{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:48:20Z","timestamp":1792806500849,"version":"4.5.0"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Idiopathic scoliosis is a three-dimensional spinal deformity characterized by a lateral curvature exceeding 10 degrees in the frontal plane accompanied by vertebral rotation in the transverse plane. Despite extensive research on genetic and neurological factors, its etiology is uncertain. This prospective observational study aims to investigate the relation between the primitive reflexes, specifically, the asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and spinal Galant reflex (SGR), which play key roles in early motor development and postural control and the severity of idiopathic scoliosis (measured via the Cobb angle and the Nash\u2013Moe rotational quota. Additionally, the study evaluated whether the retention of primitive reflexes correlates with increased progression risk over 12 months of conservative treatment. Materials and Methods: Our study cohort included 162 patients, aged 7\u201319 years, diagnosed with idiopathic scoliosis, who underwent clinical examination and assessment of retained primitive reflexes using standardized grading systems. Results: A total of 162 patients (95 girls, 67 boys; mean age: 12.73 \u00b1 2.74 years) met the inclusion criteria. In 73.5% of the cases, scoliosis was detected, with the majority occurring in the dorsal region (40.1%). The mean initial Cobb angle was 13.49\u00b0 \u00b1 7.14\u00b0, with no significant change after 12 months of conservative treatment (p = 0.584). Nash\u2013Moe rotation scores were 1 in 52.5% and 2 in 22% of the cases. Retention of the following primitive reflexes were identified at baseline: Moro (19.1%), ATNR (38.3%), STNR (44.4%), and GSR (27.8%). GSR retention significantly correlated with the Cobb angle (p = 0.011; R = 0.233). All the reflex scores decreased significantly after 12 months, but no correlation existed between the retained reflexes and scoliosis progression. Patients with a history of quadrupedal locomotion had significantly lower ATNR (p = 0.002), STNR (p &lt; 0.001), and GSR (p = 0.017) retention. Conclusions: These findings suggest that primitive reflex testing could serve as an early screening tool in scoliosis risk stratification, being a cost-effective, non-invasive instrument for identifying at-risk children before clinically significant deformity develops.<\/jats:p>","DOI":"10.3390\/medicina61030427","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T06:45:42Z","timestamp":1740725142000},"page":"427","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Persistence of Primitive Reflexes as Possible Predictive Factors for Progression, Prevention, and Early Rehabilitation Intervention in Idiopathic Scoliosis"],"prefix":"10.3390","volume":"61","author":[{"given":"Liliana","family":"Vl\u0103d\u0103reanu","sequence":"first","affiliation":[{"name":"Doctoral School of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Rehabilitation Department, Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 1 University Alley, 900470 Constanta, Romania"},{"name":"Pediatric Neurorehabilitation Department, Techirghiol Balneal and Rehabilitation Sanatorium, 34-41 Climescu Blvd., 906100 Techirghiol, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8573-3160","authenticated-orcid":false,"given":"M\u0103d\u0103lina Gabriela","family":"Iliescu","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Rehabilitation Department, Faculty of Medicine, \u201cOvidius\u201d University of Constanta, 1 University Alley, 900470 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia Tania","family":"Andronache","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Internal Medicine Clinic, \u201cAlexandru Gafencu\u201d Military Emergency Hospital Constanta, Mamaia Blvd., 900527 Constan\u021ba, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Dante\u0219","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cOvidius\u201d University of Constanta, 900470 Constanta, Romania"},{"name":"Clinical Hospital of Plmonology, 40 Sentinelei Street, 900002 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/S0140-6736(08)60658-3","article-title":"Adolescent idiopathic scoliosis","volume":"371","author":"Weinstein","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11832-012-0457-4","article-title":"Epidemiology of adolescent idiopathic scoliosis","volume":"7","author":"Konieczny","year":"2013","journal-title":"J. Child Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13013-017-0145-8","article-title":"2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth","volume":"13","author":"Negrini","year":"2018","journal-title":"Scoliosis Spinal Disord."},{"key":"ref_4","first-page":"CD006850","article-title":"Braces for idiopathic scoliosis in adolescents","volume":"2015","author":"Negrini","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"110585","DOI":"10.1016\/j.mehy.2021.110585","article-title":"Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key event","volume":"151","author":"Zaydman","year":"2021","journal-title":"Med. Hypotheses"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1097\/BPO.0b013e3181f73c12","article-title":"Top theories for the etiopathogenesis of adolescent idiopathic scoliosis","volume":"31","author":"Wang","year":"2011","journal-title":"J. Pediatr. Orthop."},{"key":"ref_7","first-page":"910","article-title":"Etiopathogenesis of adolescent idiopathic scoliosis and new molecular concepts","volume":"23","author":"Letellier","year":"2007","journal-title":"Med. Sci. M\/S"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"363","DOI":"10.17219\/acem\/67458","article-title":"Trunk rotation due to persistence of primitive reflexes in early school-age children","volume":"27","author":"Gieysztor","year":"2018","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_9","first-page":"519","article-title":"Vaclav Vojta\u2019s neurokinesiological concept for the diagnosis and therapy of children with disturbances of motor development","volume":"3","author":"Sadowska","year":"2001","journal-title":"Ortop. Traumatol. Rehabil."},{"key":"ref_10","first-page":"31","article-title":"The role of primitive survival reflexes in the development of the visual system","volume":"6","year":"1995","journal-title":"J. Behav. Opt."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pediatrneurol.2004.01.012","article-title":"Primitive reflexes and postural reactions in the neurodevelopmental examination","volume":"31","author":"Zafeiriou","year":"2004","journal-title":"Pediatr. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Maciak, M., Koszela, K., Beniuk, A., and Wolda\u0144ska-Oko\u0144ska, M. (2024). The Assessment of Postural-Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life. Children, 11.","DOI":"10.3390\/children11091071"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1748-7161-5-12","article-title":"A review of the trunk surface metrics used as Scoliosis and other deformities evaluation indices","volume":"5","author":"Patias","year":"2010","journal-title":"Scoliosis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1053\/apmr.2001.26064","article-title":"Validity, reliability, and responsiveness of the fingertip-to-floor test","volume":"82","author":"Perret","year":"2001","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_15","unstructured":"Modrell, A.K., and Tadi, P. (2023). Primitive Reflexes. StatPearls, StatPearls Publishing."},{"key":"ref_16","first-page":"67","article-title":"Vojta\u2019s method as the early neurodevelopmental diagnosis and therapy concept","volume":"67","author":"Banaszek","year":"2010","journal-title":"Przegl. Lek."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1748-7161-9-4","article-title":"SOSORT 2012 consensus paper: Reducing X-ray exposure in pediatric patients with scoliosis","volume":"9","author":"Knott","year":"2014","journal-title":"Scoliosis"},{"key":"ref_18","first-page":"118","article-title":"Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis","volume":"79","author":"Korbel","year":"2014","journal-title":"Pol. Orthop. Traumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13013-016-0076-9","article-title":"Physiotherapy scoliosis-specific exercises\u2014A comprehensive review of seven major schools","volume":"11","author":"Berdishevsky","year":"2016","journal-title":"Scoliosis Spinal Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13013-017-0141-z","article-title":"Current knowledge of scoliosis in physiotherapy students trained in the United Kingdom","volume":"12","author":"Black","year":"2017","journal-title":"Scoliosis Spinal Disord."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Linhares, N.A., Barbosa, J.C., Penha, P.J., Andrade, R.M., Ribeiro, A.P., and Magalh\u00e3es, M.O. (2022). The Impact of Training Time on Understanding the Treatment of Adolescent Idiopathic Scoliosis According to SOSORT International Guidelines: An Online Survey Study. Children, 9.","DOI":"10.3390\/children9111673"},{"key":"ref_22","first-page":"1500","article-title":"Current knowledge of idiopathic scoliosis among practising physiotherapists in South Africa","volume":"76","author":"Tawa","year":"2020","journal-title":"S. Afr. J. Physiother."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"W\u00f3jcik, P., W\u00f3jcik, A., Ewertowska, P., and Czaprowski, D. (2024). Physiotherapists\u2019 knowledge about the diagnosis, treatment and physical activity of patients with idiopathic scoliosis. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1414709"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1007\/s00586-022-07131-z","article-title":"The classification of scoliosis braces developed by SOSORT with SRS, ISPO, and POSNA and approved by ESPRM","volume":"31","author":"Negrini","year":"2022","journal-title":"Eur. Spine J."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Cordani, C., Malisano, L., Febbo, F., Giranio, G., Del Furia, M.J., Donzelli, S., and Negrini, S. (2023). Influence of Specific Interventions on Bracing Compliance in Adolescents with Idiopathic Scoliosis-A Systematic Review of Papers Including Sensors' Monitoring. Sensors, 23.","DOI":"10.3390\/s23177660"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Fregna, G., Rossi Raccagni, S., Negrini, A., Zaina, F., and Negrini, S. (2023). Personal and Clinical Determinants of Brace-Wearing Time in Adolescents with Idiopathic Scoliosis. Sensors, 24.","DOI":"10.3390\/s24010116"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.2106\/JBJS.RVW.23.00110","article-title":"Effectiveness of Orthotic Treatment on Clinical Outcomes of the Patients with Adolescent Idiopathic Scoliosis Under Different Wearing Compliance Levels: A Systematic Review","volume":"11","author":"Liu","year":"2023","journal-title":"JBJS Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"167","DOI":"10.5114\/aoms.2016.60503","article-title":"Persistence of primitive reflexes and associated motor problems in healthy preschool children","volume":"14","author":"Gieysztor","year":"2018","journal-title":"Arch. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1177\/13674935221114187","article-title":"The association between learning disorders, motor function, and primitive reflexes in pre-school children: A systematic review","volume":"28","author":"McWhirter","year":"2024","journal-title":"J. Child Health Care"},{"key":"ref_30","first-page":"357","article-title":"Factors Affecting Dynamic Postural Control Ability in Adolescent Idiopathic Scoliosis","volume":"78","author":"Yamawaki","year":"2024","journal-title":"Acta Medica Okayama"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1007\/s00586-016-4802-z","article-title":"Clinical balance tests, proprioceptive system and adolescent idiopathic scoliosis","volume":"26","author":"Guyot","year":"2017","journal-title":"Eur. Spine J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Assaiante, C., Mallau, S., Jouve, J.L., Bollini, G., and Vaugoyeau, M. (2012). Do adolescent idiopathic scoliosis (AIS) neglect proprioceptive information in sensory integration of postural control?. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0040646"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/0887-8994(95)00143-4","article-title":"Prospective follow-up of primitive reflex profiles in high-risk infants: Clues to an early diagnosis of cerebral palsy","volume":"13","author":"Zafeiriou","year":"1995","journal-title":"Pediatr. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Surowi\u0144ska, J., Sobieska, M., and Gajewska, E. (2023). Qualitative assessment in the third month of life allows for a better prognosis of the achievement of motor milestones versus assessment of pathological reflexes-prospective studies on Polish children. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1253137"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/427\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:44:14Z","timestamp":1760028254000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030427"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030427","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}