Table 3_Retained primitive reflexes are independently associated with impaired postural control in adolescents with idiopathic scoliosis.docx

Postural control was measured via computerized dynamic posturography (CDP; six sensory conditions C1–C6) and the sensory organization test (SOT). The primary analysis used hierarchical multiple regression to quantify the independent contribution of reflex retention (ATNR and Galant composite) to CDP composite score, with bootstrap resampling (5,000 iterations) to derive robust 95% confidence intervals. The STNR was analyzed separately as a specificity control.

Secondary analyses examined partial correlations between individual reflexes and individual CDP conditions.</p>Results<p>Primitive reflex retention was highly prevalent: 87.2% of participants (N=47 with complete reflex data) retained at least one reflex, and 63.8% retained both. Age alone explained 25.5% of CDP composite variance (p<0.001). After controlling for age and Cobb angle, reflex total score independently accounted for an additional 7.4% of variance (ΔR2=0.074, β=−6.18, p=0.032, 95% bootstrap CI [−13.77, −0.78]).

The Galant reflex exhibited the strongest independent associations with CDP composite (partial r=−0.35, p=0.016) and the platform-tilt condition C4 (partial r=−0.36, p=0.013). Reflex-positive participants (≥ 2 retained reflexes) demonstrated clinically meaningful deficits in postural control compared to reflex-negative participants (Cohen’s d=−0.63).</p>Conclusion<p>Retained primitive reflexes, particularly the Galant reflex, are independently associated with impaired postural control in AIS beyond age and curve severity.

These findings identify primitive reflex retention as a potential neurodevelopmental marker of postural dysfunction within the AIS population.</p>