Postural Reflexes, Landau Reflex,  Babinski Reflex, Hands Grasping / Pulling Reflexes. Part 2 Do not use or distribute without written permission.

Babinski Reflex The toes spread when the outer edge of the plantar surface of the foot is gently stroked from the heel to the toe. Protective foot-to-body midline motion Inward rotation is accompanied by the extension of the big toe in the direction of the head and a plantar flexion of the other toes like a fan Reflex emerges in the first week after birth Active from birth to 2 years Integrated in second year of life, but many linger till third year. Do not use or distribute without written permission.

Influences on Development Right Left Motor Coordination System Prepares infant for standing and walking – moving the feet To some extent also triggers Pereze Reflex Pattern Supports Crawling Reflex – coordination Supports gait patterns from homo- to cross lateral. Localization of gravity center Organization of movement dynamics Connection of the gravity and body-motion centers Affects hips Affects jaw position Most direct influence: gravity, grounding, stability, and balance Do not use or distribute without written permission.

When not Integrated Restriction of freedom of movement coordination of neck, arms, and upper back muscles In low muscle tone, neck flops forward Facial expression suspicious, blaming Tension in anterior neck flexors Reflex hyperactive – excessive head lifting, proud, scowling face Binocular vision and binaural hearing Flat footed and slow, not like walking Loose ankles that may sprain easily Adults walk more on inside or outside of their feet Hypersensitive, hyperactive – more pressure on outsides of feet When more pressure on insides feet, tendon guard reflex is activated because of Babinski delay – arch flattening Tendency to walk on toes and rotate hips inward Important to learn how to crawl efficiently Thought and movement integration Perception and thinking Can also negatively affect speech development Do not use or distribute without written permission.

Clinical Observations Note feet when lying in supine: Flop outwards Point to each other Point rigidly upward When lying in prone: Point outwards instead of inwards Point down and ankles rise off the floor Ankles either very tense or loose when: The whole leg is rotated in and out Rocking the body longitudinally Check if shoes are worn down from the inside or outside Do not use or distribute without written permission.

Babinski Reflex  https://youtu.be/O6LJl_PTNro

Assessment Stroke with thumbnail up along the outer lateral edge of the sole from the heel to the little toe. Big toe should not lift or the toes fan out of reflex is integrated Leg should not jerk back (be careful of too light touch eliciting tickle) Repeat on the other foot. Do not use or distribute without written permission.

Intervention Ideas Any type of walk such as bear walk Crawling Pushing off from wall on scooter board Kicking heavy suspended ball while in supine Ball walkouts (pushing off) Walk barefoot as much as possible Do not use or distribute without written permission.

Hands Grasping Reflex (Robinson – MNRI) Emerges 11th week in utero Active from birth through first year of life Protection, support and balance Gross hand-motor coordination Fine motor skills Lateralization Hand-eye, hand mouth, hand-head turning and hand-leg coordination Perseverance Do not use or distribute without written permission.

When non-integrated Excessive pressure on pencil Inefficient pencil grasp Finger fatigue Aversion to handwriting, written expression, fine motor skills Negative effect on speech and communication skills. Do not use or distribute without written permission.

Hands Grasping Reflex  https://youtu.be/8wmJF-G45mo

Assessment Have client lie on his/her back with arms extended into the air. Ask them to grasp your first two fingers and look at the position of the fingers, strength, symmetry, etc. If this reflex is not integrated move to “teach” the reflex by asking the client to grasp various sized objects: fingers, pencil, marker, large tube, etc. Have them hold for 7 seconds 3-5 times. Do not use or distribute without written permission.

Intervention ideas Play dough Theraputty resistance work Clothespin exercises Chinese ball manipulation Translation exercises Fingers to thumb opposition exercises Coffee ground palmar hold. Do not use or distribute without written permission.

Hands Pulling Reflex (MNRI) Emerging 12th week in utero Active from birth to second month Becomes part of pattern of pulling and flexing arms in attempt to sit or stand up. Ability to reach for and pull objects into one’s own space Do not use or distribute without written permission.

Non-integrated Poorly regulated muscle tone in arms (always bending, always straight) Poor fine motor coordination Aversion to writing Speech and communication delays Poor socialization (giving and taking) Do not use or distribute without written permission.

Hands Pulling Reflex  https://youtu.be/eS2vwH28OmE

Assessment Have the client lie on his/her back. Ask them to bend his/her arms at the elbow. Grasp the client at the wrists and ask them to come to a seated position. Notice whether the client’s head, arms, and abdominals are activated simultaneously, are they all equally strong, are they moving in the appropriate direction, etc. Do not use or distribute without written permission.

Sensory Input Somatosensory (tactile and proprioception) are the main players Wilbarger brushing protocol with joint compressions Infant massage Masgutova Tactile Integration Other massage techniques including myofacial release Deep pressure inputs and heavy work Messy play with various mediums Do not use or distribute without written permission.

Informal assessment guide for challenging clients  https://youtu.be/6VrMxkNiIhM

https://maudeleroux.com/ Maude Le Roux, OTR/L, SIPT, IMC Websites https://maudeleroux.com/ Facebook https://www.facebook.com/ATAMaudeLerouxOT/ LinkedIn https://www.linkedin.com/company/a-total-approach Blog http://www.maude-leroux.com/ Do not use or distribute without written permission.