{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:36:13Z","timestamp":1787315773677,"version":"build-2736575974"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Funct. Morphol. Kinesiol.","JFMK"],"abstract":"<jats:p>Background: Primitive reflex (PR) assessments based on the Institute for Neuro-Physiological Psychology (INPP) framework are increasingly used in developmental and athletic populations. However, the reproducibility of these observer-based assessments remains insufficiently documented. This study investigated the intra- and inter-rater reliability of subjective PR assessments and examined the potential influence of evaluator expertise in elite youth football athletes. Methods: Sixty-nine male youth football players from an elite academy (age: 18 \u00b1 2 years) participated in this study. PR assessments included the Moro reflex, asymmetrical tonic neck reflex, symmetrical tonic neck reflex, and tonic labyrinthine reflex, evaluated using standardized INPP procedures (0\u20134 ordinal scoring scale). Intra-rater reliability was assessed by an experienced examiner across three testing sessions performed over six months. Inter-rater reliability was evaluated using standardized video recordings independently scored by two novice raters. Relative reliability was assessed using intraclass correlation coefficients (ICCs) with corresponding 95% confidence intervals (95% CIs), while absolute reliability was quantified using the standard error of measurement (SEM) and the minimal detectable change at the 95% confidence level (MDC95). Results:\u00a0Good to excellent intra-rater relative reliability (ICC = 0.86\u20130.98; 95% CI = [0.81\u20130.99]) was observed, with SEM values of 0.1\u20130.6 and MDC95 values of 0.3\u20131.7 points. Moderate to excellent video-based inter-rater reliability was found (ICC = 0.69\u20130.99; 95% CI [0.56\u20130.99]), with SEM values of 0.1\u20130.7 and MDC95 values of 0.3\u20132.0 points. Pairwise comparisons among raters showed moderate to excellent relative reliability (ICC = 0.57\u20130.99; 95% CI [0.35\u20130.99]), with SEM values of 0.1\u20130.5 and MDC95 values of 0.2\u20131.3 points. Conclusions: Subjective PR assessments performed using the INPP framework demonstrated good to excellent intra-rater relative reliability and moderate to excellent video-based inter-rater relative reliability, together with generally low absolute measurement error in elite youth football athletes. These findings provide preliminary psychometric support for the use of standardized PR assessments in research and applied sport settings.<\/jats:p>","DOI":"10.3390\/jfmk11030324","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:37:34Z","timestamp":1787312254000},"page":"324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intra- and Inter-Rater Reliability of Primitive Reflex Assessments in Youth Football Athletes"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9707-4537","authenticated-orcid":false,"given":"Julie","family":"Bastiere","sequence":"first","affiliation":[{"name":"SINERGIES, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Plateforme Exercice Performance Sant\u00e9 Innovation, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Research and Development Department, ESTAC Association, 10000 Troyes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-7989","authenticated-orcid":false,"given":"Aur\u00e9lien","family":"Patoz","sequence":"additional","affiliation":[{"name":"Research and Development Department, Volodalen, 1023 Crissier, Switzerland"},{"name":"Institute of Sport Sciences, Biomechanics & Integrative Physiology of Exercise Dynamics (BIPED) Laboratory, University of Lausanne, 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Lussiana","sequence":"additional","affiliation":[{"name":"SINERGIES, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Plateforme Exercice Performance Sant\u00e9 Innovation, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Research and Development Department, Volodalen, 1023 Crissier, Switzerland"},{"name":"Research and Development Department, Volodalen, 39270 Chav\u00e9ria, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin","family":"Subryan","sequence":"additional","affiliation":[{"name":"Research and Development Department, ESTAC Association, 10000 Troyes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrille","family":"Gindre","sequence":"additional","affiliation":[{"name":"SINERGIES, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Plateforme Exercice Performance Sant\u00e9 Innovation, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Research and Development Department, Volodalen, 1023 Crissier, Switzerland"},{"name":"Research and Development Department, Volodalen, 39270 Chav\u00e9ria, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9486-3090","authenticated-orcid":false,"given":"Laurent","family":"Mourot","sequence":"additional","affiliation":[{"name":"SINERGIES, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Plateforme Exercice Performance Sant\u00e9 Innovation, Universit\u00e9 Marie et Louis Pasteur, 25000 Besan\u00e7on, France"},{"name":"Department of Biological Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","unstructured":"Illingworth, R.S. (1987). The Development of the Infant and Young Child\u2014Normal and Abnormal, Churchill Livingstone. [9th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1093\/ptj\/58.9.1061","article-title":"Primitive reflex profile. A pilot study","volume":"58","author":"Capute","year":"1978","journal-title":"Phys. Ther."},{"key":"ref_3","unstructured":"Blythe, S.G. (2009). Attention, Balance and Coordination: The A.B.C of Learning Success, John Wiley & Sons."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/j.1469-8749.1984.tb04456.x","article-title":"Primitive reflex profile: A quantitation of primitive reflexes in infancy","volume":"26","author":"Capute","year":"1984","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1111\/j.1469-8749.1982.tb13677.x","article-title":"Motor Functions: Associated Primitive Reflex Profiles","volume":"24","author":"Capute","year":"1982","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1085-9489.2005.0010206.x","article-title":"History of standard scoring, notation, and summation of neuromuscular signs. A current survey and recommendation","volume":"10","author":"Dyck","year":"2005","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/00000441-188610000-00003","article-title":"The tendon-jerk and muscle-jerk in disease, and especially in posterior sclerosis","volume":"184","author":"Morris","year":"1886","journal-title":"Am. J. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/19411243.2021.1910606","article-title":"Primitive reflex retention and attention among preschool children","volume":"15","author":"Hickey","year":"2022","journal-title":"J. Occup. Ther. Sch. Early Interv."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Pecuch, A., Gieysztor, E., Wola\u0144ska, E., Telenga, M., and Paprocka-Borowicz, M. (2021). Primitive Reflex Activity in Relation to Motor Skills in Healthy Preschool Children. Brain Sci., 11.","DOI":"10.3390\/brainsci11080967"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.17219\/pzp\/75487","article-title":"Psychomotor disorders assesment in 4\u20136 year-old children with INPP test battery","volume":"8","author":"Pecuch","year":"2018","journal-title":"Nurs. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106915","DOI":"10.1016\/j.actpsy.2026.106915","article-title":"Persisting primitive reflexes and motor and cognitive development in children: A systematic review","volume":"266","author":"Bob","year":"2026","journal-title":"Acta Psychol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"202744","DOI":"10.1016\/j.reia.2025.202744","article-title":"Associations between retained primitive reflexes and cognitive performance in autism spectrum disorder","volume":"129","author":"Leisman","year":"2026","journal-title":"Res. Autism"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Niklasson, M., Rasmussen, P., Niklasson, I., and Norlander, T. (2015). Adults with sensorimotor disorders: Enhanced physiological and psychological development following specific sensorimotor training. Front. Psychol., 6.","DOI":"10.3389\/fpsyg.2015.00480"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Horv\u00e1th-P\u00e1pai, A., T\u00f3th, E.E., Barthalos, I., Alf\u00f6ldi, Z., Tak\u00e1cs, J., and Ih\u00e1sz, F. (2025). Primitive reflexes as behavioral biomarkers of cognitive aging: Associations with physical activity and resilience\u2014A pilot study. Front. Aging Neurosci., 17.","DOI":"10.3389\/fnagi.2025.1687512"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"112583","DOI":"10.1016\/j.exger.2024.112583","article-title":"Changes in primitive reflexes in older adults and their relationship to mental health indices: An experimental investigation","volume":"196","author":"Toth","year":"2024","journal-title":"Exp. Gerontol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1002\/dys.282","article-title":"Prevalence of persistent primary reflexes and motor problems in children with reading difficulties","volume":"10","author":"McPhillips","year":"2004","journal-title":"Dyslexia"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.ridd.2016.07.010","article-title":"Persistent primary reflexes affect motor acts: Potential implications for autism spectrum disorder","volume":"83","author":"Chinello","year":"2018","journal-title":"Res. Dev. Disabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5","DOI":"10.17219\/pzp\/69471","article-title":"The degree of primitive reflexes integration as a diagnostic tool to assess the neurological maturity of healthy preschool and early school age children","volume":"7","author":"Gieysztor","year":"2017","journal-title":"Nurs. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Bogdanovi\u010da, I., and L\u0101ri\u0146\u0161, V. (2020). Case study of primitive reflexes impact on swimming skill acquisition by healthy children. Society. Integration. Education. Proceedings of the International Scientific Conference, R\u0113zeknes Tehnolo\u0123iju akad\u0113mija\/Rezekne Academy of Technologies.","DOI":"10.17770\/sie2020vol6.5180"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bastiere, J., Lussiana, T., Young, D., Gindre, C., and Mourot, L. (2024). Persistence and activity levels of primitive reflexes in young high-level football players. Front. Sports Act. Living, 6.","DOI":"10.3389\/fspor.2024.1409257"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1080\/02640414.2024.2434800","article-title":"Active primitive reflexes obstruct tactical and technical skills in football players","volume":"43","author":"Bastiere","year":"2025","journal-title":"J. Sports Sci."},{"key":"ref_22","unstructured":"Davids, K., Button, C., and Bennett, S. (2008). Dynamics of Skill Acquisition: A Constraints-Led Approach, Human Kinetics."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00221-012-3000-4","article-title":"The bliss (not the problem) of motor abundance (not redundancy)","volume":"217","author":"Latash","year":"2012","journal-title":"Exp. Brain Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Demiy, A., Kalemba, A., Lorent, M., Pecuch, A., Wola\u0144ska, E., Telenga, M., and Gieysztor, E.Z. (2020). A Child\u2019s Perception of Their Developmental Difficulties in Relation to Their Adult Assessment. Analysis of the INPP Questionnaire. J. Pers. Med., 10.","DOI":"10.3390\/jpm10040156"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Melillo, R., Leisman, G., Machado, C., Machado-Ferrer, Y., Chinchilla-Acosta, M., Kamgang, S., Melillo, T., and Carmeli, E. (2022). Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.922322"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Blythe, S.G. (2015). Neuromotor Immaturity in Children and Adults: The INPP Screening Test for Clinicians and Health Practitioners, John Wiley & Sons.","DOI":"10.1002\/9781118736852"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1080\/13575270500340234","article-title":"Releasing Educational Potential Through Movement: A Summary of Individual Studies Carried Out Using the INPP Test Battery and Developmental Exercise Programme for use in Schools with Children with Special Needs","volume":"11","author":"Blythe","year":"2005","journal-title":"Child Care Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.jclinepi.2010.03.002","article-title":"Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed","volume":"64","author":"Kottner","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1054\/ptsp.2000.0010","article-title":"Reliability in evidence-based clinical practice: A primer for allied health professionals","volume":"1","author":"Batterham","year":"2000","journal-title":"Phys. Ther. Sport"},{"key":"ref_31","first-page":"473","article-title":"Intrarater Reliability","volume":"Volume 2","author":"Massaro","year":"2008","journal-title":"Wiley Encyclopedia of Clinical Trials"},{"key":"ref_32","unstructured":"Gwet, K.L. (2014). Handbook of Inter-Rater Reliability, 4th Edition: The Definitive Guide to Measuring The Extent of Agreement Among Raters, Advanced Analytics, LLC."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.47391\/JPMA.06-861","article-title":"Reliability and validity: Importance in Medical Research","volume":"71","author":"Ahmed","year":"2021","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"593","DOI":"10.26603\/001c.35666","article-title":"Movement Competency Screens Can Be Reliable In Clinical Practice By A Single Rater Using The Composite Score","volume":"17","author":"Mann","year":"2022","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"121","DOI":"10.23736\/S0393-3660.19.04297-9","article-title":"Reliability of experienced and novice raters conducting clinical balance tests in young physically active individuals","volume":"180","author":"Udompanich","year":"2021","journal-title":"Gazz. Med. Ital. Arch. Sci. Med."},{"key":"ref_36","unstructured":"Nunnally, J.C. (1994). Psychometric Theory, Tata McGraw-Hill Education. [3rd ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Streiner, D.L., Norman, G.R., and Cairney, J. (2014). Health Measurement Scales: A Practical Guide to Their Development and Use, Oxford Academic.","DOI":"10.1093\/med\/9780199685219.001.0001"},{"key":"ref_38","first-page":"195","article-title":"Intra- and inter-rater reliability of the selective functional movement assessment (sfma)","volume":"9","author":"Glaws","year":"2014","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1519\/JSC.0b013e3181c09c04","article-title":"Interrater reliability of the functional movement screen","volume":"24","author":"Minick","year":"2010","journal-title":"J. Strength Cond. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1002\/sim.1108","article-title":"Sample size requirements for estimating intraclass correlations with desired precision","volume":"21","author":"Bonett","year":"2002","journal-title":"Stat. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1136\/jnnp.74.5.558","article-title":"The grasp and other primitive reflexes","volume":"74","author":"Schott","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/3\/324\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:08:37Z","timestamp":1787314117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/11\/3\/324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jfmk11030324"],"URL":"https:\/\/doi.org\/10.3390\/jfmk11030324","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]}}}