The association between primitive reflex symptoms and chronic low back pain

Parfrey, Kevin (2011) The association between primitive reflex symptoms and chronic low back pain. Masters thesis, Memorial University of Newfoundland.

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Abstract

Individuals with chronic low back pain (CLBP) have altered activations patterns of the anterior trunk musculature when performing the hollowing maneuver. Clinically it has been reported that there is a subgroup of individuals with CLBP who demonstrate primitive reflexes (PR). The main objective of this study was to determine if orienting the head and extremities to positions which mimic PR patterns would alter the activation patterns of the anterior trunk musculature during the performance of the hollowing maneuver. This question was investigated by comparing electromyographical (EMG) activity of bilateral rectus abdominis (RA), external oblique (EO), and the lower abdominal stabilizers (LAS) of 11 individuals with CLBP and present PR to a group of 9 healthy individuals during the execution of the hollowing maneuver in 7 different positions. Using magnitude based inferences it is likely (<75%) that the control group had a higher ratio of left LAS: left RA activation in the following positions: supine, Asymptomatic Tonic Neck Reflex (ATNR) left and right, cervical rotation to the right and cervical extension positions. A higher ratio of right LAS: right RA was detected in the supine and ATNR right position. It was also clinically likely (>75%)that the CLBP) group had higher activation of the left RA in the supine, ATNR left and right, cervical position for the right RA. When the data from both groups were compiled the LAS illustrated significantly (p<0.05) less activation when in the contralateral ATNR position compared to all other positions except cervical rotation to the right on the left LAS. Right EO activation was significantly higher (p<0.05) in the left ATNR position compared to the supine ATNR right and cervical flexion position. The results indicate that individuals with CLBP and present PR have altered activation patterns during the hollowing maneuver compared to a health control group and that altering body position can diminish the differences between groups. It is also indicated that position change alone can change the activation levels of the LAS and EO in both groups.

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