Motion sickness (MS) has long been a common complaint in road transportation. However, in the era of driving automation, MS has become an increasingly significant issue. The future intelligent vehicle is envisioned as a mobile space for work or entertainment, but unfortunately passengers’ engagement in non-driving tasks may exacerbate MS. Finding effective MS countermeasures is crucial to ensure a pleasant passenger experience. Nevertheless, due to the complex mechanism of MS, there are numerous challenges in mitigating it, hindering the development of practical countermeasures. To address this, we first review two prevalent theories explaining the mechanism of MS. Subsequently, this paper provides a summary of current subjective and objective approaches for quantifying motion sickness levels. Then, it surveys existing methods for alleviating MS, including passenger adjustment, intelligent vehicle solutions, and motion cues of various modalities. Furthermore, we outline the limitations and remaining challenges of current research and highlight novel opportunities in the context of intelligent vehicles. Finally, we propose an integrated framework for alleviating MS. The findings of this review will enhance our understanding of carsickness and offer valuable insights for future research and practice in MS mitigation within modern vehicles.
RolnickALubowRE. Why is the driver rarely motion sick? The role of controllability in motion sickness. Ergonomics1991; 34(7): 867–879.
2.
LeungAKHonKL. Motion sickness: an overview. Drugs Context2019; 8: 1–11.
3.
SchmidtEAKuiperOXWolterS, et al. An international survey on the incidence and modulating factors of carsickness. Transp Res Part F Traffic Psychol Behav2020; 71: 76–87.
4.
ReasonJT. Motion sickness adaptation: a neural mismatch model. J R Soc Med1978; 71(11): 819–829.
5.
OmanCM. Motion sickness: a synthesis and evaluation of the sensory conflict theory. Can J Physiol Pharmacol1990; 68(2): 294–303.
6.
BlesWBosJEde GraafB, et al. Motion sickness: only one provocative conflict?Brain Res Bull1998; 47(5): 481–487.
7.
BosJEBlesW. Modelling motion sickness and subjective vertical mismatch detailed for vertical motions. Brain Res Bull1998; 47(5): 537–542.
8.
KamijiNKurataYWadaT, et al. Modeling and validation of carsickness mechanism. In: SICE annual conference 2007, Takamatsu, Japan, 17–20 September 2007, pp.1138–1143. New York: IEEE.
9.
WadaTKamijNDoiS. A mathematical model of motion sickness in 6DOF motion and its application to vehicle passengers. arXiv preprint arXiv:150405261, 2015.
10.
RiccioGEStoffregenTA. An ecological theory of motion sickness and postural instability. Ecol Psychol1991; 3(3): 195–240.
KennedyRSStanneyKM. Postural instability induced by virtual reality exposure: development of a certification protocol. Int J Hum Comput Interact1996; 8(1): 25–47.
13.
BosJE. Nuancing the relationship between motion sickness and postural stability. Displays2011; 32(4): 189–193.
14.
TreismanM. Motion sickness: an evolutionary hypothesis. Science1977; 197(4302): 493–495.
15.
BowinsB. Motion sickness: a negative reinforcement model. Brain Res Bull2010; 81(1): 7–11.
16.
GoldingJF. Motion sickness susceptibility questionnaire revised and its relationship to other forms of sickness. Brain Res Bull1998; 47(5): 507–516.
17.
GoldingJF. Predicting individual differences in motion sickness susceptibility by questionnaire. Pers Individ Dif2006; 41(2): 237–248.
18.
KeshavarzBMurovecBMohanathasN, et al. The visually induced motion sickness susceptibility questionnaire (VIMSSQ): estimating individual susceptibility to motion sickness-like symptoms when using visual devices. Hum Factors2023; 65(1): 107–124.
19.
KennedyRSLaneNEBerbaumKS, et al. Simulator sickness questionnaire: an enhanced method for quantifying simulator sickness. Int J Aviat Psychol1993; 3(3): 203–220.
20.
GianarosPJMuthERMordkoffJT, et al. A questionnaire for the assessment of the multiple dimensions of motion sickness. Aviat Space Environ Med2001; 72(2): 115–119.
21.
KimHKParkJChoiY, et al. Virtual reality sickness questionnaire (VRSQ): motion sickness measurement index in a virtual reality environment. Appl Ergon2018; 69: 66–73.
22.
BosJMacKinnonSPattersonA. Motion sickness symptoms in a ship motion simulator: effects of inside, outside, and no view. Aviat Space Environ Med2005; 76(12): 1111–1118.
23.
KeshavarzBHechtH. Validating an efficient method to quantify motion sickness. Hum Factors2011; 53(4): 415–426.
24.
LambSKwokKC. MSSQ-Short norms may underestimate highly susceptible individuals: updating the MSSQ-Short norms. Hum Factors2015; 57(4): 622–633.
25.
LiDXuBChenL, et al. MOSI APP-a motion cueing application to mitigate car sickness while performing non-driving task. In: KrömkerH (ed.) HCI in mobility, transport, and automotive systems. Cham: Springer Nature Switzerland, 2023, pp.173–190.
26.
BalkSABertolaMAInmanVW. Simulator sickness questionnaire: twenty years later. In: Proceedings of the 7th international driving symposium on human factors in driver assessment, training, and vehicle design: driving assessment 2013, Bolton Landing, NY, USA, 17–20 June 2013, pp.257–263. Iowa City, IA: University of Iowa.
27.
ISO 2631-1:1997. Mechanical vibration and shock—evaluation of human exposure to whole-body vibration—part 1: general requirements.
28.
TurnerMGriffinMJ. Motion sickness in public road transport: the relative importance of motion, vision and individual differences. Br J Psychol1999; 90(4): 519–530.
29.
HtikeZPapaioannouGSiampisE, et al. Minimisation of motion sickness in autonomous vehicles. In: 2020 IEEE intelligent vehicles symposium (IV), Las Vegas, NV, USA, 19 October–13 November 2020, pp.1135–1140. New York: IEEE.
30.
HtikeZPapaioannouGSiampisE, et al. Fundamentals of motion planning for mitigating motion sickness in automated vehicles. IEEE Trans Veh Technol2022; 71(3): 2375–2384.
31.
LiDHuJ. Mitigating motion sickness in automated vehicles with frequency-shaping approach to motion planning. IEEE Robot Autom Lett2021; 6(4): 7714–7720.
HongJHKimJSQuanYS, et al. Adaptive cruise control with motion sickness reduction: data-driven human model and model predictive control approach. In: 2022 IEEE 25th international conference on intelligent transportation systems (ITSC), Macau, China, 8–12 October 2022, pp.1464–1470. New York: IEEE.
34.
KarjantoJYusofNHassanM, et al. An on-road study in mitigating motion sickness when reading in automated driving. J Hunan Univ Nat Sci2021; 48(3): 95–109.
35.
SternRMKochKLStewartWR, et al. Spectral analysis of tachygastria recorded during motion sickness. Gastroenterology1987; 92(1): 92–97.
36.
HuSGrantWFSternRM, et al. Motion sickness severity and physiological correlates during repeated exposures to a rotating optokinetic drum. Aviat Space Environ Med1991; 62(4): 308–314.
37.
HuSMcChesneyKAPlayerKA, et al. Systematic investigation of physiological correlates of motion sickness induced by viewing an optokinetic rotating drum. Aviat Space Environ Med1999; 70(8): 759–765.
38.
GrudenTPopovićNBStojmenovaK, et al. Electrogastrography in autonomous vehicles-an objective method for assessment of motion sickness in simulated driving environments. Sensors2021; 21(2): 550.
39.
CheungBVaitkusP. Perspectives of electrogastrography and motion sickness. Brain Res Bull1998; 47(5): 421–431.
40.
CowingsPSNaifehKHToscanoWB. The stability of individual patterns of autonomic responses to motion sickness stimulation. Aviat Space Environ Med1990; 61: 399–405.
41.
HolmesSRGriffinMJ. Correlation between heart rate and the severity of motion sickness caused by optokinetic stimulation. J Psychophysiol2001; 15: 35–42.
42.
DoweckIGordonCRShlitnerA, et al. Alterations in RR variability associated with experimental motion sickness. J Auton Nerv Syst1997; 67(1–2): 31–37.
43.
YokotaYAokiMMizutaK, et al. Motion sickness susceptibility associated with visually induced postural instability and cardiac autonomic responses in healthy subjects. Acta Otolaryngol2005; 125(3): 280–285.
44.
IrmakTPoolDMHappeeR. Objective and subjective responses to motion sickness: the group and the individual. Exp Brain Res2021; 239(2): 515–531.
45.
GoldingJF. Phasic skin conductance activity and motion sickness. Aviat Space Environ Med1992; 63: 165–171.
46.
WanHHuSWangJ. Correlation of phasic and tonic skin-conductance responses with severity of motion sickness induced by viewing an optokinetic rotating drum. Percept Mot Skills2003; 97(3 suppl): 1051–1057.
47.
BandoSShiogaiYHiraoA. Development of evaluating methods for passenger’s motion sickness in real driving environment. Int J Automot Eng2021; 12(2): 72–77.
48.
SmythJBirrellSWoodmanR, et al. Exploring the utility of EDA and skin temperature as individual physiological correlates of motion sickness. Appl Ergon2021; 92: 103315.
49.
ChelenWEKabriskyMRogersSK. Spectral analysis of the electroencephalographic response to motion sickness. Aviat Space Environ Med1993; 64(1): 24–29.
50.
ChenYCDuannJRChuangSW, et al. Spatial and temporal EEG dynamics of motion sickness. Neuroimage2010; 49(3): 2862–2870.
51.
LiZZhaoLChangJ, et al. EEG-based evaluation of motion sickness and reducing sensory conflict in a simulated autonomous driving environment. In: 2022 44th annual international conference of the IEEE engineering in medicine & biology society (EMBC), Glasgow, UK, 11–15 July 2022, pp.4026–4030. New York: IEEE.
52.
LinCTTsaiSFKoLW. EEG-based learning system for online motion sickness level estimation in a dynamic vehicle environment. IEEE Trans Neural Netw Learn Syst2013; 24(10): 1689–1700.
53.
LiaoCYTaiSKChenRC, et al. Using EEG and deep learning to predict motion sickness under wearing a virtual reality device. IEEE Access2020; 8: 126784–126796.
54.
OwenNLeadbetterAGYardleyL. Relationship between postural control and motion sickness in healthy subjects. Brain Res Bull1998; 47(5): 471–474.
NalivaikoERuddJASoRH. Motion sickness, nausea and thermoregulation: the “toxic” hypothesis. Temperature2014; 1(3): 164–171.
57.
TanRLiWHuF, et al. Motion sickness detection for intelligent vehicles: a wearable-device-based approach. In: 2022 IEEE 25th international conference on intelligent transportation systems (ITSC), Macau, China, 8–12 October 2022, pp.4355–4362. New York: IEEE.
58.
HwangJBangJLeeS. Classification of motion sickness levels using multimodal biosignals in real driving conditions. In: 2022 IEEE international conference on systems, man, and cybernetics (SMC), Prague, Czech Republic, 9–12 October 2022, pp.1304–1309. New York: IEEE.
59.
KochACascorbiIWesthofenM, et al. The neurophysiology and treatment of motion sickness. Dtsch Arztebl Int2018; 115(41): 687–996.
60.
McCauleyMRoyalJWylieC, et al. Motion sickness incidence: exploratory studies of habituation, pitch and roll, and the refinement of a mathematical model. Technical report, Defense Technical Information Center, Fort Belvoir, VA, 1976.
61.
DaiMRaphanTCohenB. Prolonged reduction of motion sickness sensitivity by visual-vestibular interaction. Exp Brain Res2011; 210(3–4): 503–513.
62.
IshakSBubkaABonatoF. Visual occlusion decreases motion sickness in a flight simulator. Perception2018; 47(5): 521–530.
63.
GoldingJFBlesWBosJE, et al. Motion sickness and tilts of the inertial force environment: active suspension systems vs. active passengers. Aviat Space Environ Med2003; 74(3): 220–227.
64.
WadaTKonnoHFujisawaS, et al. Can passengers’ active head tilt decrease the severity of carsickness? Effect of head tilt on severity of motion sickness in a lateral acceleration environment. Hum Factors2012; 54(2): 226–234.
65.
WadaTFujisawaSDoiS. Analysis of driver’s head tilt using a mathematical model of motion sickness. Int J Ind Ergon2018; 63: 89–97.
66.
JokerstMDGattoMFazioR, et al. Slow deep breathing prevents the development of tachygastria and symptoms of motion sickness. Aviat Space Environ Med1999; 70(12): 1189–1192.
67.
SangFDYPBillarJPGoldingJF, et al. Behavioral methods of alleviating motion sickness: effectiveness of controlled breathing and a music audiotape. J Travel Med2006; 10(2): 108–111.
68.
HoringBWeimerKSchradeD, et al. Reduction of motion sickness with an enhanced placebo instruction: an experimental study with healthy participants. Psychosom Med2013; 75(5): 497–504.
69.
BosJE. Less sickness with more motion and/or mental distraction. J Vestib Res2015; 25(1): 23–33.
KeshavarzBHechtH. Pleasant music as a countermeasure against visually induced motion sickness. Appl Ergon2014; 45(3): 521–527.
72.
GriffinMJNewmanMM. Visual field effects on motion sickness in cars. Aviat Space Environ Med2004; 75(9): 739–748.
73.
SalterSDielsCHerriottsP, et al. Motion sickness in automated vehicles with forward and rearward facing seating orientations. Appl Ergon2019; 78: 54–61.
74.
KeshavarzBNovakACHettingerLJ, et al. Passive restraint reduces visually induced motion sickness in older adults. J Exp Psychol Appl2017; 23(1): 85–99.
75.
BohrmannDBenglerK. Reclined posture for enabling autonomous driving. In: AhramTKarwowskiWPicklS, et al. (eds) Human systems engineering and design II. Vol. 1026. Cham: Springer International Publishing, 2020, pp.169–175.
76.
KeshavarzBStelzmannDPaillardA, et al. Visually induced motion sickness can be alleviated by pleasant odors. Exp Brain Res2015; 233(5): 1353–1364.
77.
D’AmourSBosJEKeshavarzB. The efficacy of airflow and seat vibration on reducing visually induced motion sickness. Exp Brain Res2017; 235(9): 2811–2820.
DielsCBosJ. User interface considerations to prevent self-driving carsickness. In: Adjunct proceedings of the 7th international conference on automotive user interfaces and interactive vehicular applications, Nottingham, UK, 2015, pp.14–19. New York: ACM.
80.
SchartmüllerCRienerA. Sick of scents: investigating non-invasive olfactory motion sickness mitigation in automated driving. In: 12th international conference on automotive user interfaces and interactive vehicular applications, Virtual Event, DC, USA, 21–22 September 2020, pp.30–39. New York: ACM.
81.
WadaT. Motion sickness in automated vehicles. In: EdelmannJPlöchlMPfefferP (eds) Advanced vehicle control AVEC’16. London: CRC Press, 2016, pp.169–174.
82.
SiddiqiMRMilaniSJazarRN, et al. Ergonomic path planning for autonomous vehicles-an investigation on the effect of transition curves on motion sickness. IEEE Trans Intell Transp Syst2022; 23(7): 7258–7269.
83.
JainVKumarSSPapaioannouG, et al. Optimal trajectory planning for mitigated motion sickness: simulator study assessment. IEEE Trans Intell Transp Syst2023; 24: 10653–10664.
84.
TangBYuTChenL, et al. Personalized trajectory planning algorithm considering passenger motion sickness level. In: 2023 IEEE 26th international conference on intelligent transportation systems (ITSC), Bilbao, Bizkaia, Spain, 24–28 September 2023, pp.5591–5596. New York: IEEE.
85.
CertosiniCPapiniLCapitaniR, et al. Preliminary study for motion sickness reduction in autonomous vehicles: an MPC approach. Procedia Struct Integr2019; 24: 127–136.
86.
CertosiniCCapitaniRAnnicchiaricoC. Optimal speed profile on a given road for motion sickness reduction. arXiv preprint arXiv:201005701, 2020.
87.
LiDXuBChenL, et al. Automated car-following algorithm considering passenger motion sickness. In: 6th international symposium on future active safety technology toward zero traffic accidents (FAST-Zero’21), Kanazawa, JSAE, 2021, pp.1–6.
88.
UkitaROkafujiYWadaT. A simulation study on lane-change control of automated vehicles to reduce motion sickness based on a computational mode. In: 2020 IEEE international conference on systems, man, and cybernetics (SMC), Toronto, ON, Canada, 11–14 October 2020, pp.1745–1750. New York: IEEE.
89.
SaruchiSMohammed AriffMHZamzuriH, et al. Lateral control strategy based on head movement responses for motion sickness mitigation in autonomous vehicle. J Braz Soc Mech Sci Eng2020; 42(5): 223.
90.
LucianiSBonfittoAAmatiN, et al. Comfort-oriented design of model predictive control in assisted and autonomous driving. In: International design engineering technical conferences and computers and information in engineering conference. Volume 4: 22nd international conference on advanced vehicle technologies (AVT), Virtual, Online, 17–19 August 2020, p.V004T04A008. New York: ASME.
91.
SiddiqiMRMilaniSJazarRN, et al. Motion sickness mitigating algorithms and control strategy for autonomous vehicles. IEEE Trans Intell Transp Syst2023; 24(1): 304–315.
92.
EkchianJGravesWAndersonZ, et al. A high-bandwidth active suspension for motion sickness mitigation in autonomous vehicles. SAE technical paper 2016-01-1555, 2016.
93.
PapaioannouGZhaoXVelenisE, et al. Integrated active seat suspension for enhancing motion comfort. In: OrlovaAColeD (eds) Advances in dynamics of vehicles on roads and tracks II. Cham: Springer International Publishing, 2022, pp.902–911.
94.
PapaioannouGNingDJerrelindJ, et al. A K-seat-based PID controller for active seat suspension to enhance motion comfort. SAE Int J Connect Autom Veh2022; 5(2): 189–199.
95.
ZhengYShyrokauBKeviczkyT, et al. Curve tilting with nonlinear model predictive control for enhancing motion comfort. IEEE Trans Control Syst Technol2022; 30(4): 1538–1549.
96.
JurischMHolzapfelCBuckC. The influence of active suspension systems on motion sickness of vehicle occupants. In: 2020 IEEE 23rd international conference on intelligent transportation systems (ITSC), Rhodes, Greece, 20–23 September 2020, pp.1–6. New York: IEEE.
97.
MikschMSteinerMMikschM, et al. Motion sickness prevention system (MSPS): reading between the lines. In: Adjunct proceedings of the 8th international conference on automotive user interfaces and interactive vehicular applications, Ann Arbor, MI, USA, 24–26 October 2016, pp.147–152. New York: ACM.
98.
HanauEPopescuV. MotionReader: visual acceleration cues for alleviating passenger e-reader motion sickness. In: Proceedings of the 9th international conference on automotive user interfaces and interactive vehicular applications adjunct, Oldenburg Germany, 24–27 September 2017, pp.72–76. New York: ACM.
99.
MeschtscherjakovAStrumeggerSTröstererS. Bubble margin: motion sickness prevention while reading on smartphones in vehicles. In: LamasDLoizidesFNackeL, et al. (eds) Human-computer interaction – INTERACT 2019. Cham: Springer International Publishing, 2019, pp.660–677.
100.
LiDTangBYuT, et al. Can we use smart phone on a moving vehicle without worrying about carsickness? Developing an effective motion cue APP with driving simulator and real vehicle experiments. Int J Hum Comput Interact. Epub ahead of print 3June2024. DOI: 10.1080/10447318.2024.2359204.
101.
HockPBenedikterSGugenheimerJ, et al. CarVR: enabling in-car virtual reality entertainment. In: Proceedings of the 2017 CHI conference on human factors in computing systems, Denver, CO, USA, 2017, pp.4034–4044. New York: ACM.
102.
KarjantoJMd YusofNWangC, et al. The effect of peripheral visual feedforward system in enhancing situation awareness and mitigating motion sickness in fully automated driving. Transp Res Part F Traffic Psychol Behav2018; 58: 678–692.
103.
de WinkelKNPrettoPNooijSAE, et al. Efficacy of augmented visual environments for reducing sickness in autonomous vehicles. Appl Ergon2021; 90: 103282.
104.
BohrmannDBruderABenglerK. Effects of dynamic visual stimuli on the development of carsickness in real driving. IEEE Trans Intell Transp Syst2022; 23(5): 4833–4842.
105.
ChoHJKimGJ. RideVR: reducing sickness for in-car virtual reality by mixed-in presentation of motion flow information. IEEE Access2022; 10: 34003–34011.
106.
DielsCDugenetetPBrietzkeA, et al. Design strategies to alleviate motion sickness in rear seat passengers - a test track study. In: 2023 IEEE 26th international conference on intelligent transportation systems (ITSC), Bilbao, Bizkaia, Spain, 24–28 September 2023, pp.5254–5258. New York: IEEE.
107.
Md. YusofNKarjantoJKapoorS, et al. Experimental setup of motion sickness and situation awareness in automated vehicle riding experience. In: Proceedings of the 9th international conference on automotive user interfaces and interactive vehicular applications adjunct, Oldenburg, Germany, 24–27 September 2017, pp.104–109. New York: ACM.
108.
LiDChenL. Mitigating motion sickness in automated vehicles with vibration cue system. Ergonomics2022; 65(10): 1313–1325.
109.
ReutenAJCSmeetsJBJRauschJ, et al. The (in)effectiveness of anticipatory vibrotactile cues in mitigating motion sickness. Exp Brain Res2023; 241(5): 1251–1261.
110.
KuiperOXBosJEDielsC, et al. Knowing what’s coming: anticipatory audio cues can mitigate motion sickness. Appl Ergon2020; 85: 103068.
111.
KuiperOXBosJESchmidtEA, et al. Knowing what’s coming: unpredictable motion causes more motion sickness. Hum Factors2020; 62(8): 1339–1348.
112.
Gálvez-GarcíaGAldunateNBascour-SandovalC, et al. Decreasing motion sickness by mixing different techniques. Appl Ergon2020; 82: 102931.
113.
LiDLiuALongX, et al. A method of generating simulated rowing scenarios using vehicle-mounted rowing machines. CN110681110A, Patent, 2020.
114.
WickensCD. Multiple resources and mental workload. Hum Factors2008; 50(3): 449–455.
115.
Md. YusofNKarjantoJTerkenJMB, et al. Gaining situation awareness through a vibrotactile display to mitigate motion sickness in fully-automated driving cars. Int J Autom Mech Eng2020; 17(1): 7771–7783.
