Made available in DSpace on 2016-09-27T13:39:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-09-14. Added 1 bitstream(s) on 2016-09-27T13:45:05Z : No. of bitstreams: 1 000869173.pdf: 2452278 bytes, checksum: 85fd789b99aa751120a5330cb5ab3a02 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O pacu (Piaractus mesopotamicus) apresenta excelentes características zootécnicas como rápido crescimento, parâmetro que está diretamente relacionado com o aumento da musculatura estriada esquelética. Pesquisas envolvendo a caracterização de genes musculares têm sido realizadas utilizando-se tecnologias moleculares, em espécies de peixes modelo como o Zebrafish que possui o genoma sequenciado. No pacu, espécie que não possui o genoma sequenciado, esta falta de informação genética dificulta a realização de pesquisas relacionadas com a identificação das vias de sinalização que regulam o desenvolvimento, o crescimento e a manutenção do fenótipo muscular. Além disso, a falta de informação promove uma limitação para o desenvolvimento de programas de melhoramento para esta espécie. Os principais objetivos do presente estudo foram: 1) aumentar os recursos genéticos disponíveis para a espécie, 2) comparar os transcriptomas dos tipos de músculo, vermelho e branco explorando as vias de sinalização que controlam os tipos de fibras musculares 3) investigar a expressão de deubiquitinas pertencente a família do sistema de Proteases ubiquitinas-específicas (USP) no músculo branco em resposta ao jejum e realimentação. Com o sequenciamento, obteve-se aproximadamente 0.6Tb de leituras a partir de bibliotecas do músculo esquelético vermelho e branco. Aproximadamente, 665 milhões de leituras foram utilizadas para a realização da montagem, resultando em 504.065 contigs com um comprimento médio de 1,334bp e N50 = 2,772bp; 47% do transcriptoma foi anotado com êxito, onde pode-se identificar cerca de 15.000 genes considerados únicos e aproximadamente 8000 sequências com região codificante completas. Dentre os genes identificados destacam-se 319 genes de vias metabólicas e 380 microssatélites. Novecentos e ciquenta e seis e 604 genes foram diferencialmente expressos entre o músculo vermelho e branco, respectivamente. / Pacu (Piaractus mesopotamicus) has excellent husbandry features like rapid growth. This parameter is directly related to the increase of skeletal muscle. Researches involving the characterization of muscle genes have been performed using molecular technologies, in species of fish such as zebrafish model that has sequenced the genome. In pacu, a species that does not have the sequenced genome, this lack of genetic information makes it difficult to conduct research related to the identification of signaling pathways that regulate development, growth and maintenance of muscle phenotype. Moreover, the lack of information promotes a limitation for the development of breeding programs for this species. The main objectives of this study were: 1) to increase the available genetic resources for the species, 2) compare the transcriptomes of red and white muscle types, exploring the signaling pathways that control the types of muscle fibers 3) to investigate the expression of deubiquitins belonging to the family of ubiquitin-specific proteases system (USP) in muscle in response to fasting and feedback. With the sequencing, it was obtained approximately 0.6Tb readings from red skeletal muscle and white libraries. Approximately 665 million readings were used to perform the assembly, resulting in 504 065 contigs with an average length of N50 = 1,334bp and 2,772bp; 47% of the transcriptome was noted successfully, which can be identified about 15,000 genes considered as unique and approximately 8000 sequences coding complete region. Among the identified genes, we could observe 319 metabolic pathways genes and 380 microsatellite. Nine hundred fifty six and 604 genes were differentially expressed between red and white muscle, respectively. We identified 442 pairs of paralogs genes resulting from genomic duplication at the base source of teleost fish. It was possible to identify differential expression of paralogous genes include the types of fibers... / CAPES: 1450/13-1 BEX / FAPESP: 2012/02489-4

Orientador: Maeli Dal Pai / Coorientador: Robson Francisco Carvalho / Banca: Renato Ferreti / Banca: Francis Lopes Pacagnelli / Banca: Tiago Luiz de Russo / Banca: Silvio Assis Oliveira Junior / Resumo: O entendimento dos mecanismos celulares e moleculares envolvidos com os processos de hipertrofia e atrofia muscular têm sido alvo de muitas pesquisas. Tal fato contribui para desenvolvimento de estratégias terapêuticas eficazes para atenuar ou até mesmo bloquear a perda de massa muscular. Neste contexto, fatores miogênicos e microRNAs (miRNAs) têm sido estudados para melhor compreender as respostas adaptativas do músculo esquelético. Os objetivos do presente trabalho foram avaliar as adaptações morfofuncionais, a expressão gênica de fatores miogênicos, anabólicos e catabólicos e a expressão dos miRNAs no músculo esquelético de ratos submetidos à estimulo atrófico, seguido de treinamento físico, aeróbico e resistido. Foram utilizados 80 ratos Wistar machos (80 dias, 250 a 300 g), divididos em 10 grupos (n=8): C: controle; I: imobilizado; C3: controle 3 dias; R3: recuperado sem exercício 3 dias; T3: treinamento aeróbico 3 dias; TF3: treinamento de força 3 dias; C7: controle 7 dias; R7: recuperado sem exercício 7 dias; T7: treinamento aeróbico 7 dias e TF7: treinamento de força 7 dias. Inicialmente, os animais dos grupos I, R3, R7, T3, T7, TF3 e TF7 foram submetidos a um período de 7 dias de imobilização dos membros posteriores. Foram analisados os músculos plantar (Pl - glicolítico e de contração rápida) e sóleo (Sol - oxidativo e de contração lenta). A atrofia muscular foi confirmada pela análise da área de secção transversal (AST) das fibras nos animais dos grupos I e C. Os grupos T3 e T7, foram submetidos a um programa de recuperação muscular com exercício aeróbico (natação) no período de 3 e 7 dias respectivamente enquanto os grupos TF3 e TF7 foram submetidos a um programa de recuperação muscular com exercício resistido (salto). Ao término do experimento os músculos Pl e Sol foram submetidos às análises: morfológica, histoquímica, bioquímica e molecular. Observamos atrofia muscular em... / Abstract: Understanding the cellular and molecular mechanisms involved in hypertrophy and atrophy processes have been the subject of much research. This fact contributes to development of effective therapeutic strategies to attenuate/block the muscle mass loss. However, myogenic factors and muscle-specific miRNAs have been studied to understand the skeletal muscle adaptive responses. The aim of this study were to evaluate the morphological and functional adaptations, the gene expression of myogenic, anabolic and catabolic factor, and the expression of microRNAs in skeletal muscle of rats submitted to atrophic stimulus followed by physical training. 80 male Wistar rats were used (80 days 250 to 300 g) were divided into 10 groups (n = 8) C: Control; IM: immobilizated; C3: control 3 days; R3: recovered without exercise 3 days; T3: aerobic training 3 days; TF3: strength training 3 days; C7: control 7 days; R7: recovered without exercise 7 days; T7: aerobic training 7 days and TF7: strength training 7 days. Initially, the animals of I, R3, R7, T3, T7, TF3 and TF7 groups were underwent period of hindlimb immobilization by 7 day. Plantaris (Pl - glycolytic and fast twitch) and soleus (Sol - oxidative and slow twitch) muscles were analyzed. Muscle atrophy was confirmed by the analysis of cross-sectional area (CSA) of fibers in groups I and C. The T3 and T7 groups, were underwent a muscle recovery program with aerobic exercise (swimming) 3 period and 7 days respectively while the TF3 and TF7 groups were underwent a muscle recovery program with resistance exercise (jump). At the end of experiment the Pl and Sol muscles were submitted to analysis: morphological, immunohistochemical, biochemical and molecular. Muscle atrophy was observed in both muscles after immobilization, but after 7 days of recovery, only the T7 group showed recovery in CSA. Gene expression data showed: increase in genes involved in muscle atrophy in group I in Sol (MAFbx, PGC-1α and ... / Doutor

Orientador: Carlos Eduardo Steiner / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T08:47:23Z (GMT). No. of bitstreams: 1 Morini_SandraRegina_M.pdf: 2171982 bytes, checksum: 43545a3cec722564439f5853d48c9de2 (MD5) Previous issue date: 2007 / Resumo: A mucopolissacaridose tipo II (MPS II) é uma doença de depósito lisossômico rara causada pela deficiência da atividade da enzima iduronato-2-sulfatase. Essa enzima é responsável pelo catabolismo de dois Glicosaminoglicanos (GAGs) diferentes, o sulfato de dermatan e o sulfato de heparan. O acúmulo lisossômico desses GAGs causa disfunção de células, tecidos e órgãos, sendo que o envolvimento do Sistema Músculo-esquelético se deve ao acúmulo essencial em articulações e no tecido conectivo. A MPS II abrange muitos aspectos e dois fenótipos são reconhecidos, o leve e o grave, que representam os dois pontos extremos de um vasto espectro da gravidade clínica. O objetivo desse estudo foi caracterizar o Sistema Músculo-esquelético de uma amostra de sujeitos com MPS II, relacionando as conseqüências biomecânicas e funcionais. Foram encontradas alterações biomecânicas, principalmente em articulações dos membros superiores, que interferiram em algumas atividades funcionais dos sujeitos do estudo. Através da goniometria, observou-se uma defasagem nas amplitudes de movimentos de várias articulações, especialmente em ombros e cotovelos. Os sujeitos apresentaram perda de força muscular em diversos grupos musculares, principalmente flexores e extensores dos dedos das mãos e pronadores e supinadores do antebraço. Foram observadas algumas alterações posturais características e disostose múltipla em todos os indivíduos. Tais alterações contribuíram para os déficits encontrados nas atividades de vida diária. As escalas PEDI e FIM foram aplicadas e os resultados demonstraram uma relação de maiores déficits em tarefas ligadas com as funções de membros superiores, tais como: pentear os cabelos, vestir uma camiseta e amarrar os sapatos / Abstract: Mucopolysaccharidosis type II (MPS-II) is a rare lysosomal storage disorder caused by deficiency in the activity of the enzyme iduronate-2-sulphatase. This enzyme is responsible for the catabolism of two different glycosaminoglycans (GAGs), dermatan sulfate and heparan sulfate. Lysosomal accumulation of these glycosaminoglycan molecules results in cell, tissue and organ dysfunction. The musculoskeletal system involvement is due to essential accumulated glycosaminoglycans in joints and connective tissue. MPS-II has many clinical features and includes two recognized clinical entities, mild and severe, that represent two ends of a wide spectrum of clinical severity. The aim of this study was to describe the musculoskeletal system in a sample of subjects with MPS-II relating the biomechanics and functional consequences. Biomechanical alterations were found, essentially in superior limbs joints that interfered in some functional activities of the subjects in the study. Deficit in movement amplitude in many joints, especially shoulders and elbows, was observed through the goniometry. The subjects showed force loss in several muscular groups, especially the flexors and extensors of the fingers as well as pronators and supinators. Dysostosis multiplex was seen in all individuals and typical postural changes were noted. These alterations contributed with the deficits in daily activities. PEDI and FIM scales was applied and the results demonstrated larger deficits in tasks with the functions of superior members, such as: to comb the hair, to dress a shirt and to tie the shoes / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Altas concentrações de ácidos graxos saturados desencadeiam resistência à insulina no músculo esquelético e o estresse de retículo endoplasmático (RE) é sugerido neste processo. Este estudo objetivou investigar, em células musculares L6, os efeitos do tratamento com palmitato sobre o estresse de RE e a ativação do NF-kB, relacionando-os com o prejuízo na expressão do GLUT4. Pelos resultados, observou-se que o tratamento com 0,75 mM de palmitato induziu redução no conteúdo de GLUT4 e Slc2a4. Os marcadores de estresse como GRP78, PERK/EIF2a e IRE1a/XBP-1/TRAF2 apresentaram pouca ativação. O fator transcricional NF-kB apresentou-se aumentado em seu conteúdo proteico e RNAm. A atividade de ligação do NF-kB à região promotora do Slc2a4 mostrou aumento independente do grau de fosforilação de IKK. Em suma, observou-se que o palmitato reprime a expressão do Slc2a4 e que induz pouco estresse de RE em células L6. Por outro lado, a participação do NF-kB parece ser importante no controle deste fenômeno reduzindo a expressão do Slc2a4 e prejudicando a homeostasia da glicose. / High concentrations of saturated fatty acids trigger insulin resistance in skeletal muscle and endoplasmic reticulum stress (ER) is suggested in this process. This study aimed to investigate, in L6 muscle cells, the effects of palmitate treatment on ER stress pathways and activation of NF-kB, relating them to the impaired expression of GLUT4. The results showed that treatment with 0.75 mM of palmitate induced reduction in the amount of GLUT4 and Slc2a4. Stress markers such as GRP78, PERK/EIF2a and IRE1a/XBP-1/TRAF2 showed little activation. The transcription factor NF-kB were increased in protein content and mRNA. The binding activity of NF-kB to the promoter region of Slc2a4 showed increased independent from the phosphorylation of IKK. Finally, it was observed that palmitate represses the expression of Slc2a4 and that this fatty acid induces little activation of reticulum stress pathways in L6 cells. On the other hand, the involvement of NF-kB appears to be important to control this phenomenon, reducing the expression of Slc2a4 and impairing glucose homeostasis.

South Africa is a labour-intensive industrially developing country. As a result, in excess of 200 000 workers suffer from musculoskeletal injuries in a year. Research is thus essential to develop more effective strategies in the reduction and rehabilitation of occupational musculoskeletal disorders within industry. It was the hypothesis of this study that by improving the physical work capacity of manual labourers, through participation in an occupation specific work-hardening programme, that the ergonomic stress index and therefore the occurrence of musculoskeletal injuries within industry, may be reduced. Twenty-five male Black and Coloured manual labourers volunteered to participate in this study. In addition to in situ task analyses, the subjects participated in cardiovascular and strength assessments in the laboratory, both pre- and post-participation in the ten-week work-hardening programme. The data were statistically analyzed in order to identify any significant • improvements in the workers' physical work capacity, as measured by cardiovascular, strength and perceptual responses, following the period of work-hardening. Two significant reductions were noted in measures of working heart rate together with significant improvements in grip strength and trunk strength tested at a velocity of 60°.sec·1 at the post-conditioning assessments. In conclusion, the ten-week work-hardening programme resulted in nominal improvements in all the cardiovascular measures and significant improvements in the subjects' strength performance. However, industrialists must recognise that this study dealt with only one aspect of reducing the ergonomic stress index at the workplace and realise that, in addition to this focus, it remains essential to design the task to fit the human operator.

Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Nursing, Durban University of Technology. Durban. South Africa, 2017. / Introduction Musculoskeletal disorders (MSDs) are classified as occupational disease. They are described as disorders that affect the musculoskeletal system, and affect the health, productivity and careers of the working population. Dental technicians are at risk of MSDs as much as other members of the dental professionals as a result of their daily activities which involves manual work or they could be labour intensive. The risk factors for MSDs among dental professionals are multifactorial. Problem Statement There are currently no established statistics on the prevalence and risk of musculoskeletal disorders among dental technicians in South Africa. Purpose The purpose of the study was to determine the prevalence and risk of MSDs among dental technicians in South Africa. Research Method A quantitative research approach using a cross sectional correlational survey design was adopted for this study. Using a purposive sampling, the data base of all the dental technicians was obtained from the South African Dental Technician Council (SADTC) and those with valid e-mail addresses and telephone numbers were invited to participate in the study. A modified Nordic musculoskeletal questionnaire was used to collect data, 79 technicians responded with only 72 valid questionnaires available for analysis. Results The twelve month prevalence rate of MSDs among dental technicians in South Africa is 90%. MSDs was reported in all body parts and across all ages and genders. The prevalence for neck, hand/wrist, upper back and low back pain were the highest, having the same prevalence rate of 68.1%. The risk factors for MSDs in at least one body part that were identified in this study are age, prolonged standing and vibration. There was no significant relationship between gender, alcohol intake, smoking, having children and MSDs in any body part. However, a relationship exists between age and MSDs in the wrist/hand, standing and elbow pain, vibration and lower back symptoms. Conclusion The study showed that the prevalence of musculoskeletal disorder is high (90%) among dental technicians in South Africa. The prevalence of MSD is not age or gender related. However, some affected body parts were directly linked to age, standing and vibration. More research needs to be done on the ergonomics and workplace in order to address the high incidence of MSDs. / M

Ergonomics aims to improve worker health and enhance productivity and quality. Knowledge and practical evidence of this relationship would be instrumental for optimising organisational performance particularly in industrially developing countries where the discipline is still in its developmental stages. Therefore this thesis set out to analyse the relationship between ergonomics deficiencies and performance. A survey was first conducted to establish the severity of quality problems in the South African manufacturing industry and to determine if these were related to Ergonomic deficiencies. The results indicated that quality problems continue to plague industry, a challenge associated with huge cost implications. Furthermore organisations were not cognisant of the fact that ergonomics deficiencies such as poor workstation design and awkward or constrained working postures are a major contributing factor to poor quality and performance decrements. This demonstrates that much is yet to be done in raising awareness about the benefits of ergonomics in South Africa and other industrially developing countries. However, for this to be effective, tangible evidence of these purported benefits is required. In lieu of this, a laboratory study was then conducted to establish the relationship between awkward working postures and the performance of precision tasks. Acknowledging that the task and the worker are interrelated elements, the impact of precision task demands on the postural strain experienced by the human was also investigated. A high and low precision task quantified positional precision while a force task (combination of pushing and pulling) was utilised to assess the ability to maintain a precise force over time. These three tasks were performed in eight different postures; namely seated, standing, stooping 300 and 600, working overhead, lying supine, and twisting to either side. A combination of the tasks and postures resulted in 24 experimental conditions that were tested on forty eight healthy male and female participants. The performance related dependent variables were movement time, deviation from the centre of the target, and the trend/slope followed by the force exerted. Muscle activity of eight arm, shoulder and back muscles, iii supplemented with heart rate and local ratings of perceived exertion, were utilised to quantify the impact of the tasks and the postures on the individual. The results revealed that awkward working postures do in fact influence performance outcomes. In this regard, awkward working postures (such as overhead work and lying supine and stooping) were evidenced to significantly affect movement time, deviations from the target and the ability to maintain a constant force over time. These variables have a direct relationship with organisational priorities such as productivity and quality. Furthermore, the results indicated that high precision demands augment postural strain elicited through high muscle activity responses and may have negative implications for the precipitation of musculoskeletal disorders. Essentially, the work done on this thesis reflected the complex nature of ergonomics by drawing on both macro and micro-ergonomics approaches. In so doing, challenges perceived to be relevant to industry as reported by organisations formed the foundation for further laboratory studies. Therefore, more collaborative research and knowledge transfer between industry and ergonomics researchers is a necessity particularly in industrially developing countries where ergonomics is still in its developmental stages.

Background: Currently, body composition (BC) assessment is usually performed to diagnose disease states and accurately estimate certain types of tissues. In athletes, performing BC assessments helps gauge training and nutrition programs to see if they are adequately meeting the athlete’s needs to improve performance. Annual Dual Energy X-ray Absorptiometry (DXA) scans before the start of an athlete’s season can help identify an athlete’s preparedness or health before training begins. Objective: To assess the preseason BC of four collegiate sports: Men’s basketball, men’s baseball, women’s volleyball, and women’s soccer, for Fat Mass (FM), bone mineral density BMD), Fat-Free Mass (FFM), and visceral adipose tissue (VAT). Methods: DXA (Lunar iDXA, GE Healthcare) scans were performed before the start of pre-season training for Men’s Basketball, Baseball, Women’s Volleyball, and Women’s Soccer. End-season DXA scans were performed after the end of the regular season for Men’s Basketball and Baseball athletes. Visceral Adipose Tissue was measured using CoreScan software provided by GE and Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) were calculated from scanned values. Results: Between the various sports, there were several significant differences that were apparent. Height and percentage of Fat Mass (%BF) were significantly different between all sports except Women’s Volleyball and Women’s Soccer. BMI, VAT, and FFMI were significantly different between males and females. Changes over a season showed increased BMD in Men’s Basketball (2.79 to 2.99 Z-score, pre to end of season scan respectively; p < 0.001). No other observations were noticed to be significant. Conclusions: Sports-specific training and sex have large influences on the body composition of athletes. FMI and FFMI are two indices that may have a stronger indication to health than parameters considered for those who are sedentary and non-active. Female athletes have little to no amounts of VAT and this warrants further investigation.

Orientador: Maeli Dal-Pai / Resumo: O músculo esquelético é capaz de adaptação fenotípica à fatores ambientais, como a disponibilidade de nutrientes, alterando o equilíbrio entre catabolismo e anabolismo muscular que, por sua vez, coordena o crescimento muscular. Os pequenos RNAs não codificados, conhecidos como microRNAs (miRNAs), reprimem a expressão de mRNAs alvo e muitos estudos demonstraram que os miRNAs regulam os mRNAs de genes catabólicos e anabólicos. Nós avaliamos a morfologia muscular, a expressão gênica de componentes envolvidos com o catabolismo, anabolismo e metabolismo energético e expressão de miRNAs no músculo rápido e lento de juvenis de pacus (Piaractus mesopotamicus) durante um período de restrição alimentar e realimentação. Nossa análise revelou que períodos curtos de restrição alimentar seguidos por realimentação afetaram predominantemente o músculo rápido, alterando o diâmetro da fibra muscular e a expressão de RNAs e miRNAs. Houve um aumento nos níveis de mRNA dos componentes catabólicos (FBXO25, ATG12, BCL2) e genes relacionados ao metabolismo energético (PGC1a e SDHA), juntamente com uma diminuição nos níveis de PPARβ / δmRNA. Curiosamente, um aumento nos níveis de mRNA dos genes anabólicos (PI3K e complexo mTORC1: mTOR, mLST8 e RAPTOR) também foi observado durante a restrição alimentar. Após realimentação, a morfologia muscular mostrou padrões similares do grupo controle; a maioria dos genes estavam ligeiramente regulados de forma up e down em mabas as musculaturas, respectivamente; o... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Skeletal muscle is capable of phenotypic adaptation to environmental factors, such as nutrient availability, by altering the balance between muscle catabolism and anabolism that in turn coordinates muscle growth. Small noncoding RNAs, known as microRNAs (miRNAs), repress the expression of target mRNAs, and many studies have demonstrated that miRNAs regulate the mRNAs of catabolic and anabolic genes. We evaluated muscle morphology, gene expression of components involved in catabolism, anabolism and energetic metabolism and miRNAs expression in both the fast and slow muscle of juvenile pacu (Piaractus mesopotamicus) during food restriction and refeeding. Our analysis revealed that short periods of food restriction followed by refeeding predominantly affected fast muscle, with changes in muscle fiber diameter and miRNAs expression. There was an increase in the mRNA levels of catabolic pathways components (FBXO25, ATG12, BCL2) and energetic metabolism-related genes (PGC1αand SDHA), together with a decrease in PPARβ/δmRNA levels. Interestingly, an increase in mRNA levels of anabolic genes (PI3K and mTORC1 complex: mTOR, mLST8 and RAPTOR) was also observed during food restriction. After refeeding, muscle morphology showed similar patterns of the control group; the majority of genes were slightly up- or down-regulated in fast and slow muscle, respectively; the levels of all miRNAs increased in fast muscle and some of them decreased in slow muscle. Our findings demonstrated that a sh... (Complete abstract click electronic access below) / Doutor

Chronic low back pain (CLBP) is defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without sciatica, that lasts for at least twelve weeks.1 It is the leading cause of disability and loss of productivity in the United States.2 There is conflicting evidence on what is the most effective nonpharmacological treatment for CLBP. Many studies have shown that any general exercise routine is effective for improving symptoms, but the literature provides conflicting evidence about what specific type of exercise is best.3 A few studies have demonstrated decreased pain and disability with supervised directional preference exercise routines compared to non-directional preference routines. The objective of this study was to determine the effectiveness of a home directional preference exercise/stretch program for reducing disability in mechanical CLBP in patients in a residency clinic and to expand on the limited evidence of directional preference exercise effectiveness. Unlike other directional preference interventional studies, this program’s simplicity and convenience of performing at home potentially could increase patient compliance and therefore effectiveness. Patients were screened at a routine clinic visit and considered eligible if they had a known diagnosis of CLBP. They were excluded if they were in an acute exacerbation. Participating patients were categorized on directional range of motion preference based on their physical exam, either flexion or extension, whichever improved their pain. They were given a simple routine with instructions and pictures consisting of three exercises and stretches that emphasized their specific directional preference. Subjects performed three sets of each routine two to three days per week. Degree of disability score was measured at initial visit by completing the gold standard disability index questionnaire, the Oswestry Disability Index (ODI). Degree of disability was reassessed with ODI at a follow-up assessment four to eight weeks later with five follow-up questions regarding compliance and acute exacerbation. Patients were excluded if they were in an acute exacerbation. Pre-interventional disability scores were then compared to post-interventional disability scores. Twelve total patients enrolled in the program. Seven were lost to follow up. Five completed the study at the proper follow up interval; however, one was in an acute exacerbation so was excluded. Of the four patients included, two had extension and two had flexion preference. Three out of four patients had decreased disability scores at follow up. Total post-intervention score on ODI improved by an average of 10 points compared to pre-intervention score for the patients who improved. The most improved post-interventional ODI score category was walking and changing degree of pain. Seventy-five percent of the patients who completed the study had an improvement in their CLBP disability score. However, due to a small sample size and study power, the results are not statistically significant. Therefore, a conclusion cannot be appropriately drawn about the effectiveness of performing a home directional preference exercise/stretch program for reducing disability in mechanical CLBP in patients at a residency clinic. Nevertheless, the results are promising and deserve further investigation with a larger sample size.