Primitive reflex inhibition and sensory motor training improves cognitive learning function and symptoms in chronic disabling low back pain: A case series

Reference as: Gibbons SGT 2009 Primitive reflex inhibition and sensory motor training improves cognitive learning function and symptoms in chronic disabling low back pain: A case series. Manual Therapy. 14 (S1): S24

Introduction
Cognitive learning problems are common in chronic pain and are associated with neurological soft signs. These present a potential important barrier to rehabilitation. Primitive reflex inhibition (PRI) and sensorimotor rehabilitation (SR) improves cognitive function in sub-groups of children with learning disabilities, thus provides a potential rehabilitation option for chronic low back pain (CLBP).

Methods
56 subjects (34F/22M) who had failed to benefit from an active exercise program and a specific motor control combined movement control exercise program participated in the study. The main outcome was the Motor Control Abilities Questionnaire (MCAQ) which assesses aspects of cognitive learning and sensorimotor function. Secondary outcomes included: Quadruple Pain Numerical Rating Scale (QNRS), Roland Morris Disability Questionnaire, Patient Specific Functional Questionnaire, quality of life (SF36v2) and the ability to learn lower abdominal hollowing and a lumbar spine movement control exercise. The subjects attended a clinic once a week for 12 weeks to progress through a PRI program individual to their initial presentation. They were asked to perform the movements at home twice a day. 27 subjects continued for another twelve weeks and added SR.

Results

The mean change in score on the MCAQ was a decrease of 32.7 (range 17-51). Pain decreased a mean of 15.6, disability decreased a mean of 4.6, function increased a mean of 16.7, quality of life increased a mean of 23.2. 48 subjects were able to learn the specific exercises and could participate in a standard exercise program.

Discussion 
Significant cognitive learning dysfunction reduces a client’s ability to benefit from many standard types of therapy when skills such as reading and concentrating are involved. This study provides preliminary evidence that a PRI and SR may improve cognitive dysfunction and other health benefits in a sub-group of CLBP subjects. This group represents an important sub-classification in chronic musculoskeletal conditions.

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Ottawa, Canada: March 6-8, 2020: Primitive Reflex & Motor Skill Learning

Barcelona, Spain: March 20-22, 2020: Primitive Reflex & Motor Skill Learning

Toronto, Canada: May 2-3: Body Image, Motor Skill Learning & Primitive Reflexes for Pelvic Health 

Warsaw, Poland: May 8-10: Primitive Reflexes

Warsaw, Poland: May 11-13: Body Image, Motor Skill Learning & Advanced Primitive Reflexes

Harrogate, UK: May 16-17: Body Image, Motor Skill Learning & Advanced Primitive Reflexes

Montreal, Canada: June 5-7: Body Image, Motor Skill Learning & Advanced Primitive Reflexes for Pelvic Health 

Milan, Italy: June 19-21: Advanced Concussion & Body Image

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