“…Immobility results in specific effects on synovial joints, including reduction of the interzone region between adjacent skeletal rudiments, with continuity of cartilaginous rudiments across joints (fusion) in many cases; loss of normal cellular organisation with absence of the chondrogenous layers at the ends of rudiments (zones of future articular cartilage marked by increased cell density oriented parallel to the joint line); and failure to commence cavitation (Singh et al, 2018;Nowlan et al, 2014;Roddy et al, 2011b;Nowlan et al, 2010a;Kahn et al, 2009;Osborne et al, 2002). Changes within the rudiment termini also result in abnormal joint shape (Sotiriou et al, 2019;Brunt et al, 2016;Brunt et al, 2015;Roddy et al, 2011b) and all of these changes have been shown to be underpinned by altered gene expression and activation of signalling pathways that guide essential developmental steps including Wnt, BMP and Hippo (Shea et al, 2019;Rolfe et al, 2018;Singh et al, 2018;Brunt et al, 2017;Rolfe et al, 2014;Roddy et al, 2011b;Kahn et al, 2009). Disturbances of the spine due to immobility include curvature abnormalities, posterior and anterior vertebral fusions and altered vertebral shape (Levillain et al, 2019;Rolfe et al, 2017;Hosseini and Hogg, 1991).…”