Primitive reflexes are brain stem-mediated, complex automatic movement patterns that commence in utero. If primitive are present they will influence normal motor control and can interfere with normal rehabilitation.
The full pattern of a primitive reflex is not often seen in “neurologically intact” adults. There is a highly variable amount of cortical inhibition. So we look for “remnants” of the primitive reflex pattern.
During the Asymmetrical Tonic Neck Reflex (ATNR) one of the key assessments is to have the subject actively rotate the cervical spine in supine. The therapist monitors the medial (and lateral) malleolus for an apparent leg length shortening or vertical movement. This is essentially a “hip hike” or coronal movement of the pelvis.
Primitive reflexes can have significant influences on movement patterns and motor control.
The video is a fluoroscopy of a subject from the study back in 2008. The subject is turning their head to the left and there iliac crest raises slightly (a “hip hike”). The subject had a positive Asymmetrical Tonic Neck Reflex (ATNR) with apparent leg length shortening on the right when the cervical spine was turned to the left.
It should be appreciated that this hip hike can influence muscle EMG in the regions involved in the neurological patterns. We did not measure the hip or shoulder muscles in this study. It is possible there should be other changes given that the ATNR is a whole body reflex (e.g., contralateral limb flexion and ipsilateral extension patterns).
https://www.researchgate.net/publication/260372903_Effect_of_head_and_limb_orientation_on_trunk_muscle_activation_during_abdominal_hollowing_in_chronic_low_back_pain
The above study was conducted as a follow up to clinical observations in the rehabilitation of a transversus abdominis biased abdominal hollowing.
https://www.researchgate.net/publication/262912493_Retraining_of_asymmetry_in_recruitment_of_transversus_abdominis?_sg%5B0%5D=OPSavToxKps4AHa9RnNJC8Z_PSj6upgpoKQdTtQPeUDYzipTwAQGri_DrDSHNvr3aLB3yrhWkwJJ8-_UYgIWbIFlTy1-y7cTz7N55wCb.W4smeb8-ItBeOGpFzPEW-2TBLdZc1aZlsT3cqQ36sNdcHtn_tnR4OXugvdLvXDHDnysmOiLtb9vcRyhkBOTnaA&_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InByb2ZpbGUiLCJwYWdlIjoicHJvZmlsZSIsInByZXZpb3VzUGFnZSI6InByb2ZpbGUiLCJwb3NpdGlvbiI6InBhZ2VDb250ZW50In19
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