Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 3, March, p. 363–366

doi: 10.17219/acem/67458

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Trunk rotation due to persistence of primitive reflexes in early school-age children

Ewa Z. Gieysztor1,A,B,C,D,F, Ludwika Sadowska1,A,E,F, Anna M. Choińska1,A,E,F, Małgorzata Paprocka-Borowicz1,E,F

1 Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland


Background. The angle of trunk rotation (ATR) is a measurement that allows an objective assessment of a growing child’s spine. Early detection of trunk rotation prevents the progression of scoliosis. One of the factors that predispose children to the formation of faulty posture may be primitive reflexes, which should be integrated in the central nervous system (CNS) by the age of one year. If retained, primitive reflexes affect children’s physical development as well as their development at school.
Objectives. The aim of the study was to determine the prevalence of trunk asymmetry and the persistence of primitive reflexes and their inter-relationships in early school-age children.
Material and Methods. In this population-based survey, 61 children, average age 6.3 years (SD ±1.43), were examined. The ATR was examined using a scoliometer. The degree of integration of reflexes was assessed using tests developed by S. Goddard to assess the asymmetrical tonic neck reflex (ATNR), symmetrical tonic neck reflex (STNR), and spinal Galant reflex (SGR) on a 0–4 scale. Spearman’s rank correlation coefficient and the χ2 test were used in the statistical analysis.
Results. In almost half of the children body rotation was observed, in most cases toward the right (p = 0.012). This asymmetry was positively correlated with non-integrated Galant reflex on the same side (r = 0.335, p = 0.050). The presence of trunk rotation is associated with sex: There was higher frequency of asymmetry among the girls than among the boys.
Conclusion. In the evaluation of scoliosis, it could be useful to examine primitive reflexes as a possible reason for trunk rotation. In the treatment of scoliosis, primitive reflex integration methods should be used in some cases.

Key words

children, the angle of trunk rotation, primitive reflex integration, scoliosis

References (23)

  1. Krawczyński A, Kotwicki T, Szulc A, Samborski W. Clinical and radiographic measurement of the rotation of the vertebrae in patients with idiopathic scoliosis. Ortop Traumatol Rehabil. 2006;6:602–607.
  2. Kotwicki T, Walczak A. Szulc A. Trunk rotation and hip joint range of rotation in adolescent girls with idiopathic scoliosis: does the‘ dinner plate’ turn asymmetrically? Scoliosis. 2008;3:1.
  3. Ellis MD, Drogos J, Carmona C, Keller T, Dewald JPA. Neck rotation modulates flexion synergy torques, indicating an ipsilateral reticulospinal source for impairment in stroke. J Neurophysiol. 2012; 11:3096–3104.
  4. Gieysztor EZ, Choińska AM, Paprocka-Borowicz M. Persistence of primitive reflexes and associated motor problems in healthy preschool children. Arch Med Sci. 2018;1:167–173.
  5. Goddard-Blythe S, Hyland D. Screening for neurological dysfunction in the specific learning difficulty child. Br J Occup Ther. 1998;61:459–464.
  6. Sadowska L. Vaclav Vojta’s neurokinesiological concept for the diagnosis and therapy of children with disturbances of motor development. Ortop Traumatol Rehabil. 2001;3:519–526.
  7. Amendt LE, Ause-Ellias KL, Eybers JL. et al. Validity and reliability testing of the Scoliometer®. Phys Ther. 1990;70:108–117.
  8. Bunnell WP. An objective criterion for scoliosis screening. J Bone Jt Surg Am. 1984;66:1381–1387.
  9. Bunnell WP. Selective screening for scoliosis. Clin Orthop. 2005;434: 40–45.
  10. Goddard-Blythe S. Attention, Balance and Coordination: The A.B.C. of Learning Success. Wiley-Blackwell; 2009.
  11. Goddard-Blythe S. The role of primitive survival reflexes in the development of the visual system. Journ Behav Opt. 1995;6(2):31–36.
  12. Samuelsson L, Noren L. Trunk rotation in scoliosis the influence of curve type and direction in 150 children. Acta Orthop Scand. 1997; 68:273–276.
  13. Białek M, M’hango A, Kotwicki T. Monitoring of changes in trunk rotation during scoliosis physiotherapy. Scoliosis. 2007;2:1.
  14. Wnuk B, Blicharska I, Błaszczak E, Durmała J. The impact of the derotational mobilization of manual therapy according to Kaltenborn-Evjenth on the angle of trunk rotation in patients with adolescent idiopathic scoliosis – Pilot study. Direct observation. Ortop Traumatol Rehabil. 2015;17:343–350.
  15. Białek M, Kotwicki T, M’hango A, Szulc A. Angle of trunk rotation in primary and compensatory scoliotic curve in children after individual rehabilitation with FITS method. Ann Acad Med Siles. 2007;61:45–48.
  16. Kim KD, Hwangbo PN. Effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with idiopathic scoliosis that is an operative indication. J Phys Ther Sci. 2016;28:923–926.
  17. Borysov M, Borysov A. Scoliosis short-term rehabilitation (SSTR) according to ‘Best Practice’ standards – are the results repeatable? Scoliosis. 2012;7:1.
  18. Yawn BP, Yawn RA, Hodge D, et al. A population-based study of school scoliosis screening. JAMA. 1999;282:1427–1432.
  19. Fong DY, Lee CF, Cheung KM, et al. A meta-analysis of the clinical effectiveness of school scoliosis screening. Spine. 2010;35:1061–1071.
  20. Grivas TB, Vasiliadis ES, Koufopoulos G, et al. Study of trunk asymmetry in normal children and adolescents. Scoliosis. 2006;1:19.
  21. Grzywniak C. The effect of the form of persistent trace reflexes to rise the difficulties of school. Szk Spec. 2010;98–112.
  22. Kowalski IM, Dwornik M, Lewandowski R, et al. Early detection of idiopathic scoliosis – analysis of three screening models. Arch Med Sci. 2015;11:1058–1064.
  23. Chowańska J, Kotwicki T, Rosadziński K. Sliwiński Z. School screening for scoliosis: Can surface topography replace examination with scoliometer? Scoliosis. 2012;7:9.