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Pelvic Symmetry Is Influenced by Asymmetrical Tonic Neck Reflex during Young Children's Gait
Ewa Gieysztor1, Anna Pecuch1, Mateusz Kowal1
1Physiotherapy Department, Faculty of Health Sciences, Wroclaw Medical University, 50-355 Wroclaw, Poland.
Insights
Persistent asymmetrical tonic neck reflex (ATNR) negatively impacts preschool children's gait symmetry, affecting pelvic movement. Early evaluation and therapy are crucial for supporting normal development and improving walking patterns.
Area of Science:
- Pediatric physiotherapy
- Developmental neurology
- Biomechanics of gait
Background:
- Gait symmetry and economy are key indicators of healthy child development.
- The asymmetrical tonic neck reflex (ATNR) is a normal developmental reflex, typically inhibited by six months postnatal.
- Persistent ATNR beyond infancy can manifest as abnormal muscle tension responses to head rotation, potentially affecting motor development.
Purpose of the Study:
- To investigate the influence of persistent ATNR on gait symmetry in preschool children.
- To analyze specific gait parameters, particularly pelvic movement, in children with ATNR.
- To understand the relationship between ATNR and developmental variations in gait.
Main Methods:
- Study included fifty preschool children with a trace form of ATNR.
- Gait parameters were measured using the BTS G-SENSOR instrument.
- Analysis focused on pelvic obliquity, pelvic rotation, and pelvic tilt symmetry.
Main Results:
- Persistent ATNR was found to negatively influence pelvic obliquity and pelvic rotation (p < 0.01).
- Younger children exhibited statistically higher symmetry in pelvic obliquity (p = 0.015).
- Boys demonstrated greater symmetry in pelvic tilt compared to girls (p = 0.027).
Conclusions:
- ATNR significantly affects walking symmetry in preschool-aged children.
- The findings underscore the importance of evaluating reflex activity, including ATNR.
- Targeted physiotherapy interventions are recommended to address ATNR and support proper gait development.
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.
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