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Spinal Galant Reflex, Spinal Pereze Reflex and Tonic Labyrinthine Neck Reflex (TLR)
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Spinal Galant Reflex Person/child lies on side or stomach -touched on the right or left side of the spine (Not touching on spinal column itself) - Causes flexion (rotation to 45 degrees) of the body to the side of the touch Could also respond by raising and extending the leg Should be present with equal strength bilaterally 15th to 18th week in utero Starts to function from 5th to 6th month in utero Actively present at birth Active from 3rd month to 9th month of infant’s life Helps fetus to turn the head down for the birthing process Conducting body vibrations in the fetus Developing vestibular system Activation of the S. G. sometimes extends into ATNR Do not use or distribute without written permission.
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Pulgar Marx Reflex (1955) When both sides of the spine are stroked simultaneously Flexion of both legs, lordosis of the spine, elevation of the pelvis Lifting of the head, loud crying – could lead to apnea Emptying the bladder Relaxation of the rectum with bowel movement Hypertonia after for a few seconds Inhibited by 2 to 3 months of age Sometimes seen in Asperger Syndrome Children with history of continued soiling during the day above age 5 Do not use or distribute without written permission.
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Influences in Development
Homolateral one-sided movement Gross motor coordination – front-back, up-down, prepares for stand- and walking Precise motor coordination Activates semi-circular canals, Auditory Processing Differentiated, controlled, and goal oriented side bending for movements of reaching and escaping with whole body Future physical and mental skills, such as concentration and motivation In utero important for bringing sound and vibrations into the infant’s body, preparing for auditory skills If both sides of infant is touched simultaneously, experiences chaos. Assists with ATNR and STNR in facilitating the birth process Do not use or distribute without written permission.
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Auditory Assists with primitive reactions to sounds from the mother’s womb Also makes radiation of soundwaves possible via body vibrations 4th month in utero assists in development of physiological and anatomical hearing 4 stages of hearing: Resonance through proprioception Sounds of nature, low frequency sounds (20 to 3000Hz). Includes mother’s heartbeat, breathing, digestion. Mentions specifically Mozart and Gregorian Chants Sounds of birds and animals – foundational for speech development Human speech, higher frequency sounds after 5 ½ months in utero Do not use or distribute without written permission.
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When Not Integrated Fidgeting, poor concentration, ADD, decrease in short-term memory, inability to persist even for a short time, and fatigue. Difficulty sitting still for any length of time (ants in the pants); restless Lack of coordination in motor activity Low motivation for motor development Scoliosis, lordosis, incorrect hip posture Bedwetting, incontinence, IBS, feeling uncomfortable in tight clothing, belts Leaning back against a chair may activate it Distracted during attentive activities Prefer loose clothing tight clothing may trigger reflex Spastic Colitis in adults Do not use or distribute without written permission.
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Spinal Galant Reflex
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Test Four point kneeling position – “table” position
Using light brush (back of nail), stroke down the back from below the shoulder to the base of the lumbar region at a distance of ½ inch from the spine First one side, then the other Repeat the procedure up to 3 times Do not use or distribute without written permission.
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Scoring 0 = No response 1 = Movement outwards, beyond 45 degrees, and may effect the client’s balance 2 = Undulation or movement of the hip outwards to 45 degrees 3 = Undulation or movement of the hip outwards to 30 degrees 4 = Fully integrated Hypersensitivity – ticklishness – may also be present Do not use or distribute without written permission.
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Intervention Ideas Passive and active stimulation of the knees - RMT
Rolling the bottom from side to side – passive or active Cat arches – emphasis on lumbar spine Sagging and arching the lumbar spine Isometric pressure Modified core activation type exercise Exercise on the back with pelvic tilting Client sidelying, therapists hands on hip and shoulder, provide resistance with side contractions and while elongating. (RMT) Do not use or distribute without written permission.
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TLR and Spinal Galant Home Program - Video
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Spinal Pereze Reflex Person / child is in prone
Touch on back from tailbone to neck Backward arching movement of the trunk/torso, flexion of upper and lower limbs, lifting of head and pelvis Sometimes accompanied by screaming Emerges at birth Active until 2nd to 3rd month of life Integrated with whole body month by 6th month Can stay physiologically active until 2nd year of life Do not use or distribute without written permission.
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Spinal Perez
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Influences on Development
Basis for whole body coordination Links between limbs and head through core of body, front and back Becomes a part of Tendon Guard Reflex and STNR Influences the work of cerebrospinal fluid pumping system and cranial movement Affects integration of brainstem, diencephalon, and brain hemispheres Do not use or distribute without written permission.
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When Non-Integrated If reflex is hyperactive – hyperactivity of auditory and tactile systems Disorders in sensory processing Impulsive tendencies in behavior, ADHD Narrow visual field, inadequacy or increased feelings of fear, also phobia Lack of internal control, emotional delay Bedwetting, incontinence, allergies Do not use or distribute without written permission.
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Spinal Perez Primitive Reflex Inhibition Exercise -Video
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Tonic Labyrinthine Reflex (TLR)
Activated by head position in space (forwards or backwards) Tone of neck and leg flexors increase in prone position In supine position, tone of back and leg extensors is increased. Emerges in utero about 12 weeks, present at birth, integrated by 3 to 4 months In flexion position at 12th week Assures proper position of infant for birthing process Active from 2nd month, up to the 4th month Moro and TLR closely linked in early months – both are vestibular in origin, both activated by head movement Head control takes over by 6 months – essential pre-requisite for development of all functions - prime initiator of movement, tone and balance (Cephalo-Caudal) Do not use or distribute without written permission.
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The Infant Adapting to new gravitational conditions after delivery
Early primitive reaction to pull of gravity Develop muscle tone and proprioception Practice balance Causes involuntary muscle tone changes when moving forward or backward Do not use or distribute without written permission.
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Influences on Development
Whole body muscle tone – helps the neonate to “straighten out” Changes in head position relative to the body’s midline Trains neuro links between proprioceptive system and ear labyrinth system Allows infant to react to changes in gravity Basis for stability, equilibrium, muscle tone, proprioception and balance Up-Down and Front-Back Motor System Prepares infant for rolling over, then crawling on all fours, standing, and walking Assists in Head Righting Reflex for forward and backward motions May also have an influence in the regulation of muscle growth and body weight. Do not use or distribute without written permission.
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When Not Integrated Chronic Muscle Reactivity – “trips” the vestibular system in it’s actions and interaction with other systems Disorders in posture, muscle tone (hyper and hypo- patterns) and vestibular-proprioceptive system Gravitational Insecurity (Ayers 1979 to 1982) – “throws” center of balance May experience fear of heights Prevent crawling phase – also impact on STNR (remaining locked to override TLR) Child may not be interested in movement activity and sports, lack of adequate conscious movements Difficulty judging space, distance, depth, and velocity May experience difficulties with time and space perception, cause and effect links, organizing actions and behavior Difficulty holding head up Weak neck muscles, hunched posture Sense of direction will be impacted – think astronauts Will impede head righting reflexes, leading to difficulties with vestibulo-ocular reflex Standing for any length of time not integrated “Bowing” of the body – tendency to stand with head poked forward – poor posture Jerky and “stiff” in movement patterns Poor development of praxis – sequencing and timing Toe walking Eye muscles may be affected, even cross eyed. Do not use or distribute without written permission.
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TLR in adults Will impact retaining of other primitive reflexes
Balance difficulties Fear of heights Muscle tone Do not use or distribute without written permission.
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Figure-Ground Effect Cannot easily separate and categorize conflicting visual information Walking up an open stair case Crossing over a slatted bridge, where water can be seen through the boards May have difficulty re-adjusting eyes from far to near distances – temporary “blind spot” in visual information Effects spatial perception – also impacting in having difficulty locating sound –become disoriented Do not use or distribute without written permission.
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Vestibulo-Ocular Reflex (VOR)
Ability to maintain gaze despite head rotation Integrated by 6 yrs old Balance affected by visual information and vision affected by balance Together with proprioception – 3-way system of “mismatch” Hold pencil ruler length midline to eyes in front of child Ask child to keep vision focused on pencil while moving head side to side (VOR1) Move pencil side to side, keep vision on pencil while moving head to opposite side. (VOR2) Do not use or distribute without written permission.
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VOR TEST 1 and 2
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Vestibular Ocular Reflex VOR Exercises - Video
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TLR Test Stand with feet together
Arms straight at the sides of the body Slowly tilt client’s head back into extended position Ask client to close eyes Stand behind to support in case there is any loss of balance After 10 secs, ask client to slowly move the head forward as if to look at toes Maintain for 10 secs Repeat sequence up to 3 to 6 times Do not use or distribute without written permission.
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TLR Testing
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Scoring 0 = No response 1 = Loss of balance and / or massive alteration of muscle tone in attempt to maintain balance. This may be accompanied by dizziness or nausea, and in adults, feelings of panic. 2 = Near loss of balance, alteration of muscle tone and / or disorientation as a result of the testing procedure 3 = Disturbance of balance during test and / or alternation of muscle tone at the back of the knees 4 = Integrated Do not use or distribute without written permission.
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Tonic Labyrinthine Reflex: "The Meatball” - Video
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Intervention Ideas Prone extension/superman/superwoman
SWINGS!: net swing, parachute swing, bolster, platform Rolling head first, body follows in crawling position Prone over ball Ball pushes Cat arches Cycling for adults and older children Vestibular stimulation: rotation, rolling and rocking, initially done with eyes closed Stretching and flexion exercises performed on the floor in supine and prone with eyes closed Do not use or distribute without written permission.
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RMT Ideas Cycling in the air with legs in supine position slowly
Must feel tension and activation in neck – no hurt though Put hands under buttocks if pain in the back. Lift head in supine, breathing out slowly for 7 to 8 secs Move head side to side breathing out slowly for 7 to secs Can add pressure / resistance Press head gently into the floor Do not use or distribute without written permission.
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https://maudeleroux.com/
Maude Le Roux, OTR/L, SIPT, IMC Websites Facebook LinkedIn Blog Do not use or distribute without written permission.
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