Scoliosis is a three dimensional deformity in which the spine deviates from the normal sagittal and coronal position in upright posture and becomes fixed in an unbalanced posture. The aetiology is poorly understood, however the spinal deformity is a problematic developmental process, the outcome of which can be altered with appropriate intervention. There is some evidence in the literature that scoliosis is reversible. Asymmetric loading is the driving force for development and progression of curvatures. Progression of curvatures is related to growth potential, magnitude of the curve and bone age. Curves that are not managed result in signs and symptoms of pain, deformity, pulmonary dysfunction and psychological distress. For many cases that end up in surgery, spinal fusion fails to address the significant clinical symptoms of spinal deformity. The complications of surgery are high. There is controversy as to whether conservative management of wearing a brace and exercises are effective in stabilising the curve. Past studies have shown that exercises alone do not improve the curve. Studies have also shown that a brace only prevents progression of the curve and the efficiency of the brace is not clear. Guidelines for brace wearing have not been given in the literature. High correction bracing has however been shown to have favourable outcomes when patients are compliant. The aim of this study was therefore to determine the effect of compliance to the RSC brace and a specific exercise programme on idiopathic scoliosis curvature. Further objectives were to determine factors affecting compliance to the treatment protocol. The quality of life and psychological traits of compliant subjects and non compliant subjects during the study were established and compared. To achieve these objectives a pre test /post test study design was used with a post study comparison between subjects who complied with the management and those who did not comply. Fifty one subjects, girls aged 12-16 years were drawn from a private physiotherapy practice in Randburg, South Africa referred by different orthopaedic surgeons. Cobb angles were between 20-50 degrees and subjects had no prior treatment. Subjects were divided into two groups after the brace and exercise interventions were complete and when weaning out of the brace had begun. Subjects were allocated to the two groups according to their compliance. The compliant group was defined as those subjects who wore the brace 20 or more hours a day and exercised three or more times per week. The non-compliant group were those subjects who wore the brace less than 20 hours a day and exercised less than three times per week. The study was terminated the day the subjects started weaning out of the brace. The two study groups were compared with respect to the Cobb angle, kyphotic and lordotic angle, apical vertebral rotation, scoliometer measures, peak flow, quality of life and personality traits. The subjects in both groups were well matched at baseline. The compliant group, who wore the brace 21.5 hours per day and exercised four times a week, significantly improved in all measures compared to non compliant subjects, who wore the brace 12 hours per day, exercised 1.7 times a week and significantly deteriorated. The non compliant group followed the natural history of progression of IS curvatures. The major Cobb angles in the compliant group improved 10.19° (±5.5) and deteriorated 5.52°(±4.3) in the non compliant group. Compliant subjects had a significantly better quality of life than the non compliant subjects. Vitality, physical functioning, self esteem, bodily pain, school activity and general health perception, emotional function were significantly better in the compliant group compared to the non compliant group. The compliant group were significantly more emotionally mature, stable and realistic than the non compliant group. In conclusion good compliance to a conservative treatment programme of the RSC brace and a specific regime of exercises resulted in a significant improvement in curvatures, poor compliance resulted in progression/deterioration. A poorer quality of life in the non compliant group possibly was caused by personality traits of the group, being more emotionally immature and unstable. Possibly different personality traits have different psychosocial coping mechanisms and when put in a stressful situation, result in different levels of compliance. A personality trait questionnaire is recommended on subjects initially, to predict compliance and then to include psychological support if required. This conservative treatment programme can be offered to patients all over South Africa and Africa. The patients only have to visit the physiotherapist and brace technician once a month and in some cases every three months. Further studies are required on the long term effects of this conservative treatment programme. Scoliosis is a complex condition of the developing child, and their psychosocial coping mechanisms need further research to improve compliance.

published_or_final_version / Medicine / Master / Doctor of Medicine

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Correct neck support is required during sleep to align the spine and maintain neutral posture, and to immobilise the joints in the neck which would allow the cervical paraspinal muscles to relax (De Laittre, 1974; Ambrogio et al., 1998; Erfanian et al., 1998). Poor spinal posture during sleep however, has been hypothesized to result in lateral bending and uneven loading on the intervertebral discs and cervical facet joints, and compression of pain-sensitive structures in the neck (Leilnahari et al., 2011). The pillow is a significant contributing factor to sleep quality and the development of symptoms on waking (Gordon et al., 2011). This should theoretically reduce pressure on the pain-sensitive structures and allow the intervertebral discs to be unloaded and rehydrated (Leilnahari et al., 2011). Aim: To determine and compare the effect of the Simmons’ Beautyrest pillow, a polyester foam pillow, a latex pillow, and no pillow, on cervico-thoracic and forward head posture in the supine and recumbent supine positions in asymptomatic individuals. Methods: Forty asymptomatic subjects between the ages of 20 and 30 years were recruited using convenience sampling. The study was a double-blinded comparative investigation where all participants underwent a case history, physical examination and an orthopaedic examination of the cervical spine. Thereafter, digital photographic images of the participants lying without a pillow and on three different pillows (Simmons Beautyrest® pillow, a polyester foam pillow and a latex pillow) in the supine and recumbent positions were captured. These images were then uploaded onto a computer, and using the linear co-ordinates of each anatomical landmark (which was determined by the researcher using CorelDraw Graphics Suite 12), the cervico-thoracic and craniocervical postures were determined. The cervico-thoracic posture was determined by calculating the gradients of the intersegmental slopes, relative to the horizontal plane, using the formula (y2 − y1)/(x2 − x1). The craniocervical posture was determined by calculating the craniocervical angle. This angle was determined by constructing lines between the anatomical landmarks and measuring the angle produced at C7. At the end of the objective data collection, participants were asked verbally which pillow they found most comfortable. All data was collected by the researcher. Statistical analysis was done using IBM SPSS version 21.0. Repeated measures ANOVA test was used to compare the mean slope measurements in the four conditions. Inferential techniques included Wilcoxon Signed-Rank test and t-tests. A p-value of < 0.05 indicated statistical significance. iv Results: The mean (± SD) age of the participants was 24.3 (± 2.57) years. In terms of pillow preference, 15 participants preferred the latex pillow, 8 preferred the polyester pillow and 17 preferred the Simmons Beautyrest® pillow. In the recumbent position for the C2-EOP slope the latex and Simmons Beautyrest® pillows supported the neck in a similar manner (p= 0.480) and closer to neutral than no pillow and the latex pillow. For the C4-C2 and the C7-C4 slopes, the latex pillow produced the least extreme slope. For the T3-C7 slope, the polyester pillow produced the slope closest to neutral. Overall, for the entire cervical spine, the latex pillow produced the least extreme slopes, but at the cervico-thoracic junction, the polyester pillow produced the most neutral slope. In all segments, the condition without a pillow produced the most extreme slopes. When comparing the slopes themselves, it can be seen that the most extreme deviations from neutral occurred at the C2-EOP segment. The midcervical spine deviated least from neutral. In the supine position, there were no significant differences (p> 0.05) in the sagittal angular displacement between the pillows. Conclusion: The results of this study support the view that there is no one particular pillow that is better than the others for providing optimal support to the head and neck. Furthermore, practitioners should be aware that it is the craniocervical and cervico-thoracic slopes, which are determined with the patient in the recumbent position, that provide significant information regarding support provided by the pillow rather than the sagittal angular displacement assessed in the supine position. / Durban University of Technology

The human spine is an integral part of the human body. Its functions include mobilizing the torso, controlling postural stability, and transferring loads from upper body to lower body, all of which are essential for the activities of daily living. However, the many complex tasks of the spine leave it vulnerable to damage from a variety of sources. Prolonged walking with a heavy backpack can cause spinal injuries. Spinal diseases, such as scoliosis, can make the spine abnormally deform. Neurological disorders, such as cerebral palsy, can lead to a loss of torso control. External torso support has been used in these cases to mitigate the risk of spinal injuries, to halt the progression of spinal deformities, and to support the torso. However, current torso support designs are limited by rigid, passive, and non-sensorized structures. These limitations were the motivations for this work in developing the science for design of torso exoskeletons that can improve the effectiveness of current external torso support solutions. Central features to the design of these exoskeletons were the abilities to sense and actively control the motion of or the forces applied to the torso. Two applications of external torso support are the main focus in this study, backpack load carriage and correction of spine deformities. The goal was to develop torso exoskeletons for these two applications, evaluate their effectiveness, and exploit novel assistive and/or treatment paradigms. With regard to backpack load carriage, current torso support solutions are limited and do not provide any means to measure and/or adjust the load distribution between the shoulders and the pelvis, or to reduce dynamic loads induced by walking. Because of these limitations, determining the effects of modulating these loads between the shoulders and the pelvis has not been possible. Hence, the first scientific question that this work aims to address is What are the biomechanical and physiological effects of distributing the load and reducing the dynamic load of a backpack on human body during backpack load carriage? Concerning the correction of spinal deformities, the most common treatment is the use of a spine brace. This method has been shown to effectively slow down the progression of spinal deformity. However , a limitation in the effectiveness of this treatment is the lack of knowledge of the stiffness characteristics of the human torso. Previously, there has been no means to measure the stiffness of human torso. An improved understanding of this subject would directly affect treatment outcomes by better informing the appropriate external forces (or displacements) to apply in order to achieve the desired correction of the spine. Hence, the second scientific question that this work aims to address is How can we characterize three dimensional stiffness of the human torso for quantifiable assessment and targeted treatment of spinal deformities? In this work, a torso exoskeleton called the Wearable upper Body Suit (WEBS) was developed to address the first question. The WEBS distributes the backpack load between the shoulders and the pelvis, senses the vertical motion of the pelvis, and provides gait synchronized compensatory forces to reduce dynamic loads of a backpack during walking. It was hypothesized that during typical backpack load carriage, load distribution and dynamic load compensation reduce gait and postural adaptations, the user’s overall effort and metabolic cost. This hypothesis was supported by biomechanical and physiological measurements taken from twelve healthy male subjects while they walked on a treadmill with a 25 percent body weight backpack. In terms of load distribution and dynamic load compensation, the results showed reductions in gait and postural adaptations, muscle activity, vertical and braking ground reaction forces, and metabolic cost. Based on these results, it was concluded that the wearable upper body suit can potentially reduce the risk of musculoskeletal injuries and muscle fatigue associated with carrying heavy backpack loads, as well as reducing the metabolic cost of loaded walking. To address the second question, the Robotic Spine Exoskeleton (ROSE) was developed. The ROSE consists of two parallel robot platforms connected in series that can adjust to fit snugly at different levels of the human torso and dynamically modulate either the posture of the torso or the forces exerted on the torso. An experimental evaluation of the ROSE was performed with ten healthy male subjects that validated its efficacy in controlling three dimensional corrective forces exerted on the torso while providing flexibility for a wide range of torso motions. The feasibility of characterizing the three dimensional stiffness of the human torso was also validated using the ROSE. Based on these results, it was concluded that the ROSE may alleviate some of the limitations in current brace technology and treatment methods for spine deformities, and offer a means to explore new treatment approaches to potentially improve the therapeutic outcomes of the brace treatment.

by Chan Kwai Foon May. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 103-114). / Abstracts in English and Chinese. / Declaration --- p.2 / Abstract --- p.3 / Abstract in Chinese --- p.6 / Acknowledgements --- p.8 / Chapter Chapter 1. --- Introduction --- p.15 / Chapter Chapter 2. --- Osteoporosis : The relationship between aging and skeletal organization between men and women --- p.17 / Chapter 2.1. --- Skeletal organization --- p.17 / Chapter 2.1.1. --- Bone structure --- p.17 / Chapter 2.1.2. --- Bone metabolism --- p.17 / Chapter 2.1.3. --- Peak bone mass --- p.18 / Chapter 2.2. --- Bone loss between men and women --- p.20 / Chapter 2.2.1. --- Aging and bone loss --- p.20 / Chapter 2.2.2. --- Clinical aspects of bone loss in men and women --- p.21 / Chapter Chapter 3. --- Vertebral deformity : Bone Mineral Density and Body Composition --- p.23 / Chapter 3.1. --- Bone mineral density --- p.23 / Chapter 3.1.1. --- Types of vertebral deformity --- p.23 / Chapter 3.1.2. --- Clinical diagnosis in vertebral deformity --- p.24 / Chapter 3.1.3. --- Bone mineral density measurements --- p.25 / Chapter 3.1.4. --- Vertebral deformity and bone mineral density --- p.28 / Chapter 3.2. --- Bone composition --- p.33 / Chapter Chapter 4. --- Literature Review on Health Consequences of Vertebral Deformity --- p.36 / Chapter 4.1. --- Back pain --- p.36 / Chapter 4.1.1. --- Back pain and vertebral deformity --- p.36 / Chapter 4.1.2. --- Back pain in men and women with vertebral deformity --- p.38 / Chapter 4.2. --- Morale and functional limitation and vertebral deformities --- p.39 / Chapter 4.2.1. --- Function evaluation : The Barthel Index --- p.40 / Chapter 4.2.2. --- Philadelphia Geriatric Morale Scale --- p.41 / Chapter Chapter 5. --- Objectives --- p.43 / Chapter Chapter 6. --- "Subjects and methods for phase I: anthropometric measurement, body composition and bone mineral density measurement in vertebral deformity patients and controls" --- p.44 / Chapter 6.1. --- Study subjects --- p.44 / Chapter 6.2. --- Radiology and digitization protocol for diagnosis vertebral deformity --- p.46 / Chapter 6.3. --- Diagnosis of vertebral deformity --- p.48 / Chapter 6.4. --- Body composition and bone mineral density measurements --- p.54 / Chapter 6.4.1. --- Body composition analysis --- p.54 / Chapter 6.4.2. --- Lumbar spine and hip bone mineral analysis --- p.54 / Chapter 6.5. --- Quality control --- p.56 / Chapter 6.5.1. --- Routine quality control of measurements --- p.56 / Chapter 6.5.2. --- Precision on patient repositioning --- p.56 / Chapter Chapter 7. --- Subjects and methods for phase II: health consequences of vertebral deformity patients and controls --- p.57 / Chapter 7.1. --- Questionnaire on health consequences --- p.57 / Chapter 7.1.1 --- Back pain and disability --- p.57 / Chapter 7.1.2 --- Activities of daily living --- p.59 / Chapter 7.1.3 --- Morale --- p.59 / Chapter 7.2. --- Statistical methods --- p.60 / Chapter 7.2.1. --- Bone mineral density and body composition --- p.60 / Chapter 7.2.2. --- Back pain and disability --- p.60 / Chapter 7.2.3. --- Activities of daily living and morale --- p.61 / Chapter Chapter 8. --- "Results for phase I: anthropometric measurement, body composition and bone mineral density measurement in vertebral deformity patients and controls" --- p.62 / Chapter 8.1. --- Demographic characteristics of study population --- p.62 / Chapter 8.2. --- Anthropometric measurements : Body composition and bone mineral density --- p.64 / Chapter Chapter 9. --- Results for phase II: Health Consequences of vertebral deformity patients and control --- p.76 / Chapter 9.1. --- Back pain --- p.76 / Chapter 9.2. --- Disability --- p.78 / Chapter 9.3. --- Activities of daily living --- p.81 / Chapter 9.4. --- Morale --- p.82 / Chapter Chapter 10. --- Discussion I --- p.83 / Chapter 10.1. --- Study Sample --- p.83 / Chapter 10.2. --- Digitization method and definition of vertebral deformity --- p.84 / Chapter 10.3. --- Methods for bone mineral density measurement --- p.87 / Chapter 10.4. --- Questionnaire validity --- p.88 / Chapter 10.4.1. --- Back pain and disability --- p.88 / Chapter 10.4.2. --- Barthel Index --- p.88 / Chapter 10.4.3. --- Philadelphia Geriatric Morale Scale --- p.89 / Chapter Chapter 11. --- Discussion II --- p.92 / Chapter 11.1 . --- Body composition and bone mineral density --- p.92 / Chapter 11.2. --- Differences of vertebral deformity between Chinese men and Caucasian men --- p.93 / Chapter 11.3. --- Health consequences in Chinese men --- p.96 / Chapter 11.4. --- Comparison of health consequences between Chinese men and Caucasian men --- p.98 / Chapter 11.5. --- Variation of health consequences between Chinese men and Chinese women --- p.101 / Chapter 11.5.1. --- Back pain and disability --- p.101 / Chapter 11.5.2. --- Morale --- p.102 / Chapter Chapter 12. --- Conclusion --- p.103 / Reference --- p.104 / Appendix I --- p.115 / Appendix II Publication

Thesis (MEng) -- Stellenbosch University, 2014. / ENGLISH ABSTRACT: The Dorsiflexometer is a device designed and built for the assessment of a patient’s balance capabilities. The birth of the Dorsiflexometer is due to a serious need for physiological balance assessment equipment, capable of conducting dynamic tests in the clinical setting. This is accomplished by recording and analysing the patient’s response to sagittal plane perturbations. The Dorsiflexometer is operated from a computer software interface program. It uses the measurements from a single force plate to calculate four balance metrics’ characterising a patient’s ability to maintain balance. These balance metrics include the sway index, equilibrium score, postural stability index and radius parameter. A single and a double inverted pendulum model of the human body is derived to calculate a patient’s centre of mass movement in the sagittal plane with the measured force plate data and body parameters. Three experiments, involving 48 subjects, were conducted. The experimental tests proved the competency of the machine, the accuracy of both inverted pendulum models and the balance response of seafarers aboard an Antarctic research and supply vessel during rough sea conditions. The tests concluded that the inverted pendulum models can be used to calculate the body centre of mass displacement. The double inverted pendulum model results are more accurate compared with the single inverted pendulum model. During rough sea conditions, the body movement and postural response of seafarers are increased in order to keep themselves upright. The body is furthermore exposed to a fluctuating ground reaction force which may lead to the progression of osteoarthritis and musculoskeletal injuries. The Dorsiflexometer proved to be capable of conducting repeatable assessments and yielding accurate results which can be used to distinguish between balance capabilities. / AFRIKKANSE OPSOMMING: Die Dorsiflexometer is ’n apparaat wat die balansvermoë van pasiënte analiseer. Die masjien is ontwerp en vervaardig weens die groot behoefte aan fisiologiese balans assesserings toerusting wat dinamiese toetse in die mediese sektor kan bepaal. Dit word bereik deur pasiënte se liggaamsreaksie in die sagittale vlak te meet en te assesseer. Die Dorsiflexometer is beheerbaar vanaf ’n rekenaar sagteware koppelvlak program. Die masjien maak gebruik van ’n enkele kragplaat om pasiënte se balans statistieke te meet. Hierdie balans statistieke wat die pasiënte se balans vermoë beskryf en karakteriseer behels die sogenaamde: swaai indeks, balans telling, posturale stabiliteit indeks en die radius parameter. ’n Enkel en dubbel inverse slinger model van die liggaam is afgelei. Hierdie modelle maak gebruik van ’n pasiënt se kragplaat metings en sy liggaamlike parameters om die swaartepunt tydens beweging te bereken. Drie eksperimente, waarin 48 persone betrokke was, is gedoen. Die eksperimente is gedoen om die apparaat se bevoegdheid te bewys, die akkuraatheid van altwee inverse slinger modelle te toets en verder die balans van seevaarders op die Antarktiese navorsings en toevoer skip tydens rowwe see toestande te analiseer. Die toetse het bewys dat die inverse modelle gebruik kan word om die liggaam se swaartepunt te bereken. Die dubbel inverse slinger model resultate is wel akkurater as die enkel slinger model. Daar is bevind dat seevaarders van meer liggaamsbeweging en posturale reaksies gebruik moet maak om orent te bly tydens rowwe seetoestande. Verder word hul liggame blootgestel aan ’n wisselende grond reaksie krag wat kan lei tot die ontwikkeling van osteoarthritis en muskuloskeletale beserings. Die Dorsiflexometer is bewys as ’n aparaat wat wat akurate resultate lewer vir herhaalbare assesserings. Dit kan gebruik word om te onderskei tussen verskillende balans vermoëns.

by Chan Yat Heung. / Thesis submitted in: December 1998. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 81-88). / Abstract also in Chinese. / Declaration --- p.2 / Abstract --- p.3 / Abstract in Chinese --- p.5 / Acknowledgements --- p.7 / Chapter Chapter 1. --- Introduction --- p.12 / Chapter Chapter 2. --- Literature review on the prevalence of vertebral deformity --- p.16 / Chapter 2.1 . --- Prevalence of vertebral deformity in women --- p.16 / Chapter 2.2. --- Prevalence of vertebral deformity in men --- p.21 / Chapter Chapter 3. --- Literature review on the risk factors for osteoporosis and vertebral deformity --- p.25 / Chapter 3.1. --- Dietary calcium intake --- p.25 / Chapter 3.1.1 --- Epidemiological studies --- p.25 / Chapter 3.1.2 --- Intervention studies --- p.26 / Chapter 3.1.3 --- Calcium intake and osteoporosis in Chinese --- p.28 / Chapter 3.2. --- Physical Activity --- p.30 / Chapter 3.2.1 --- Epidemiological studies --- p.30 / Chapter 3.2.2 --- Intervention studies --- p.33 / Chapter 3.2.3 --- Physical activity and osteoporosis in Chinese --- p.34 / Chapter 3.3. --- Cigarette smoking --- p.35 / Chapter 3.4. --- Alcohol consumption --- p.37 / Chapter Chapter 4. --- Subjects and Methods --- p.39 / Chapter 4.1. --- Objectives --- p.39 / Chapter 4.2. --- Study Subjects --- p.40 / Chapter 4.3. --- Radiology and digitization protocol --- p.41 / Chapter 4.4. --- Diagnosis of vertebral deformity --- p.43 / Chapter 4.5. --- Definition of cases and controls --- p.48 / Chapter 4.6. --- Questionnaire and measurement of risk factors --- p.49 / Chapter 4.6.1. --- Dietary calcium intake --- p.49 / Chapter 4.6.2. --- Physical activity --- p.49 / Chapter 4.6.3. --- Cigarette smoking --- p.50 / Chapter 4.6.4. --- Alcohol consumption --- p.50 / Chapter 4.7. --- Pilot study --- p.51 / Chapter 4.8. --- Statistical methods --- p.52 / Chapter Chapter 5. --- Results of Prevalence study --- p.54 / Chapter 5.1 . --- Demographic characteristics --- p.54 / Chapter 5.2. --- Vertebral height and vertebral height ratio --- p.55 / Chapter 5.3. --- Distribution of deformity --- p.59 / Chapter 5.4. --- Comparison of prevalence between Chinese and Caucasian populations --- p.61 / Chapter Chapter 6. --- Results of study on risk factors --- p.62 / Chapter 6.1. --- Dietary calcium intake --- p.62 / Chapter 6.2. --- Physical activity --- p.63 / Chapter 6.3. --- Cigarette smoking --- p.65 / Chapter 6.4. --- Alcohol consumption --- p.67 / Chapter 6.5. --- Results of Multiple logistic regression --- p.69 / Chapter Chapter 7. --- Discussion --- p.70 / Chapter 7.1. --- Study sample --- p.70 / Chapter 7.2. --- Digitization method and definition of vertebral fracture --- p.71 / Chapter 7.3. --- Prevalence of vertebral deformity in Chinese men --- p.72 / Chapter 7.4. --- Risk factors --- p.74 / Chapter 7.4.1. --- Calcium intake --- p.74 / Chapter 7.4.2. --- Physical activity --- p.75 / Chapter 7.4.3. --- Cigarette Smoking --- p.77 / Chapter 7.4.4. --- Alcohol consumption --- p.78 / Chapter Chapter 8. --- Conclusion --- p.80 / Reference --- p.81 / Appendix --- p.89

microRNAs (miRNAs), ~21-24 nucleotide-long RNAs that post-transcriptionally regulate gene expression, have rapidly become one of the most extensively studied mechanisms of the past decade. Since their discovery as temporal regulators of post-embryonic development in C. elegans, miRNAs have been functionally implicated in almost every cellular process investigated to date. miRNAs are integral to the complex biological processes of embryonic development and aging. In this research, we sought to determine whether misregulation of miRNAs could be responsible for eliciting adverse effects during these two distinct developmental stages. First, to uncover the potential role of miRNAs in teratogenicity, we investigated whether miRNAs were involved in regulation of retinoic acid (RA) induced vertebrate axis defects. Global miRNA expression profiling revealed that RA exposure suppressed the expression of miR-19 family members during zebrafish somitogenesis. Bioinformatics analyses predict that miR-19 targets cyp26a1, a key RA detoxifying enzyme, and a physiological reporter assay confirmed that cyp26a1 is a bona fide target of miR-19. Transient knockdown of miR-19 phenocopied RA-induced body axis defects. In gain-of-function studies, exogenous miR-19 rescued the axis defects caused by RA exposure. Our findings indicate that the teratogenic effects of RA exposure result, in part, from repression of miR-19 and the subsequent misregulation of cyp26a1. This highlights a previously unidentified role of miR-19 in facilitating vertebrate axis development. Next, to explore whether age-related changes in miRNAs trigger deficits in regeneration capacity, we performed mRNA and small RNA sequencing on regenerating and non-regenerating caudal fin tissue from aged, adult and juvenile zebrafish. An unbiased approach identified cbx7 as the most abundant transcript with significantly increased expression in regenerative-competent adult and juvenile tissue and decreased expression in regenerative-compromised aged tissue. While cbx7 is a known regulator of aging, this is the first report of its role in tissue regeneration. A computational approach was used to discover mRNAs expressed during regeneration, which are potential targets of the significantly expressed miRNAs in regenerating tissue. miR-21 was one of the most abundant and significantly increased miRNAs in regenerating tissue and exhibited an aberrant age-dependent expression profile. Bioinformatics predicts miR-21 to target the 3' UTR of cbx7 and a reporter assay confirmed that miR-21 targets cbx7 in vivo. Transient knockdown of miR-21 inhibited tissue regeneration, suggesting a role for miRNA mediated regulation of cbx7 during regeneration. These findings reveal a novel, age-dependent regenerative function of cbx7 and emphasize the importance of miR-21 as a master regulator of vertebrate regenerative responses. This research, when combined, underscores the negative consequences misregulation of miRNAs has on embryonic development and aging. / Graduation date: 2013 / Access restricted to the OSU Community at author's request from Dec. 5, 2012 - Dec. 5, 2013

A escoliose é considerada a quinta patologia mais comum em desenvolvimento na adolescência. Sendo que no Brasil a prevalência desta patologia varia de 2% a 4% em adolescentes na faixa etária de 10 a 16 anos. O método Pilates pode ser considerado como alternativa no tratamento conservador desse desvio postural. O objetivo deste estudo foi avaliar o método Pilates no alinhamento postural de adolescentes portadores de escoliose, por meio da eletromiografia e da simetrografia. Foi realizado um estudo exploratório no período de Fevereiro a Abril de 2015, com 22 adolescentes, com idade de 12 a 18 anos, de ambos os sexos, que apresentaram o desvio postural escoliose, fisicamente ativos, sem experiência em treinamento resistido do Método Pilates e que não tinham realizado cirurgia corretiva ortopédica na coluna vertebral e nem recebido diagnóstico de doença reumática. Os voluntários pesquisados preencheram termo de assentimento informado livre e esclarecido e os responsáveis preencheram o termo de consentimento livre e esclarecido. Os adolescentes investigados inicialmente foram submetidos à avaliação antropométrica, percentual de gordura, simetria corporal, teste de Adams e avaliação eletromiográfica nos músculos trapézio, eretores espinhais, oblíquos e reto abdominal, na posição sentada equilibrando um livro sobre a cabeça processados no domínio temporal (EMGAmp) e espectral (EMGFmed). Na sequência foram submetidos á 24 sessões com dois atendimentos semanais de um protocolo de tratamento constituído por exercícios do método Pilates. Após a aplicação deste protocolo, foram novamente submetidos às avaliações iniciais. Os dados foram analisados pela ANOVA e processados utilizando o software estatístico R versão 3.2.0. e teste de McNemar. Os resultados com relação à escoliose mostraram que nove adolescentes melhoraram o alinhamento postural (40,9%) (p=0,001) e também no encurtamento do trapézio (p=0.031) e nos ombros assimétricos (p=0.001). Relativo à EMGAmp na escoliose postural à direita (EPD) houve diferença entre antes e depois (p=0.081) e também entre os músculos (p=0.031); na escoliose torácica à direita (ETD) houve diferença entre antes e depois (p≈0), o lado direito do esquerdo (p=0.04) e também entre os músculos (p≈0); na escoliose torácica à esquerda (ETE) e na escoliose tóraco-lombar destro convexa (ETLDC) houve diferença entre antes e depois (p≈0) e entre os músculos (p≈0). Referente à EMGFmed na EPD houve diferença entre antes e depois (p≈0) e entre os músculos (p=0.001); na ETD houve diferença entre antes e depois (p≈0) e entre os músculos (p=0.007); na ETE e ETLDC houve diferença apenas entre antes e depois (p≈0); na ETLE houve diferença entre antes e depois (p=0.007). Em todos os casos de escoliose estudados, houve aumento da EMGFmed com destaque para os músculos OBLI e RA. Verificaram-se diferenças estatísticas nas variáveis estatura (p=0,003) e aumento na flexibilidade (p=0,000). Conclui-se que os resultados apontam para a importância dos exercícios do método Pilates como forma de tratamento conservador da escoliose, ocasionando mudanças no padrão de ativação neuromuscular. Porém em relação ao tempo de aplicação terapêutico relativo ao alinhamento postural, sugere-se desenvolvê-lo em prazos maiores. / Scoliosis is considered the fifth most common pathology in development during adolescence. And in Brazil the prevalence of this disease ranges from 2% to 4% in adolescents aged 10-16 years old. The Pilates method can be considered as an alternative to conservative treatment of this postural deviation. The aim of this study was to evaluate the Pilates method in the postural alignment of adolescents with scoliosis through electromyography and symmetrography. An exploratory study was conducted from February to April 2015, with 22 12 to 18 year old male and female adolescents who had the scoliosis postural deviation, physically active, without experience in resistance training of Pilates and who had not performed orthopedic corrective surgery on the spine and not been diagnosed with rheumatic disease. Both surveyed volunteers and their parents filled informed consents. The investigated teenagers initially underwent anthropometric measurements, body fat percentage, body symmetry, Adams test and electromyographic assessment in trapezius, erector spinal, obliques and rectus abdominis, in a seated position balancing a book on their heads processed in the time (EMGAmp ) and spectral domains (EMGFmed). After that they were submitted to 24 sessions with two weekly appointments of a treatment protocol consisting of Pilates exercises. After the application of this protocol, they were again subjected to initial assessments. Data were analyzed by ANOVA and processed by using the statistical software R version 3.2.0. and McNemar test. Results regarding scoliosis showed that nine adolescents improved postural alignment (40.9%) (p = 0.001) and there was also an improvement in the shortening of the trapezius (p = 0.031) and asymmetrical shoulders (p = 0.001). Concerning the EMGAmp in right postural scoliosis (EPD), there was a significant difference between before and after (p = 0.081) and also between muscles (p = 0.031); in the right thoracic scoliosis (ETD) there was a difference between before and after (p≈0), the right side of the left (p = 0:04) and between muscles (p≈0); in the left thoracic scoliosis (ETE) and convex left thoracolumbar scoliosis (ETLDC) differences between before and after (p≈0) and between muscles (p≈0) were found. Concerning the EMGFmed in the EPD there was a difference between before and after (p≈0) and between muscles (p = 0.001); in the ETD there was a difference between before and after (p≈0) and between muscles (p = 0.007); in ETE and ETLDC there was a difference only between before and after (p≈0); in ETLE there was a difference between before and after (p = 0.007). In all cases of scoliosis studied here, there was an increase of EMGFmed notably in the OBLI and RA muscles. There were statistical differences in height variables (p = 0.003) and increased flexibility (p = 0.000). One can conclude that the results point to the importance of Pilates exercises as a form of conservative treatment of scoliosis, causing changes in the pattern of neuromuscular activation. However, in relation to the therapeutic application time relative to postural alignment, it is suggested to develop it in longer periods.

A escoliose é considerada a quinta patologia mais comum em desenvolvimento na adolescência. Sendo que no Brasil a prevalência desta patologia varia de 2% a 4% em adolescentes na faixa etária de 10 a 16 anos. O método Pilates pode ser considerado como alternativa no tratamento conservador desse desvio postural. O objetivo deste estudo foi avaliar o método Pilates no alinhamento postural de adolescentes portadores de escoliose, por meio da eletromiografia e da simetrografia. Foi realizado um estudo exploratório no período de Fevereiro a Abril de 2015, com 22 adolescentes, com idade de 12 a 18 anos, de ambos os sexos, que apresentaram o desvio postural escoliose, fisicamente ativos, sem experiência em treinamento resistido do Método Pilates e que não tinham realizado cirurgia corretiva ortopédica na coluna vertebral e nem recebido diagnóstico de doença reumática. Os voluntários pesquisados preencheram termo de assentimento informado livre e esclarecido e os responsáveis preencheram o termo de consentimento livre e esclarecido. Os adolescentes investigados inicialmente foram submetidos à avaliação antropométrica, percentual de gordura, simetria corporal, teste de Adams e avaliação eletromiográfica nos músculos trapézio, eretores espinhais, oblíquos e reto abdominal, na posição sentada equilibrando um livro sobre a cabeça processados no domínio temporal (EMGAmp) e espectral (EMGFmed). Na sequência foram submetidos á 24 sessões com dois atendimentos semanais de um protocolo de tratamento constituído por exercícios do método Pilates. Após a aplicação deste protocolo, foram novamente submetidos às avaliações iniciais. Os dados foram analisados pela ANOVA e processados utilizando o software estatístico R versão 3.2.0. e teste de McNemar. Os resultados com relação à escoliose mostraram que nove adolescentes melhoraram o alinhamento postural (40,9%) (p=0,001) e também no encurtamento do trapézio (p=0.031) e nos ombros assimétricos (p=0.001). Relativo à EMGAmp na escoliose postural à direita (EPD) houve diferença entre antes e depois (p=0.081) e também entre os músculos (p=0.031); na escoliose torácica à direita (ETD) houve diferença entre antes e depois (p≈0), o lado direito do esquerdo (p=0.04) e também entre os músculos (p≈0); na escoliose torácica à esquerda (ETE) e na escoliose tóraco-lombar destro convexa (ETLDC) houve diferença entre antes e depois (p≈0) e entre os músculos (p≈0). Referente à EMGFmed na EPD houve diferença entre antes e depois (p≈0) e entre os músculos (p=0.001); na ETD houve diferença entre antes e depois (p≈0) e entre os músculos (p=0.007); na ETE e ETLDC houve diferença apenas entre antes e depois (p≈0); na ETLE houve diferença entre antes e depois (p=0.007). Em todos os casos de escoliose estudados, houve aumento da EMGFmed com destaque para os músculos OBLI e RA. Verificaram-se diferenças estatísticas nas variáveis estatura (p=0,003) e aumento na flexibilidade (p=0,000). Conclui-se que os resultados apontam para a importância dos exercícios do método Pilates como forma de tratamento conservador da escoliose, ocasionando mudanças no padrão de ativação neuromuscular. Porém em relação ao tempo de aplicação terapêutico relativo ao alinhamento postural, sugere-se desenvolvê-lo em prazos maiores. / Scoliosis is considered the fifth most common pathology in development during adolescence. And in Brazil the prevalence of this disease ranges from 2% to 4% in adolescents aged 10-16 years old. The Pilates method can be considered as an alternative to conservative treatment of this postural deviation. The aim of this study was to evaluate the Pilates method in the postural alignment of adolescents with scoliosis through electromyography and symmetrography. An exploratory study was conducted from February to April 2015, with 22 12 to 18 year old male and female adolescents who had the scoliosis postural deviation, physically active, without experience in resistance training of Pilates and who had not performed orthopedic corrective surgery on the spine and not been diagnosed with rheumatic disease. Both surveyed volunteers and their parents filled informed consents. The investigated teenagers initially underwent anthropometric measurements, body fat percentage, body symmetry, Adams test and electromyographic assessment in trapezius, erector spinal, obliques and rectus abdominis, in a seated position balancing a book on their heads processed in the time (EMGAmp ) and spectral domains (EMGFmed). After that they were submitted to 24 sessions with two weekly appointments of a treatment protocol consisting of Pilates exercises. After the application of this protocol, they were again subjected to initial assessments. Data were analyzed by ANOVA and processed by using the statistical software R version 3.2.0. and McNemar test. Results regarding scoliosis showed that nine adolescents improved postural alignment (40.9%) (p = 0.001) and there was also an improvement in the shortening of the trapezius (p = 0.031) and asymmetrical shoulders (p = 0.001). Concerning the EMGAmp in right postural scoliosis (EPD), there was a significant difference between before and after (p = 0.081) and also between muscles (p = 0.031); in the right thoracic scoliosis (ETD) there was a difference between before and after (p≈0), the right side of the left (p = 0:04) and between muscles (p≈0); in the left thoracic scoliosis (ETE) and convex left thoracolumbar scoliosis (ETLDC) differences between before and after (p≈0) and between muscles (p≈0) were found. Concerning the EMGFmed in the EPD there was a difference between before and after (p≈0) and between muscles (p = 0.001); in the ETD there was a difference between before and after (p≈0) and between muscles (p = 0.007); in ETE and ETLDC there was a difference only between before and after (p≈0); in ETLE there was a difference between before and after (p = 0.007). In all cases of scoliosis studied here, there was an increase of EMGFmed notably in the OBLI and RA muscles. There were statistical differences in height variables (p = 0.003) and increased flexibility (p = 0.000). One can conclude that the results point to the importance of Pilates exercises as a form of conservative treatment of scoliosis, causing changes in the pattern of neuromuscular activation. However, in relation to the therapeutic application time relative to postural alignment, it is suggested to develop it in longer periods.