Primitive/Spinal Reflexes Flexor withdrawal

Stimulus Noxious stimulus (pinprick) to sole of foot. Tested In supine or Sitting position Noxious stimulus to ball of foot of extremity fixed in extension; tested in supine position.

Response Toes extend. foot doni6excs, entire leg flexes uncontrollalbly. Onset: 28 weeks gestation. lntegrared. 1-2 months Opposite lower extremity flexes. Then adducts and extends Onset: 28 weeks gestation Integrated. 1-2 months. Grasp and total flexion of the upper extremity. Onset: 28 weeks gestation Integrated : 2-5 months. Extension, abduction of upper extremities. hand opening. and crying followed byflexion, adduction of arms across chest. Onset: 28 weeks gestation Integrated: 5-6 months. Sudden extension or abduction of arms. crying. Onset: birth. integrated: persists Maintained flexion of fingers or toes. Onset: palmer, birth; plantar, 28 weeks gestation. Integrated: palmer, 4 -6 months; plantar, 9 months

Crossed extension

Traction

Grasp forearm and pull up from supine into sitting position.

Moro

Sudden change in position of head in relation to trunk; drop patient . backward from sitting position

Startle

Sudden loud or harsh noise

Grasp

Mainuined pressure to palm of hand (palmer grasp) or to ball of foot under toes (plantar grasp),

Tonic/Braintem reflexes Assymetrical tonic neck (ATNR)

Stimulus Rotation of the head to one side

Response Flexion of skull Iimbs. extension of the jaw limbs, "bow and arrow" or "fencing" posture. Onset: birth. Integrated. -1-6 months.

Symetrical tonic neck (STNR)

Flexion or extension of the head.

With head flexion: flexion of arms, extension of legs; With head extension: extension of arms, flexion of legs. Onset: 4-6 months. lntegrated. 8-12 months. With prone position: increased flexor tone/flexion of all limbs; Witth supine: increased tone/extension of all limbs. Onset: birth. Integrated: 6 months. Rigid extension (co-contraction) of the lower extremities. Onset: birth. Inregrared. 6 months.

Symetrical tonic labyrinthine (TLR or STLR)

Prone or supine position

Positive Supporting

Contact to the ball of the foot in upright standing position.

Associated reactions

Resisted voluntary movement in any part of the body.

Involuntary movement in a resting extremity. Onset. birth-3 months. Integrated. 8-9 years.

Midbraln/Cortical Reflexes Stimulus Response

Neck righting acrlon on the body (NOB)

Body righting acting on the body (BOB) Labvrinthine head righting (LR) Optical righting (OR) Body righting acting on head (BOH) Protecnve extension (PE)

Passively turn head to one side; tested in supine.

Body rotates as a whole (log rolls) to allign the body with the head. Onset: 4-6 months. Integrated. 5 years
Body segment not rotated follows to allign ihe body segments. Onset: -1-6 months ; Iruegrated. 5 years. Head orients to vertical positon with rnouth horizontal. Onset: btnh-2 months ; Integrated: persists Head orients to vertical position with mouth horizontal. Onset: birth-2 months ; Integrated. persists Head orients to verticalt position with rnouth horizontal. Onset: birth-2 months; Integrated. 5 years. Arms or legs extend arid abduct to support and to protect the body against falling. Onset: arms 4-6 months.,legs. 6-9 month ;Integrated. persists. Curvature of the trunk coward the Upward side along with extension and abduction of the extrimitiess on that side; protective extension on the opposite (downward) side. Onset: prone 6 months; supine : 7 -8 rnonths, Sitting 7-8 months; quadruped 9-12 months; sunding 12-21 months. Integrated: persists. Curvature of the trunk towardthe exrernal force with extension and abduction of the extrermities on the side to which rhe force was applied. Onset: prone 6 months; Supine 7-8 rnonthss ; sitting 7-8 months; quadruped 9-12 moorhs ; standing 12-21 months. Intcgrared. persists.

Passively rotate upper or lower trunk segment: tested in supine. Occlude vision; alter body position by tipping body in all directions. Alter body position by tipping body in all directions. Place in prone or supine position.

Displace center of gravity outside the base of support.

Equlllibrium reactions tillting (ER)

Displace the Center of gravity by tilting or moving the support surface (e.g .with a movable object such as an equilibrium board or ball).

Equilibrium reactions postural fixation

Apply a displacing force to the body, altering the center of gravity in its relation to the base ofsupport; can also be observed during voluntary acrivirv.