Primitive Reflex Influencing Movement & Motor Control: Assessment & Rehabilitation

Changing the Brain for Movement, Pain & Function:

Assessment and Rehabilitation of Primitive Reflexes & Postural Reflexes influencing Motor Control, Tone & Pain

Course Description

Primitive reflexes (PR) are brain stem-mediated, complex automatic movement patterns that commence in utero.  They are naturally occurring patterns that happen in all individuals as the central nervous system (CNS) develops, and are used as a simple screening tool to determine CNS integrity.   As the CNS matures these PR start to disappear or transform around the age of six months.  This is around the same age as when voluntary action and cortical inhibition develops.  If PR persist beyond their average lifespan they may begin to interfere with proper CNS development and could indicate neurological impairment. They PR may be retained: i.e. present due to incomplete neurological development and manifest as conditions such as learning difficulties (i.e. dyslexia, attention deficit disorder) or movement disorders in children and adults. Alternatively, the PR can become uninhibited and reappear due to various conditions i.e. psychiatric disorders (i.e. anxiety, OCD), altered sensory input into the CNS (musculoskeletal injury – i.e whiplash) or altered processing (i.e. concussion or mild head injury).  The presence of PR will influence motor control and may indicate altered CNS neurocognitive processing (i.e. problem solving, rationale thought, catastrophizing).  The presence of significant PR can interfere with normal rehabilitation. 

A sub group of patients have difficulty understanding the exercises or education we give them.  These patients have significant deficits in sensory motor function, learning skills, and have primitive reflexes in the nervous system.  Research shows that there is a strong relationship between sensory motor function, presence of primitive reflexes and neurocognitive function.  The Motor Control Abilities Questionnaire is an instrument developed to identify patients who have difficulty understanding stability and movement control exercises.  On this course we will cover the assessment and rehabilitation of primitive reflexes that influence movement, motor control and neurocognitive function in adults.  Strategies for treatment in the clinic and home exercise will be discussed in detail. 

This is an evidence based course.  Two randomized controlled trials provide evidence that a primitive reflex inhibition program can improve reading skills in dyslexia.  A case series provides evidence that a primitive reflex program combined with sensory motor rehabilitation can improve cognitive function, the ability to perform specific motor control exercises, reduce pain and disability, and improve function and quality of life. 

This course is suitable for orthopaedic, paediatric and neurology physiotherapists.

No Prerequisite

Course Objectives:  

  • Identify clients who will unlikely progress with specific stability exercises by using the Motor Control Abilities Questionnaire and with a sensory motor & primitive reflex assessment
  • Understand the role of primitive reflexes in pain, neurocognitive function and motor control. 
  • Assess and rehabilitate primitive reflexes and recognize how they influence pain, motor control, stability and cognitive function
  • Use primitive reflex inhibition strategies to improve motor control, tone and pain
  • Value the learning process and apply suitable learning styles in rehabilitation
  • Appreciate the types of motor and cognitive dysfunctions that occur with pain
  • Prescribe exercises for patients to improve neurocognitive learning function

What will you get from this course that you may not already have?

Primitive Reflexes
Understand the role of primitive reflexes in pain, cognitive function and motor control.  This has a huge influence on correcting movement, rehab strategies and learning skills. This is also important for neurological rehab.

CNS Coordination – A New Sub-Classification
Our clinical reasoning promotes a diagnosis of movement dysfunction, tissue, pain mechanisms and CNS Coordination.  The latter represents a new, but significant sub-classification, which represents the cognitive and motor functions of the CNS.

Motor Control Ability Screening
What about the people who can`t seem to learn the exercises we teach them?  You will learn how to use the Motor Control Abilities Questionnaire and a sensory motor function assessment to screen people for the ability to learn specific motor control exercises.  You will learn alternative treatment options to rehabilitate this problem population. 

Learning Difficulties
Appreciate the importance of cognitive based learning skills in rehabilitation.

Motor Control Problem Solving
Problem solving with some clients can be difficult.  We have developed a Universal Problem Solving Model of Motor Control to help you make exercises easier or harder.  We have to give people exercises they can do, not ones they can’t.

Program & Pre-course Reading

Useful Web Address www.positscience.com

Suggested pre-course reading

Revision of the Sub-classification course (if taken)

Edwards S, Sarwark JF 2005 Infant and Child Motor Development. Clinical Orthopaedics and Related Research. Number 434: 33–39

Goddard S 2005 Reflexes, Learning and Behavior. Fern Ridge Press. Eugene, Oregon. USA

Jordan-Black JA 2005 The effects of the Primary Movement programme on the academic performance of children attending ordinary primary school. Journal of Research in Special Educational Needs. 5 (3): 101–111

McPhillips M, et al 2000 Effects of replicating primary-reflex movements on specific reading difficulties in children: a randomized, double-blind, controlled trial. The Lancet 355: 537-340

McPhillips M, Sheehy N 2004 Prevalence of persistent primary reflexes and motor problems in children with reading difficulties. Dyslexia 10: 316-338

Reynolds D et al 2003 Evaluation of an exercise-based treatment for children with reading difficulties. Dyslexia 9: 164-166

McAuley E, Kramer AF, Colcombe SJ 2004 Cardiovascular fitness and neurocognitive function in older Adults: a brief review. Brain, Behavior, and Immunity. 18: 214–220

Free articles available at:  http://www.ncbi.nlm.nih.gov/sites/gquery

Allin M, M Rooney, T Griffiths, M Cuddy, J Wyatt, L Rifkin, and R Murray Neurological abnormalities in young adults born preterm. J Neurol Neurosurg Psychiatry. 2006 April; 77(4): 495–499.

Ole K. Harlem and Arve Lönnum. A Clinical Study of the Abdominal Skin Reflexes in Newborn Infants. Arch Dis Child. 1957 April; 32(162): 127–130.

Jensen JP, U Grøn, and H Pakkenberg Comparison of three primitive reflexes in neurological patients and in normal individuals. J Neurol Neurosurg Psychiatry. 1983 February; 46(2): 162–167.

Schott J and M Rossor. The grasp and other primitive reflexes. J Neurol Neurosurg Psychiatry. 2003 May; 74(5): 558–560.

 

Program
Day 1
8:30 – 9:00 Overview of motor system changes with pain & Sub-classification
9:00 – 9:30 Role of primitive reflexes
9:30 – 10:00 CNS Coordination Disorder: Clinical Prediction Rules for Diagnosis and Rehabilitation
10:00 – 10:30 Break
10:30– 11:00 Development & clinical use of the Motor Control Abilities Questionnaire
11:00– 12:00 Trunk reflexes assessment & rehabilitation
12:00 – 1:00 Lunch
1:00 – 3:00 Trunk reflexes continued
3:00 – 3:15 Break
3:15 – 4:30 Trunk reflexes continued
Day 2
8:30 – 10:00 Lower limb reflexes assessment & rehabilitation
10:00 – 10:30 Break
10:30– 12:00 Upper limb reflexes assessment & rehabilitation
12:00– 1:00 Lunch
1:00 – 2:00 Facial reflexes assessment & rehabilitation
2:00 – 3:15 Postural Reflexes: introduction to assessment & rehabilitation
3:15– 3:30 Break
3:30– 4:00 Active exercise, Proprioception, enrichment concepts, computer based learning and EEG
4:00 – 4:30 Clinical Integration & Summary

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