12]) received a combined islet-lung transplant with 2892 IEQ/kg [2293-6185]. Transplant success was achieved in 7 out of 10 participants at 1-year post transplant. Fasting plasma C-peptide increased from 0.91 μg/L [0.56-1.29] to 1.15 μg/L [0.77-2.2], HbA1c decreased from 7.8% [6.5-8.3] (62 mmol/mol [48-67]) to 6.7% [5.5-8.0] (50 mmol/mol [37-64]), with 38% decrease in daily insulin doses. No complications related to the islet injection procedure were reported. In this pilot study, combined pancreatic islet-lung transplantation restored satisfactory metabolic control and pulmonary function in patients with CF, without increasing the morbidity of lung transplantation.

International audience; The purpose of this study is to determine the moderating effects of team cohesion and knowledge sharing on the performance of teams that utilise empowering leadership using a multiple regression analysis on a sample from three departments within 114 family firms in Lebanon. The results suggest that there is a significant relationship between empowering leadership and team cohesion and that knowledge sharing and team cohesion have an indirect influence on team performance. Our study provides important insights regarding team cohesion and knowledge sharing in empowering leadership practices in the Middle East. More importantly, our paper underlines how critical team performance is by highlighting the fact that a willingness to share skills, expertise and know-how benefits all team members and groups of a department or managerial structure. Group cohesiveness is crucial for a leader and for a firms management team and team performance.

The scholars provide numerous findings on the process of firm internationalization. However, there remains still a research gap in understanding the process of internationalization of niche SMEs, despite their strategic interest in France. The paper investigates the entry modes of SMEs to international markets and provides a deeper insight into the internationalization process by using an abductive exploratory approach. The results show hybrid forms of internationalization that traditional internationalization models only partially take into account. Badania naukowe dostarczają wielu wniosków na temat procesu internacjonalizacji firm. Jednak nadal istnieje luka badawcza w zrozumieniu procesu internacjonalizacji MŚP działających na niszowych rynkach, pomimo ich strategicznego zainteresowania we Francji. W artykule przedstawiono proces internacjonalizacji tych firm. Eksploracyjne badanie abdukcyjne zostało podjęte w celu zidentyfikowania odmienności w procesach internacjonalizacji małych i średnich firm w porównaniu do klasycznych form tego procesu. Uzyskane wyniki pokazują podejście hybrydowe w formach internacjonalizacji, które tradycyjne modele internacjonalizacji uwzględniają jedynie częściowo.

Background The 3D printing technology allows to produce custom shapes and add functionalities to foot orthoses which offers better options for the treatment of flatfeet. This study aimed to assess the effect of 3D printed foot orthoses stiffness and/or a newly design posting on muscle activity, plantar pressures, and center of pressure displacement in individuals with flatfeet. Methods Nineteen individuals with flatfeet took part in this study. Two pairs of foot orthoses with different stiffness were designed for each participant and 3D printed. In addition, the flexible foot orthoses could feature an innovative rearfoot posting. Muscle activity, plantar pressures, and center of pressure displacement were recorded during walking. Findings Walking with foot orthoses did not alter muscle activity time histories. Regarding plantar pressures, the most notable changes were observed in the midfoot area, where peak pressures, mean pressures and contact area increased significantly during walking with foot orthoses. The latter was reinforced by increasing the stiffness. Concerning the center of pressure displacement, foot orthoses shifted the center of pressure forward and medially at early stance. At the end of the stance phase, a transition of the center of pressure in posterior direction was observed during the posting condition. No effect of stiffness was observed on center of pressure displacement. Interpretation The foot orthoses stiffness and the addition of posting influenced plantar pressures during walking. The foot orthoses stiffness mainly altered the plantar pressures under the midfoot area. However, posting mainly acted on peak and mean pressures under the rearfoot area.

Adults living with cerebral palsy (CP) report bimanual and unimanual difficulties that interfere with their participation in activities of daily living (ADL). There is a lack of quantitative methods to assess the impact of these motor dysfunctions on the relative use of each arm. The objective of this study was to evaluate the concurrent and discriminative validity of accelerometry-based metrics when used to assess bimanual and unimanual functions. Methods: A group of control subjects and hemiplegic adults living with CP performed six ADL tasks, during which they were wearing an Actigraph GT9X on each wrist and being filmed. Four bimanual and unimanual metrics were calculated from both accelerometry-based and video-based data; these metrics were then compared to one other with an intraclass correlation coefficient (ICC). Some of these metrics were previously validated in other clinical population, while others were novel. The discriminative validity was assessed through comparisons between groups and between tasks. Results: The concurrent validity was considered as good to excellent (ICC = 0.61–0.97) depending on the experience of the raters. The tasks made it possible to discriminate between groups. Conclusion: The proposed accelerometry-based metrics are a promising tool to evaluate bimanual and unimanual functions in adults living with CP.

Introduction/Background* In patients with gestational trophoblastic tumors (GTT) with a FIGO score ≥ 7, or GTT resistant to both standard monotherapies, the recommended polychemotherapy regimen is EMA-CO. In case of resistance to polychemotherapy, the prognosis is poor. The anti-PD-L1 monoclonal antibody avelumab may be effective for GTT resistant to monochemotherapy (You et al JCO 2020). The efficacy data of avelumab in patients with GTT resistant to polychemotherapy enrolled in cohort B of TROPHIMMUN trial (NCT03135769) are presented. Methodology In cohort B, patients with GTT resistant to polychemotherapy received avelumab 10 mg/kg Q2W until hCG normalization, and for 3 additional cycles thereafter. The primary endpoint was the rate of patients with hCG normalization, following a 2-step Simon design. The cohort was closed prematurely for futility. Result(s)* 2017-2020 : seven patients were treated with the French Gestational Trophoblastic Center (median age was 37 ; choriocarcinoma: 4; placental-site: 1; epithelioid: 1; other: 1) ; stage I/III: 43%/57%; FIGO score 8-10: 43%; score 11-15: 57%. Patients had experienced previous failures to monochemotherapy (n=5), pelvis surgery (n=2), and polychemotherapy (EMA-CO, n=5; EMA-EP, n=1; TP/TE, n=1; APE; n=1). They received a median of 6 avelumab cycles (range: 3-13). Six (85.7%) patients achieved initial hCG stabilization/decline, and one patient (14.2%) had successful hCG normalization after 13 cycles. Another patient experienced favorable hCG decline, but avelumab was discontinued for hemostatic hysterectomy, followed by sustained hCG normalization. The 5 other patients (71.4%) experienced hCG re-increase suggesting avelumab resistance, including two patients who developed brain hemorrhage after 4 cycles (brain metastases in one patient; arteriovenous malformation in one patient who died). The 4 remaining patients were subsequently treated with hysterectomy, other polychemotherapy, including high-dose/bone-marrow-transplant for two; pembrolizumab for one (who died). Conclusion* TROPHIMMUN is the first trial of immunotherapy in GTT. Contrarily to avelumab suggested effectiveness in patients with monotherapy resistance (Cohort A), avelumab activity was limited in patients with polychemotherapy resistance. Despite initial changes in hCG kinetics in most patients, eventual hCG normalization was rare (14%). The prognosis of patients experiencing polychemotherapy resistance remains poor. Combination treatments with immunotherapy should be considered.

À travers l’étude de cas longitudinale de la start-up française 1083 qui fabrique et vend des jeans et des chaussures « made in France », nous cherchons à savoir comment l’appel à la foule peut impacter un processus effectual de création et de développement d’une entreprise. Pour cela, nous définissons les motivations de l’appel à la foule lors des phases de création, puis de développement de l’entreprise. Nous analysons également les conséquences de l’appel à la foule sur la gestion de l’entreprise. Nous identifions ainsi deux nouvelles raisons qui ont motivé l’entreprise à avoir recours à la foule : l’éducation des consommateurs et l’influence que l’entreprise peut exercer sur ses partenaires. Nos résultats montrent qu’il existe un lien étroit entre la logique effectuale de création et de développement d’une entreprise et le recours à la foule. D’une part, ces deux phénomènes se renforcent mutuellement et d’autre part, le processus d’effectuation impose une coconstruction du projet entrepreneurial avec plusieurs parties prenantes. Nous observons aussi que, même si la foule participe à la création de valeur pour l’entreprise, son implication peut devenir contraignante pour le dirigeant., Through the longitudinal case study of the French startup 1083 which manufactures and sells jeans and shoes “Made in France” and which adopted an effectual logic during its creation, we seek to answer the following question: how can the crowdsourcing impact an effectual process of creating and developing a business? For that, we first define the motivations of the crowdsourcing during the creation stage, then during the development of the company, but also we analyze the consequences of crowdsourcing on the company’s management. We identify two new reasons that motivated the company for crowdsourcing: consumer education and the influence the company can have on its partners. We also show that there is a close link between the effectual logic of creating and developing a business and crowdsourcing. On the one hand, these two phenomena reinforce each other and on the other hand, the process of carrying out imposes a coconstruction of the entrepreneurial project with several stakeholders. We also find that, even if the crowd participates in the creation of value for the company, the consequences of its involvement can become binding for the manager., A través del estudio del caso longitudinal de la startup francesa 1083 que fabrica y comercializa tejanos y calzado «made in France» y que adoptó una lógica de efectuación durante su creación, deseamos responder a la siguiente pregunta ¿Cómo puede el atractivo del público impactar en un proceso efectivo de creación y desarrollo de un negocio? Para eso, primero definimos las motivaciones de la participación colectiva durante la fases de creación, luego el desarrollo de la empresa, también analizamos las consecuencias de la participación colectiva en la gestión de la empresa. Identificamos dos nuevas razones que motivaron a la compañía a usar al público: la educación del consumidor y la influencia que la compañía puede ejercer sobre sus socios. Demostramos que existe un fuerte vínculo entre la lógica real de creación y desarrollo de una empresa y el uso de la multitud. Por un lado, estos dos fenómenos se refuerzan mutuamente y, por otro lado, el proceso de efectuación requiere una co-construcción del proyecto emprendedor con varias partes interesadas. Encontramos que, incluso si la participación colectiva en la creación de valor para la empresa, las consecuencias de la implicación de ésta pueden volverse contrigentes para el líder a partir de entonces.

Cross-sectional and longitudinal (exploratory) studies.Rotator cuff (RC) tendinopathy is the most prevalent shoulder diagnosis, and proprioception deficits are often observed in individuals with RC tendinopathy.This study aimed to evaluate upper limb proprioception during a multijoint task in participants with and without RC tendinopathy and to determine if symptoms, functional limitations, and proprioception are improved after a rehabilitation program.Twenty participants with and 20 without RC tendinopathy were recruited for the cross-sectional study, and 23 participants with RC tendinopathy were recruited for the longitudinal study. Proprioception was evaluated by an active joint-repositioning task: The upper limb was passively moved to a predetermined position, and the participant was asked to actively replicate the movement. The difference between the predetermined position and the replicated position was measured. The mean errors in positions of lateral, medial, and neutral rotation of the shoulder and the global mean error were reported. In addition to the active-repositioning assessment in the longitudinal study, symptoms and functional limitations were evaluated by the Disability of the Arm Shoulder and Hand questionnaire.Significant deficits in active repositioning (p .01), independent of the position, were observed in participants with RC tendinopathy compared with controls. The DASH score was improved after rehabilitation intervention (p .001), and patients with active-repositioning deficits at baseline had reduced repositioning error (p .05).Upper limb active joint repositioning was impaired in participants with RC tendinopathy. Symptoms and functional limitations and active joint repositioning in participants with RC tendinopathy and initial deficits were improved after a 6-week global rehabilitation program.

Background Transcranial direct current stimulation (tDCS) is a promising tool for stroke rehabilitation. Yet, so far, results from the available clinical trials are inconclusive. Objectives The primary objective of the present work was to test the efficacy of multiple sessions of tDCS combined with a highly standardized and progressive resistance training program of the affected upper limb in individuals in the chronic phase of recovery after a stroke. Secondary objectives were to test the safety and tolerability of these combined interventions. Methods This two-arm parallel pilot trial recruited participants that were ≥18 years old, community-dwelling, and had sustained a supratentorial stroke ≥6 months prior to the study. They were allocated using a stratified randomization into two groups: 1) real tDCS + resistance training and 2) sham tDCS + resistance training. The resistance training program targeted the affected upper limb and consisted in 60 minutes of exercises, 3 times/week over 4 weeks. During each session, participants received either real- or sham-tDCS, using a bi-hemispheric montage for the first 20 minutes, and were blinded to the tDCS intervention. Outcome measures of clinical efficacy (Fugl-Meyer Assessment, Box and Block Test, Wolf Motor Function Test, grip strength, modified Ashworth scale and Motor Activity Log) were assessed by a blinded evaluator before and after the 4-week training program. Safety and tolerability were evaluated, respectively, by the number and characteristics of tDCS adverse events and dropout rates with their reasons. Results From the 147 individuals screened for eligibility, 14 participants (68.9±10.0 years old; 70.9±57.6 months post-stroke) met the selection criteria and were allocated to real-tDCS (n = 7) or sham-tDCS (n = 7) groups. Both groups improved on the clinical outcome measures, but these changes were not significantly different between groups (p > 0.17). No dropout occurred throughout the study. Participants frequently reported mild skin tingling during the administration of both real- and sham-tDCS, and no group difference was noted for its frequency and intensity (p > 0.38). One participant having received real-tDCS complained about a mild skin burning sensation after two sessions. The a priori sample size analysis performed on the Fugl-Meyer Assessment scores revealed that 56 participants would be required in a future clinical trial to reach 80% power at a significance level of 0.05. Conclusions In this pilot study, repeated sessions of bi-hemispheric tDCS coupled with resistance training were found safe and tolerable for individuals at the chronic phase post-stroke. However, the use of tDCS did not result in additional sensorimotor improvements when compared to sham-tDCS. Further research is needed to better assess the clinical benefits of combining non-invasive transcranial stimulation with rehabilitation after a stroke.

International audience; This study aims to analyze the relationship between gender diversity in the boardroom and companies’ overall financial performance. Our focus bears on the impact of the increase of women sitting on the boards of French medium-sized companies (ETI) has on their performance. Our research is supported by an unbalanced panel of 965 firm-year observations of 173 boards of directors from publicly traded French ETIs (Euronext and Alternext). Our findings support the thesis that an increase in the number of female directors on the board has a positive impact on companies’ financial performance. Our findings are in line with the critical mass and Token status theories. The more women there are in the boardroom, the better the company’s financial performance will be.; Cet article analyse la relation entre la diversité démographique des Conseils d’Administration (CA) et la performance financière des entreprises, et plus particulièrement, l’impact de l’évolution croissante du nombre de femmes sur la performance financière d’entreprises de taille intermédiaire (ETI) françaises. À cet effet, nous avons eu recours à un échantillon de référence comprenant plus de 965 observations correspondant à un panel témoin de la disparité démographique déséquilibrée de 173 CA d’ETI françaises cotées en Bourse (Euronext et Alternext). Les résultats obtenus montrent l’impact positif du nombre croissant de femmes sur les performances financières de ces entreprises. Ce résultat confirme les théories de la masse critique et du Token. Plus nombreuses sont les femmes au sein des conseils et meilleure est la performance financière de l’entreprise.

BackgroundCorticospinal excitability is subject to alterations after stroke. While the reversal of these alterations has been proposed as an underlying mechanism for improvement walking capacity after gait-specific training, this has not yet been clearly demonstrated. Therefore, the objective of this review is to evaluate the effect of gait-specific training on corticospinal excitability in stroke survivors.DesignSystematic review of the literatureMethodsWe conducted an electronic database search in four databases (i.e., Medline, Embase, CINAHL and Web of Science) in June 2022. Two authors independently screened and selected all studies that investigated the effect of gait-specific training in post-stroke individuals on variables such as motor-evoked potential amplitude, motor threshold, map size, latency, and corticospinal silent period.ResultsNineteen studies investigating the effect of gait-specific training on corticospinal excitability were included. Some studies showed an increased MEP amplitude (7/16 studies), a decreased latency (5/7studies), a decreased motor threshold (4/8 studies), an increased map size (2/3 studies) and a decreased cortical silent period (1/2 study) after gait-specific training. No change has been reported in term of short interval intracortical inhibition after training. Five studies did not report any significant effect after gait-specific training on corticospinal excitability.ConclusionThe results of this systematic review suggest that gait-specific training modalities can drive neuroplastic adaptation among stroke survivors. However, given the methodological disparity of the included studies, further clinical trials with better methodological quality are needed to draw conclusions. Hence, the findings from this review can serve as a rationale for future studies and continued efforts in investigating the effects of gait-specific training on the central nervous system.

Individuals with cerebral palsy have difficulties performing activities of daily living. Beyond motor execution impairments, they exhibit motor planning deficits contributing to their difficulties. The objective of this review is to synthesize the behavioral evidence of motor planning deficits during an upper limb motor task in children, adolescents and young adults with cerebral palsy aged between 3 and 21 years. Methods: The inclusion criteria were: (1) including individuals with cerebral palsy from 3 to 21 years old; (2) assessing upper limb motor planning. Six databases were screened. The quality assessment of the studies was performed. Results: Forty-six studies and 686 participants were included. Five articles have been identified as very high quality, 12 as high, 20 as moderate, six as low, three as very low. Force planning studies reported a deficit for the more affected hand but adequate performances for the less affected hand. Object-manipulation studies reported hand posture planning deficits irrespectively of the hand assessed. Conclusions: Motor planning deficits has been shown in the more affected hand for force scaling, while the results for other variables showed overall deficits. Hence, variables affected by motor planning deficits in both hands should be considered in children with cerebral palsy to optimize intervention.

OBJECTIVES: Monitoring psychosocial, emotional, and hedonic aspects of food behavior is important to understand cancer patients’ distress and help to reduce risks of malnutrition. However, to date, there is no specific tool to measure the impact of diet, eating behavior, and chemotherapy side effects on patients’ food-related quality of life during cancer and its treatments. The objective was to develop and validate a questionnaire that aims to assess the food-related quality of life in cancer patients undergoing chemotherapy. METHODS: Relevant items from the existing food-related quality of life assessment tools were selected to compose the present 46-item questionnaire. The validation of the questionnaire was conducted in 276 healthy volunteers and 173 cancer patients. Exploratory Factor Analysis (EFA) was performed in both groups, construct and discriminant validity, and test-retest reliability were calculated. RESULTS: The questionnaire was perceived as clear and required less than14 minutes for completion (93% complete responses) in a pre-test (n = 156). The EFA allowed the inclusion of 9 dimensions in the food-related quality of life questionnaire. Common patterns between patients and healthy volunteers (factor loadings ≥ 0.4 in both groups) were used to calculate scores by dimension. Scores in the dimensions of adapting diet and sensorial discomfort (taste/odor) were higher in cancer patients, whilst scores in the dimension of discomfort in satiety were higher in healthy volunteers. Among patients with cancer, the total scores in sensorial discomfort, digestive discomfort, and discomfort in satiety were higher under chemotherapy than no treatment. Reproducibility after one week was in increasing order; digestive discomfort 0.6, adapting diet 0.61, products’ quality 0.67, cooking 0.75, healthy diet 0.76, eating and pleasure 0.80, discomfort in satiety 0.82, and sensorial discomfort 0.85. CONCLUSIONS: This 46-item questionnaire can discriminate cancer patients versus healthy volunteers, and patients receiving vs those not receiving chemotherapy. A good to very good reproducibility was found for the most important factors of food-related quality of life of patients with cancer, i.e, eating and pleasure, sensorial discomfort, and discomfort in satiety. FUNDING SOURCES: This study is funded by La Région Auvergne Rhône-Aples and La Métropôle de Lyon.

AIM To synthetize studies assessing somatosensory deficits and alterations in cerebral responses evoked by somatosensory stimulation in individuals with cerebral palsy (CP) compared to typically developing individuals. METHOD A scoping review of the literature was performed in the MEDLINE, Embase, PsycInfo, CINAHL, Evidence-Based Medicine Reviews, and Web of Science databases (last search carried out on 6th and 7th August 2020) with a combination of keywords related to CP and somatosensory functions. Somatosensory deficits were measured with clinical tests and alterations in cerebral responses were measured with functional magnetic resonance imaging, electroencephalography, and magnetoencephalography. RESULTS Forty-eight articles were included. Overall, 1463 participants with CP (mean [SD] age 13y 1mo [4y 11mo], range 1-55y; 416 males, 319 females, sex not identified for the remaining participants) and 1478 controls (mean [SD] age 13y 1mo [5y 8mo], range 1-42y; 362 males, 334 females, sex not identified for the remaining participants) were included in the scoping review. For tactile function, most studies reported registration (8 out of 13) or perception (21 out of 21) deficits in participants with CP. For proprioception, most studies also reported registration (6 out of 8) or perception (10 out of 15) deficits. Pain function has not been studied as much, but most studies reported registration (2 out of 3) or perception (3 out of 3) alterations. Neuroimaging findings (18 studies) showed alterations in the somatotopy, morphology, latency, or amplitude of cortical responses evoked by somatosensory stimuli. INTERPRETATION Despite the heterogeneity in the methods employed, most studies reported somatosensory deficits. The focus has been mainly on tactile and proprioceptive function, whereas pain has received little attention. Future research should rigorously define the methods employed and include a sample that is more representative of the population with CP. What this paper adds Most of the papers reviewed found tactile registration and perception deficits in the upper limbs. Proprioceptive deficits were generally observed in cerebral palsy but results were heterogeneous. Pain has received little attention compared to tactile and proprioceptive functions. Neuroimaging studies supported behavioral observations. Alterations were observed for both the most and least affected limb.

People living with cerebral palsy (CP) exhibit motor and sensory impairments that affect unimanual and bimanual functions. The importance of sensory functions for motor control is well known, but the association between motor and sensory functions remains unclear in people living with CP. The objective of this systematic review was to characterize the relationship between sensory deficits and upper limb motor function in individuals living with CP. Methods: Five databases were screened. The inclusion criteria were: (1) including people living with CP, (2) reporting measurements of upper limb motor and sensory functions. A qualitative analysis of the studies’ level of evidence was done. Results: Thirty-three articles were included. Twenty-five articles evaluated tactile functions, 10 proprioceptive functions and 7 visual functions; 31 of the articles reported on unimanual functions and 17 of them reported on bimanual functions. Tactile functions showed a moderate to high association; it was not possible to reach definitive conclusions for proprioceptive and visual functions. Conclusions: The heterogeneity of the results limits the ability to draw definitive conclusions. Further studies should aim to perform more comprehensive assessments of motor and sensory functions, to determine the relative contribution of various sensory modalities to simple and more complex motor functions.

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.

International audience; The aim of this paper is to examine whether willingness to change, generational involvement, perceived technological opportunities, and competitive aggressiveness, in addition to strategic planning, affect the corporate entrepreneurship of family firms in Lebanon. Using a sample of 85 Lebanese family firms, our results suggest that family-business-related characteristics and strategic planning have a positive relationship with corporate entrepreneurship. Our study provides important insights to regulators and practitioners interested in enhancing governance practices in family firms in Lebanon based on the impact of family-business-related characteristics and strategic planning on corporate entrepreneurship. More importantly, our paper helps understand how corporate entrepreneurship in a Middle Eastern country can be affected by willingness to change, generational involvement, perceived technological opportunities, and competitive aggressiveness.

Background: A popular outcome in rehabilitation studies is the activity intensity count, which is typically measured from commercially available accelerometers. However, the algorithms are not openly available, which impairs long-term follow-ups and restricts the potential to adapt the algorithms for pathological populations. The objectives of this research are to design and validate open-source algorithms for activity intensity quantification and classification. Methods: Two versions of a quantification algorithm are proposed (fixed [FB] and modifiable bandwidth [MB]) along with two versions of a classification algorithm (discrete [DM] vs. continuous methods [CM]). The results of these algorithms were compared to those of a commercial activity intensity count solution (ActiLife) with datasets from four activities (n = 24 participants). Results: The FB and MB algorithms gave similar results as ActiLife (r &gt, 0.96). The DM algorithm is similar to a ActiLife (r &ge, 0.99). The CM algorithm differs (r &ge, 0.89) but is more precise. Conclusion: The combination of the FB algorithm with the DM results is a solution close to that of ActiLife. However, the MB version remains valid while being more adaptable, and the CM is more precise. This paper proposes an open-source alternative for rehabilitation that is compatible with several wearable devices and not dependent on manufacturer commercial decisions.

Background Neuropathic pain is a major problem following spinal cord injury (SCI). Central mechanisms involved in the modulation of nociceptive signals have been shown to be altered at the chronic stage, and it has been hypothesized that they might play a role in the development of chronic pain. Objective This prospective longitudinal study aimed to describe the evolution of pain modulation mechanisms over time after SCI, and to explore the relationships with the presence of clinical (neuropathic and musculoskeletal) pain. Methods Patients with an SCI were assessed on admission (n = 35; average of 38 days postinjury) and discharge (n = 25; average of 131 days postinjury) using the International Spinal Cord Injury Pain Basic Data Set. Conditioned pain modulation was assessed using the cold pressor test (10 °C; 120 s) as the conditioning stimulus and tonic heat pain, applied above the level of injury, as the test stimulus (120 s). Heat pain threshold was also assessed. Results A marked decrease in the efficacy of conditioned pain modulation was observed over time, with 30.2% of inhibition at admission and only 12.9% at discharge on average ( P = .010). This decrease was observed only in patients already suffering from neuropathic pain at admission and was not explained by a general increase in sensitivity to thermal nociceptive stimuli. Conclusion These results suggest that the presence of neuropathic pain leads to a decrease in conditioned pain modulation over time, rather than supporting the hypothesis that inefficient conditioned pain modulation mechanisms are leading to the development of neuropathic pain.

International audience; INTRODUCTION: In nephropathic cystinosis (NC), adherence to cysteamine remains challenging; poor adherence is worsening the disease progression with a decline of kidney function and increase of extrarenal morbidities. Our objective was to describe adherence to cysteamine in NC patients, using electronic monitoring systems. METHODS: Patients with confirmed NC, aged \textgreater 4 years and receiving oral cysteamine (short acting or delayed release formulation as standard of care) from 3 French reference centers, were included. Adherence to treatment was primarily assessed as the percentage of days with a good adherence score, adherence score rating from 0 (poor) to 2 (good). A descriptive analysis was performed after 1-year follow-up. RESULTS: Seventeen patients (10 girls, median age: 13.9 (5.4-33.0) years) were included. Median age at diagnosis was 17.0 (3.0-76.9) months and age at start of cysteamine was 21.0 (15.5-116.3) months. Median daily dose of cysteamine was 1.05 (0.55-1.63) g/m(2)/day. Over the year, the median percentage of days with a good adherence score was 80 (1-99)% decreasing to 68 (1-99)% in patients \textgreater 11 years old. The median of average number of hours covered by treatment in a day was 22.5 (6.1-23.9) versus 14.9 (9.2-20.5) hours for delayed release versus short acting cysteamine. CONCLUSION: Our data are the first describing a rather good adherence to cysteamine, decreasing in adolescents and adults. We described a potential interest of the delayed release formulation. Our data highlight the need for a multidisciplinary approach including therapeutic education and individualized approaches in NC patients transitioning to adulthood. Graphical abstract.

Individuals with pain report higher sensory disturbances during sensorimotor conflicts compared to pain-free individuals. In the pain field, it is frequently assumed that disturbances arise from a discordance between sensory and efference copies (defined as sensory-motor conflict), while in the sensorimotor control field they are considered to result from the incongruence between sensory modalities (defined as sensory-sensory conflict). The general aim of this study was to disentangle the relative contribution of motor efferences and sensory afferences to the increased sensitivity to sensorimotor conflicts in individual with fibromyalgia (n = 20) compared to controls (n = 20). We assessed sensory and motor disturbances during sensory-sensory and sensory-motor conflicts using a robotized exoskeleton interfaced with a 2D virtual environment. There was a significant interaction between the group and the type of conflict (p = 0.03). Moreover, the increase in conflict sensitivity from sensory-sensory to sensory-motor conflicts in fibromyalgia was related to conflict-induced motor disturbances (r = 0.57; p < 0.01), but did not result from a poorer proprioception (r = 0.12; p = 0.61). Therefore, it appears that higher conflict sensitivity in fibromyalgia is mainly explained by a sensory-motor conflict rather by a sensory-sensory conflict. We suggest this arises due to a deficit in updating predicted sensory feedback rather than in selecting appropriate motor commands.

Contexte : L’enseignement de la communication aux étudiants en médecine a longtemps été négligé, bien que figurant dans les compétences visées par le cursus de formation universitaire. Le département de médecine générale de la faculté Paris Sud a mis en place, en 2014, un enseignement obligatoire se déroulant sur les trois années du cursus des internes du diplôme d’études spécialisées (DES). Cet enseignement progressif se déroule en deux modules. Le premier intègre des apports théoriques, en alternance avec des ateliers de mise en application, le second consiste en des ateliers filmés suivis de comptes rendus critiques. Objectif : Évaluer, chez les internes de première année, l’impact du premier module de formation de communication en termes de connaissances et de mise en application des outils ainsi que leur appréciation sur la formation reçue. Méthodes : Étude quantitative réalisée trois mois après la première session de formation. Les internes étaient invités à répondre à un questionnaire anonyme visant à évaluer leurs connaissances en matière de communication, leur capacité à les mettre en application en pratique hospitalière et leur évaluation du dispositif de formation. Résultats : Parmi 78 étudiants formés, 77 ont répondu à ce questionnaire. Plus de 75 % des étudiants se sont sentis en confort dans les exercices de simulation, ont observé des changements dans leur comportement communicationnel et pensent pouvoir intégrer ces outils dans leurs pratiques. Conclusion : À l’issue de cet enseignement, les internes sont demandeurs de ce type de formation dont ils disent observer les effets dans leur pratique.

Chronic pain is often accompanied by patient-reported distorted body perception and an altered kinesthesia (referring to the senses of limb position and limb movement), but the association between these deficits is unknown. The objectives of this study were to assess body perception and the senses of limb position and limb movement in complex regional pain syndrome (CRPS) and to test whether these variables are related to each other and to pain intensity. Thirteen patients with upper limb CRPS (mean pain intensity, 4.2 ± 2.4 out of 10) and 13 controls were recruited. Body perception was self-reported with a questionnaire, and the senses of limb position (task 1) and of limb movement (task 2) were assessed with a robotic system combined with a 2D virtual reality display. The results showed altered kinesthesia in the patients with CRPS compared with controls (all P.05). Moreover, in the CRPS group, greater pain intensity was associated with lower performance on task 2 (r = -.60; P.05). Although alterations in participants' sense of limb position and limb movement were associated with each other (r = -.70, P.01), they were not related to the altered body perception (all P.26). Therefore, the results suggest that kinesthesia and body perception should be considered and evaluated separately in patients with CRPS. PERSPECTIVE: Senses of limb position and movement rely on sensorimotor integration. Both are altered in complex regional pain syndrome. However, they are not related to the subjective perception of the painful limb, and thus they should be assessed separately in rehabilitation.

International audience; Throughout history, civilisations have expanded their territories in the search for wealth and enrichment. Hence, foreign expansion has alwaysbeen perceived as a way of increasing and acquiring resources, crafts, knowledge and markets. In our days, foreign expansion is mostly executed by firms driven by the same reasons. The foreign market attractiveness theory stands as a reference for any multinational entrepreneurial expansion and related foreign venturing prospects. Our approach tests the validity of the theory’s constraints when subjected to social ties and relations. The research analyses how entrepreneurs weigh information of a foreign market opportunity transmitted through socially tied sources. We found that the trust factor between the entrepreneur and his socially tied source of information negatively influences the foreign market entry attractiveness theory. Additionally, entrepreneurs with strong social knowledge base and bonds investigate any information communicated to them by a socially tied source.

Background Anodal transcranial direct-current stimulation (a-tDCS) has been shown to enhance the effects of sensorimotor training in neurological populations. Sensorimotor training leads to reduced pain and increased function in the treatment of rotator cuff tendinopathy. The addition of a-tDCS during a rehabilitation program centered on sensorimotor training may improve treatment outcomes in individuals with rotator cuff tendinopathy. Objective To compare 2 groups of individuals with rotator cuff tendinopathy, one receiving a rehabilitation program centered on sensorimotor training with a-tDCS and the other receiving the same rehabilitation program with sham a-tDCS. Methods In this triple-blind, parallel-group randomized controlled trial, 40 adults with rotator cuff tendinopathy participated in a 6-week rehabilitation program (8 treatments with home exercises and including sensorimotor training, patient education, and strengthening). They were randomly assigned to 1 of 2 groups to receive either real a-tDCS (stimulation, 1.5 mA for 30 minutes) or sham a-tDCS during the first 5 treatments. Symptoms and functional limitations (Disabilities of the Arm, Shoulder and Hand questionnaire, Western Ontario Rotator Cuff index) of all participants were evaluated at baseline and at 3, 6, and 12 weeks. Acromiohumeral distances (ultrasonographic measurement at 0°, 45°, and 60° of arm elevation) were assessed at baseline and 6 weeks. Two-way or 3-way repeated-measures analyses of variance were used for statistical analyses. Results Both groups showed statistically significant improvement in Disabilities of the Arm, Shoulder and Hand questionnaire and Western Ontario Rotator Cuff index scores at 3, 6, and 12 weeks, and in acromiohumeral distance at 45° and 60° at 6 weeks (P.05). No significant group-by-time interaction was observed for all outcomes (P.43). Conclusion Results do not demonstrate any improved treatment outcomes from the addition of a-tDCS during a rehabilitation program for individuals with rotator cuff tendinopathy. Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2018;48(7):541-551. Epub 10 May 2018. doi:10.2519/jospt.2018.7871.

KEY POINTS Experimental pain or its anticipation influence motor preparation processes as well as upcoming movement execution, but the underlying physiological mechanisms remain unknown. Our results showed that movement-related pain modulates corticospinal excitability during motor preparation. In accordance with the pain adaptation theory, corticospinal excitability was higher when the muscle has an antagonist (vs. an agonist) role for the upcoming movement associated with pain. Anticipation of movement-related pain also affects motor initiation and execution, with slower movement initiation (longer reaction times) and faster movement execution compared to movements that do not evoke pain. These results confirm the implementation of protective strategies during motor preparation known to be relevant for acute pain, but which may potentially have detrimental long-term consequences and lead to the development of chronic pain. ABSTRACT When a movement repeatedly generates pain, we anticipate movement-related pain and establish self-protective strategies during motor preparation, but the underlying mechanisms remains poorly understood. The current study investigated the effect of movement-related pain anticipation on the modulation of behaviour and corticospinal excitability during the preparation of arm movements. Participants completed an instructed-delay reaction-time (RT) task consisting of elbow flexions and extensions instructed by visual cues. Nociceptive laser stimulations (unconditioned stimuli) were applied to the lateral epicondyle during movement execution in a specific direction (CS+) but not in the other (CS-), depending on experimental group. During motor preparation, transcranial magnetic stimulation was used to measure corticospinal excitability in the biceps brachii (BB). RT and peak end-point velocity were also measured. Neurophysiological results revealed an opposite modulation of corticospinal excitability in BB depending on whether it plays an agonist (i.e. flexion) or antagonist (i.e. extension) role for the CS+ movements (P