Is it important to take a detailed birth history? Yes it is – sometimes. It is most important when there is very poor motor skill learning, body imagery deficits or when there is a battery of primitive reflexes present. If you truly want to get an understanding of the of the presentation, a birth history is indicated.
What does a birth history involve? It includes: the mothers health during pregnancy; specialist care during pregnancy; fetal development, movements and health; birthing history. A history of gross and fine motor development, breast feeding or illnesses during development should also be included.
The mothers health, medication use, alcohol use, atypical birth history (pre-term, induced labor, low birth weight, C-section, breech, shoulder dystocia, forceps birth, vaccum extraction, APGAR score) and abnormal milestones are associated with a large variety of health conditions including: neurocognitive function, allergies, asthma, chronic pain (Note: some of these associations are in groups and not individual).
Our own epidemiological findings have shown that a battery of these (especially atypical birth history, late walking or absent crawling) is associated with body imagery disturbances. This history is also associated with por motor skill learning.
Clinical implications
Many countries unfortunately have different names for this subgroup of patients (e.g., “Motor Moron” – Canada, “Proprioceptively Vacant” old school in the UK) which were previously often considered problematic in rehab. This subgroup of patients often display characteristics of Developmental Coordination Disorder or other neurodevelopmental disorder(s).
This group of patients has a variety of neurological soft signs including primitive reflexes and a body imagery disorder. Clinically, they are successfully rehabilitated with primitive reflex inhibition, specific sensory motor function midline rehabilitation and postural reflexes if the only obvious causation is an atypical birth history.
Gibbons SGT 2016 Are a battery of obstetric and neurodevelopmental variables are associated with a subgroup of fibromyalgia and unclassified pain patients. A retrospective case control study. Proceedings of: “Cognitive Vitality” The CAPM&R 64th Annual Scientific Meeting. May 25-29, London, Ontario. Journal of Rehabilitation Medicine)
Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-group for whiplash associated disorders. J Rehabil Med 2011; Suppl 50: 23
Gibbons SGT 2009 Neurological soft signs are present more often and to a greater extent in adults with chronic low back pain with cognitive learning deficits. Manual Therapy. 14 (S1): S20
Gibbons SGT 2009 The development, initial reliability and construct validity of the motor control abilities questionnaire. Manual Therapy. 14 (S1): S22
Gibbons SGT 2009 Primitive reflex inhibition and sensory motor training improves cognitive learning function and symptoms in chronic disabling low back pain: A case series. Manual Therapy. 14 (S1): S24
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