Pelvic Symmetry Is Influenced by Asymmetrical Tonic Neck Reflex during Young Children's Gait.

Ewa Gieysztor,Anna Pecuch,Małgorzata Paprocka-Borowicz,Wojciech Borowicz,Mateusz Kowal

doi:10.3390/ijerph17134759

Abstract

Gait is one of the examined functions in child development. It should be economical and symmetrical. One test increasingly used by physiotherapists and pediatricians is asymmetrical tonic neck reflex (ATNR). Physiologically, it is observed from in utero up to six postnatal months. This reaction is inhibited with the growing maturation of the central nervous system (CNS). In some children, when the natural process of development is incorrect, ATNR manifests later in life, when it is observed as an automatic response of muscle tension to head rotation. Analysis of pelvis symmetry in the gait of children with active ATNR is important for better understanding their specific movements. In the gait of children with persistent ATNR, some variations are observed. The aim of the study was to investigate the gait symmetry of preschool children and the influence of persistent ATNR. Fifty preschool children with a trace form of ATNR were examined. The distribution of the gait parameters was determined using a BTS G-SENSOR measurement instrument. ATNR negatively influences pelvic obliquity and pelvic rotation (p < 0.01). Younger children have a statistically higher symmetry index of pelvis obliquity in the examined group (p = 0.015). Boys obtain a higher result of symmetry in pelvic tilt than girls in the group (p = 0.027). ATNR affects walking symmetry in preschool children, thus evaluation of the reflex activity and then proper therapy is required to support proper development.

Highlights

Gait symmetry is one of the determinants of proper child development
Using the Ayres test to examine the activity of asymmetrical tonic neck reflex, the results show that nearly 15% of examined children had no activity of the ATNR
The results indicate that about 20% of the preschool children show the maximum intensity of ATNR, in both tests

Summary

Introduction

Gait symmetry is one of the determinants of proper child development. For parents and pediatricians as well as physiotherapists, the wide spectrum of factors influencing child development should be known for proper movement analysis [1]. Is one of the factors that can impact child development. It has been found very commonly in healthy preschool children. The activity of the reflex during the motion gives some additional muscle tension response, which involves the central nervous system (CNS) after reception of additional stimuli. The movement of the head, in people with active ATNR, induces movement or muscle contraction in the limbs and trunk. This is especially visible in closed-chain tasks.

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