#primitive reflexes

1. The Anons. I have recieved quite a few messages that I never feel deserve the recognition of posting essentially accusing me of making things up for attention, so included in this post is a screenshot of the notes from my most recent doctors visit, specifically the part of the note where the "active problem list" is. This is the list of all of my current diagnosis that we are working on treating, managing or learning to live with. I do not feel I should have even needed to provide this but here it is. If anyome had any questions on that feel free to ask but please don't be an ass, my life is hard enough as is.

Next is Updates,

Uhmm so I have a few things to touch on here.

1. After much discussion with my doctors, my specialists etc. My fears have been confirmed, due to the medical problems I have on top of the cognitive defecits plus the neuropathy eventually, we don't know when, there is no specific time frame, eventually I will go downhill and not come out of it. Pretty much right now I have good days and bad days about half and half but the bad days will start to be more frequent and more severe and then the good days just wont happen anymore.

2.We also talked at length about the bladder issues, I am self cathing multiple times a day still having incontinence, still bedwetting and still with no sensory awareness (This means I cant tell when I have gone) we talked about options and he said we arent there yet but a suprapubic catheter is inevitable and I will be needing one placed down the line. This is a catheter that will be placed in my bladder through my belly opposed to my urethra, meaning I can still be sexually active, Id be at a lower risk for infection, it is a more comfortable option and would mean that I would no lo get be dependent on briefs or dependent on an aid changing my briefs on my bad days. Insurance wants to give pelvic floor therapy a go one more time before they approve the procedure amd my doctor has informed me that once its in goong back to "normal urination" will not be a feesible option meaning once its places it will be permanent and I will be peeing through the tube for the rest of my life.

3. In Occupational therapy last week I was tested for primitive reflexes, primitive reflexes are a reflex developped ineutero that should go away or "integrate" at various stages in the first few years of life. These reflexes should be present in infants but NOT in "neurologically intact adults" 4 of 9 of these reflexes are still present for me, which means that that part of my brain did not develop adequately but this part of the brain is a foundation so when that didnt develop appropriately nothing else did either. Now they could integrate these reflexes which is the goal which will help reduce the physical reflexive response to stimuli BUT the under development to the rest of the brain already happened and can not be corrected. Included is a chart about the reflexes and the signs and consequences that happen in the event that the reflex was retained and not integrated. My Primitive reflexes still present are the Tonic Labrynthe, Moro, Spinal Galant and Palmar Grasp. Apparently retaining these reflexes is not abnormal in people with Autism.

All of this said, I have alot going on, I have a lot of things I am trying to figure out and trying to work on and fix and tons of appointments and follow ups and procedures and I could use some help, I really could. I have a amazon wishlist that essentially consists of cloth and disposable briefs primarily, uhmm we are grying to switch me over to cloth briefs as they are easier on the skin and will be more cost effective in the long term they also feel more natural I feel like but also disposable ones are on the list as they will be necessary to help hold us over till we can get more cloth briefs. Also on the list is some workout clothes items as my doctor and I are trying to increase my daily activity, I have been walking and am getting a YMCA membershio from my insurance next month and I dont have anything to work out in so any help would be great. Thanks in advance.

All I do is make colorful charts tbh. Here’s some primitive reflexes!

This week on Virgin Radio Chris Evans discussed how having his son’s retained reflexes treated was helping him with his learning difficulties. We are so happy to hear this talked about! Children’s primitive reflexes seem to be a big secret to most parents. Both myself, Beccy, and Laura, are both trained in treating retained reflexes. We have seen so many benefits and would love the opportunity to…

Toe Walking in Children. Do you know what you are dealing with ?

In the literature this condition typically has prompted thoughts of possible Autism-spectrum, possible CMT (Charcot-Marie Tooth Disease), CP (Cerebral Palsy), MD (Muscular Dystrophy).  Those are ominous diagnoses to consider if you are a parent with a toe walking child. There will be long sleepless nights without answers. When these types of disorders can clearly be ruled out, a diagnosis of "Idiopathy Toe Walking" is claimed.  But, the research in recent years has brought new light onto the issue and we wanted to use today's blog post to be a brief introduction. We will be doing another post in the coming week to look more deeply into this clinical phenomenon, but today will just serve as an introduction to wet your palate and get your head in the right direction. 

As you can see in this gait, nothing appears to be terribly abnormal in the foot structure (from what we can tell), the client is merely remaining in the plantarflexed posture and forefoot weight bearing.  This is highly ineffective gait and can be very fatiguing let alone to mention the sustained loading into the posterior compartment and plantarflexor mechanism (gastrosoleus-achilles). And remember, the tibialis posterior and long toe flexors are close neighbors with capabilities of plantarflexion moments, so there are possible clinical manifestations there as well not to mention the obvious (especially to long-time Gait Guys readers) deficits that will be found in functional ankle dorsiflexion, ankle rocker and S.E.S. (skill, endurance, strength) of the anterior compartment mechanism (tibialis anterior, long toe extensors, peroneus tertius).  Even if this client were to go into normal heel strike and stance phases right now, they would have lots of work to do to restore the anterior-posterior compartment balance, the 3 foot rockers (heel, ankle and forefoot) to avoid functional pathology. 

Idiopathic toe walking is suggested to be as prevalent as 12%. Neuromotor maturation comes about via the suppression of the primitive reflexes/windows and appearance of the postural reflexes and responses. Delays or subtractions of these windows/reflexes may cause challenges in the normal development and maturation of the central and/or peripheral nervous systems.  With toe walking, the clinical window most studies suggest is to begin investigation after 3 years of age when the primitive motor patterns should have solidified and the gait and postural patterns have begun to layer on top of those primitive reflexes.  Remember though, the primitive patterns are not sequentially fixed, meaning that infants move in and out of these reflexes until they become permanent.  It is not until they are fixed that the postural patterns, which are volitional, can be gradually built. This should bring some thoughts to your mind right now.  Is toe walking behavior a missed primitive window or a non-volitional postural window? These kids are not doing this by choice, anyone who has worked with these types of cases knows this very well, and we have seen our share. 

So what could be going on here ? Is this neurodevelopmental ? Yes, for sure.  But where did things go awry ?  And how do we fix it ? We will get into all of this next week but in the mean time remember that the development of primitive and postural reflexes is supposed to occur proximal to distal (ie. from core to hand/foot). This must be a motor-sensory deficit or mismatch, and we will go into that next week on the blog. In the meantime, consider the definition:

Idiopathic: Of unknown cause. Any disease that is of uncertain or unknown origin may be termed idiopathic. 

That definition should only occur if further research does not render sufficient answers and theories. Next week we will propose some new ideas in the research up to 2014, ideas and proposals that will hopefully lead us to answers and dropping of "idiopathic" from this disorder. 

Have a great day gait brethren !