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Investigation of Trunk and Extremity Movement Associated With Passive Head Turning in Newborns

NA Clopton, PT, PhD, is Associate Professor, Physical Therapy Program, Texas Tech University Health Sciences Center, 3601 4th St, Lubbock, TX 79430 (USA) (alhnac{at}ttuhsc.edu).
T Duvall, PT, B Ellis, PT, M Musser, PT, and S Varghese, PT, are recent graduates of the Physical Therapy Program, Texas Tech University Health Sciences Center

Address all correspondence to Dr Clopton

Background and Purpose. Physical therapist examination of pediatric clients or clients with neurological conditions often includes the observation of stereotypical movement patterns such as the asymmetrical tonic neck reflex and righting reactions. The purpose of this study was to investigate whether extremity and trunk responses to passive head turning could be documented in newborn infants. Subjects and Methods. Forty-two newborns with no known medical problems were videotaped within 5 days of birth while an investigator turned their heads left and right. Videotapes were stopped at 5-second intervals to record the direction of head turn with the rest of the body obscured. A second investigator recorded trunk and extremity position with the head obscured. Results. The direction of head turning affected upper-and lower-extremity position, with extension stronger on the face side. The direction of trunk convexity was also affected by head position, with the trunk convex to the side to which the face was turned. Conclusion and Discussion. Extremity responses and trunk responses to passive head turning can be documented corresponding to patterns reported for the asymmetrical tonic neck reflex and righting reflexes in neonates with no known medical problems more frequently than would occur by chance.

Key Words: Asymmetrical tonic neck reflex • Reflex • Righting • Stereotypical movement