Reflexos primitivos e aplicação clínica podológica: Uma Revisão Narrativa Crítica com Proposta de Enquadramento Avaliativo
Palavras-chave:
Reflexos primitivos; Integração neuromotora; Podologia; Biomecânica do pé; marcha.
Resumo
Os reflexos primitivos constituem respostas motoras automáticas, mediadas por circuitos tronco-encefálicos e espinhais, cuja integração progressiva acompanha a maturação do sistema nervoso central. A sua persistência ou reativação patológica está associada a alterações do desenvolvimento neuromotor, défices posturais, perturbações da marcha e, em contexto neurológico do adulto, a sinais de libertação cortical. Apesar de a biomecânica do pé e a podologia clínica dependerem diretamente da qualidade da ativação neuromuscular, da integração postural e dos padrões de marcha ,domínios intimamente relacionados com a integração reflexa , a literatura podológica não incorporou sistematicamente esta dimensão neurofuncional na sua prática avaliativa. O presente artigo efetua uma revisão narrativa crítica da evidência disponível sobre reflexos primitivos com relevância específica para a avaliação e a intervenção podológica. São analisadas as bases neurofisiológicas da integração reflexa, os reflexos com maior impacto documentado na marcha e na função do pé (nomeadamente preensão plantar, Babinski, reflexo tónico labiríntico, reflexo tónico cervical assimétrico, Galant e toe grasp), a evidência sobre parâmetros espácio-temporais da marcha em crianças com reflexos persistentes, os padrões podológicos mais frequentemente associados e um protocolo de avaliação integrado. Conclui-se que a inclusão de uma avaliação reflexa dirigida no exame podológico aumenta a especificidade diagnóstica, orienta a diferenciação entre causa neuromotora e ortopédica e contribui para planos de intervenção mais fundamentados. São identificadas as limitações metodológicas do campo e propostas prioridades de investigação
Referências
ALTUNKALEM SEYDI, K.; KAYA, D.; YAVUZ, I.; ONTAN, M. S.; DOST, F. S.; ISIK, A. T. Primitive reflexes and dementia in older adults: a meta-analysis of observational and cohort studies. Psychogeriatrics, 2024. DOI: https://doi.org/10.1111/psyg.13098.
BLYTHE, S. Are immature neuromotor skills significant factors in educational under-achievement and special educational needs? Literature review of the role of primitive reflexes as indicators and measures of neuromotor immaturity. Special School, 2023. DOI: https://doi.org/10.5604/01.3001.0053.7205.
BLYTHE, S.; DUNCOMBE, R.; PREEDY, P.; GORELY, T. Neuromotor readiness for school: the primitive reflex status of young children at the start and end of their first year at school in the United Kingdom. Education 3-13, v. 50, p. 654-667, 2021. DOI: https://doi.org/10.1080/03004279.2021.1895276.
GIEYSZTOR, E.; KOWAL, M.; PAPROCKA-BOROWICZ, M. Primitive reflex factors influence walking gait in young children: an observational study. International Journal of Environmental Research and Public Health, v. 19, p. 4070, 2022. DOI: https://doi.org/10.3390/ijerph19074070.
HERNÁNDEZ-MARTÍNEZ, A.; SÁNCHEZ-MATAS, Y.; GUTIÉRREZ-DÍAZ, D.; EXPÓSITO, L. Relationships among integration of primitive reflexes and motor competence in children. Early Child Development and Care, 2025. DOI: https://doi.org/10.1080/03004430.2025.2596692.
HIROSE, N.; TASHIRO, Y.; TAKASAKI, T. Effects of a 12-week exercise intervention on primitive reflex retention and social development in children with ASD and ADHD. Children, v. 12, 2025. DOI: https://doi.org/10.3390/children12080987.
HORVÁTH-PÁPAI, A.; TÓTH, E. E.; BARTHALOS, I.; ALFÖLDI, Z.; TAKÁCS, J.; IHÁSZ, F. Primitive reflexes as behavioral biomarkers of cognitive aging: associations with physical activity and resilience - a pilot study. Frontiers in Aging Neuroscience, v. 17, 2025. DOI: https://doi.org/10.3389/fnagi.2025.1687512.
LEISMAN, G.; MELILLO, R. Evaluating primitive reflexes in early childhood as a potential biomarker for developmental disabilities. Journal of Paediatrics and Child Health, v. 61, p. 846-851, 2025. DOI: https://doi.org/10.1111/jpc.70053.
MACIAK, M.; KOSZELA, K.; BENIUK, A.; WOLDAŃSKA-OKOŃSKA, M. Development of postural-motor, coordination, and reflex functions in children in the first year of life. Polski Merkuriusz Lekarski, v. 52, n. 5, p. 576-582, 2024. DOI: https://doi.org/10.36740/merkur202405105.
MCWHIRTER, K.; STEEL, A.; ADAMS, J. The association between learning disorders, motor function, and primitive reflexes in pre-school children: a systematic review. Journal of Child Health Care, v. 28, p. 402-428, 2022. DOI: https://doi.org/10.1177/13674935221114187.
MELILLO, R.; LEISMAN, G.; MACHADO, C.; MACHADO-FERRER, Y.; CHINCHILLA-ACOSTA, M.; KAMGANG, S.; MELILLO, T.; CARMELI, E. Retained primitive reflexes and potential for intervention in autistic spectrum disorders. Frontiers in Neurology, v. 13, 2022. DOI: https://doi.org/10.3389/fneur.2022.922322.
NAGY, Á.; RÁROSI, F.; DOMOKOS, M.; WILHELM, M. Development of asymmetrical, symmetrical tonic neck reflex test and tonic labyrinth reflex test (TASHUN) for the assessment of neurotypical children: validity and reliability. Applied Sciences, 2025. DOI: https://doi.org/10.3390/app15158601.
PAVLOVIĆ, A.; DJURIC-ZDRAVKOVIC, A.; MILOVANOVIĆ, M.; DJORDJEVIC, J.; ZDRAVKOVIC-PAREZANOVIC, R.; PAVLOVIĆ, D. Primitive reflexes in developing and adult brain - from intellectual disability to dementia. Srpski Arhiv za Celokupno Lekarstvo, v. 153, n. 11-12, p. 619-624, 2025. DOI: https://doi.org/10.2298/SARH250906089P.
PECUCH, A.; GIEYSZTOR, E.; WOLAŃSKA, E.; TELENGA, M.; PAPROCKA-BOROWICZ, M. Primitive reflex activity in relation to motor skills in healthy preschool children. Brain Sciences, v. 11, 2021. DOI: https://doi.org/10.3390/brainsci11080967.
PROVAZNÍK, A.; MUSÁLEK, M.; BOB, P.; VĚTROVSKÝ, T.; MALAMBO, C.; SILVA, A. F.; ANDERSON, D. Persisting primitive reflexes and motor and cognitive development in children: a systematic review. Acta Psychologica, v. 266, p. 106915, 2026. DOI: https://doi.org/10.1016/j.actpsy.2026.106915.
REY-MOTA, J.; ESCRIBANO-COLMENA, G.; DALAMITROS, A.; ÁLVAREZ, D.; CLEMENTE-SUÁREZ, V. Effectiveness of a single functional neurology intervention on primitive reflex integration dysfunction in children. Clinical Case Reports, v. 13, 2025. DOI: https://doi.org/10.1002/ccr3.70797.
SERRA, L.; RIOS, D.; RIOS, M.; DE ALMEIDA, B.; DE SOUZA FERNANDES, K.; LUCENA, R.; DE SIQUEIRA, I. Primitive reflexes in infants with cerebral palsy due to congenital Zika syndrome and its relationship with other motor features. Frontiers in Pediatrics, v. 13, 2025. DOI: https://doi.org/10.3389/fped.2025.1483959.
SHARMA, Y.; JANGRA, M.; KAUR, S.; SAXENA, A. Problems associated with persisting primitive reflexes in healthy school-going children: a scoping review. Critical Reviews in Physical and Rehabilitation Medicine, 2025. DOI: https://doi.org/10.1615/CritRevPhysRehabilMed.2024055164.
SHAW, T.; GARCIA, S. Chiropractic management of toe-walking in an eight-year-old male diagnosed with autism spectrum disorder utilizing a functional approach: a case study. Journal of Bodywork and Movement Therapies, v. 26, p. 538-541, 2021. DOI: https://doi.org/10.1016/j.jbmt.2021.03.014.
SIGAFOOS, J.; ROCHE, L.; O'REILLY, M.; LANCIONI, G. Persistence of primitive reflexes in developmental disorders. Current Developmental Disorders Reports, v. 8, p. 98-105, 2021. DOI: https://doi.org/10.1007/s40474-021-00232-2.
STEPHENS-SARLÓS, E.; SZABO, A. Primitive reflexes as candidate quantitative readouts of hierarchical inhibitory control across the lifespan. Frontiers in Human Neuroscience, v. 20, 2026. DOI: https://doi.org/10.3389/fnhum.2026.1860053.
SUROWIŃSKA, J.; SOBIESKA, M.; GAJEWSKA, E. 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. Frontiers in Public Health, v. 11, 2023. DOI: https://doi.org/10.3389/fpubh.2023.1253137.
TELE-HERI, B.; CSAPO, K.; SZABO, J.; PAPP, C.; GESZTELYI, R.; ZSUGA, J. Effects of a 6-month exercise intervention on primitive reflexes in children with developmental language disorder. Children, v. 12, 2025. DOI: https://doi.org/10.3390/children12121616.
TEPPITAK, W.; NOPPARAT, C.; THICHANPIANG, P.; KAOKHIEO, J.; KUNWITTAYA, S.; PERMPOONPUTTANA, K. Assessing primitive reflex retention and its effect on motor proficiency in Thai preschoolers. Human Movement, 2025. DOI: https://doi.org/10.5114/hm/203539.
TIBICHI, D.; CIOBANU, D.; IANC, D. A study regarding the role of physical therapy in improving gross motor function and the integration of the archaic reflexes in children with cerebral palsy. Romanian Journal of Physical Therapy, 2024. DOI: https://doi.org/10.61215/RJPT.2024.30.52.23.
WANG, M.; YU, J.; LI, H.; ZHAO, C.; LI, Y.; YANG, X. Development of the children's primitive reflex integration assessment scale. Frontiers in Psychology, v. 16, 2025. DOI: https://doi.org/10.3389/fpsyg.2025.1495990.
YILDIZ, M.; ELIÖZ, M.; ÇEBI, M.; ŞIMŞEK, L. The relationship between motor skills and primitive reflexes in children with special needs. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 2025. DOI: https://doi.org/10.1055/a-2785-4991.
BLYTHE, S. Are immature neuromotor skills significant factors in educational under-achievement and special educational needs? Literature review of the role of primitive reflexes as indicators and measures of neuromotor immaturity. Special School, 2023. DOI: https://doi.org/10.5604/01.3001.0053.7205.
BLYTHE, S.; DUNCOMBE, R.; PREEDY, P.; GORELY, T. Neuromotor readiness for school: the primitive reflex status of young children at the start and end of their first year at school in the United Kingdom. Education 3-13, v. 50, p. 654-667, 2021. DOI: https://doi.org/10.1080/03004279.2021.1895276.
GIEYSZTOR, E.; KOWAL, M.; PAPROCKA-BOROWICZ, M. Primitive reflex factors influence walking gait in young children: an observational study. International Journal of Environmental Research and Public Health, v. 19, p. 4070, 2022. DOI: https://doi.org/10.3390/ijerph19074070.
HERNÁNDEZ-MARTÍNEZ, A.; SÁNCHEZ-MATAS, Y.; GUTIÉRREZ-DÍAZ, D.; EXPÓSITO, L. Relationships among integration of primitive reflexes and motor competence in children. Early Child Development and Care, 2025. DOI: https://doi.org/10.1080/03004430.2025.2596692.
HIROSE, N.; TASHIRO, Y.; TAKASAKI, T. Effects of a 12-week exercise intervention on primitive reflex retention and social development in children with ASD and ADHD. Children, v. 12, 2025. DOI: https://doi.org/10.3390/children12080987.
HORVÁTH-PÁPAI, A.; TÓTH, E. E.; BARTHALOS, I.; ALFÖLDI, Z.; TAKÁCS, J.; IHÁSZ, F. Primitive reflexes as behavioral biomarkers of cognitive aging: associations with physical activity and resilience - a pilot study. Frontiers in Aging Neuroscience, v. 17, 2025. DOI: https://doi.org/10.3389/fnagi.2025.1687512.
LEISMAN, G.; MELILLO, R. Evaluating primitive reflexes in early childhood as a potential biomarker for developmental disabilities. Journal of Paediatrics and Child Health, v. 61, p. 846-851, 2025. DOI: https://doi.org/10.1111/jpc.70053.
MACIAK, M.; KOSZELA, K.; BENIUK, A.; WOLDAŃSKA-OKOŃSKA, M. Development of postural-motor, coordination, and reflex functions in children in the first year of life. Polski Merkuriusz Lekarski, v. 52, n. 5, p. 576-582, 2024. DOI: https://doi.org/10.36740/merkur202405105.
MCWHIRTER, K.; STEEL, A.; ADAMS, J. The association between learning disorders, motor function, and primitive reflexes in pre-school children: a systematic review. Journal of Child Health Care, v. 28, p. 402-428, 2022. DOI: https://doi.org/10.1177/13674935221114187.
MELILLO, R.; LEISMAN, G.; MACHADO, C.; MACHADO-FERRER, Y.; CHINCHILLA-ACOSTA, M.; KAMGANG, S.; MELILLO, T.; CARMELI, E. Retained primitive reflexes and potential for intervention in autistic spectrum disorders. Frontiers in Neurology, v. 13, 2022. DOI: https://doi.org/10.3389/fneur.2022.922322.
NAGY, Á.; RÁROSI, F.; DOMOKOS, M.; WILHELM, M. Development of asymmetrical, symmetrical tonic neck reflex test and tonic labyrinth reflex test (TASHUN) for the assessment of neurotypical children: validity and reliability. Applied Sciences, 2025. DOI: https://doi.org/10.3390/app15158601.
PAVLOVIĆ, A.; DJURIC-ZDRAVKOVIC, A.; MILOVANOVIĆ, M.; DJORDJEVIC, J.; ZDRAVKOVIC-PAREZANOVIC, R.; PAVLOVIĆ, D. Primitive reflexes in developing and adult brain - from intellectual disability to dementia. Srpski Arhiv za Celokupno Lekarstvo, v. 153, n. 11-12, p. 619-624, 2025. DOI: https://doi.org/10.2298/SARH250906089P.
PECUCH, A.; GIEYSZTOR, E.; WOLAŃSKA, E.; TELENGA, M.; PAPROCKA-BOROWICZ, M. Primitive reflex activity in relation to motor skills in healthy preschool children. Brain Sciences, v. 11, 2021. DOI: https://doi.org/10.3390/brainsci11080967.
PROVAZNÍK, A.; MUSÁLEK, M.; BOB, P.; VĚTROVSKÝ, T.; MALAMBO, C.; SILVA, A. F.; ANDERSON, D. Persisting primitive reflexes and motor and cognitive development in children: a systematic review. Acta Psychologica, v. 266, p. 106915, 2026. DOI: https://doi.org/10.1016/j.actpsy.2026.106915.
REY-MOTA, J.; ESCRIBANO-COLMENA, G.; DALAMITROS, A.; ÁLVAREZ, D.; CLEMENTE-SUÁREZ, V. Effectiveness of a single functional neurology intervention on primitive reflex integration dysfunction in children. Clinical Case Reports, v. 13, 2025. DOI: https://doi.org/10.1002/ccr3.70797.
SERRA, L.; RIOS, D.; RIOS, M.; DE ALMEIDA, B.; DE SOUZA FERNANDES, K.; LUCENA, R.; DE SIQUEIRA, I. Primitive reflexes in infants with cerebral palsy due to congenital Zika syndrome and its relationship with other motor features. Frontiers in Pediatrics, v. 13, 2025. DOI: https://doi.org/10.3389/fped.2025.1483959.
SHARMA, Y.; JANGRA, M.; KAUR, S.; SAXENA, A. Problems associated with persisting primitive reflexes in healthy school-going children: a scoping review. Critical Reviews in Physical and Rehabilitation Medicine, 2025. DOI: https://doi.org/10.1615/CritRevPhysRehabilMed.2024055164.
SHAW, T.; GARCIA, S. Chiropractic management of toe-walking in an eight-year-old male diagnosed with autism spectrum disorder utilizing a functional approach: a case study. Journal of Bodywork and Movement Therapies, v. 26, p. 538-541, 2021. DOI: https://doi.org/10.1016/j.jbmt.2021.03.014.
SIGAFOOS, J.; ROCHE, L.; O'REILLY, M.; LANCIONI, G. Persistence of primitive reflexes in developmental disorders. Current Developmental Disorders Reports, v. 8, p. 98-105, 2021. DOI: https://doi.org/10.1007/s40474-021-00232-2.
STEPHENS-SARLÓS, E.; SZABO, A. Primitive reflexes as candidate quantitative readouts of hierarchical inhibitory control across the lifespan. Frontiers in Human Neuroscience, v. 20, 2026. DOI: https://doi.org/10.3389/fnhum.2026.1860053.
SUROWIŃSKA, J.; SOBIESKA, M.; GAJEWSKA, E. 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. Frontiers in Public Health, v. 11, 2023. DOI: https://doi.org/10.3389/fpubh.2023.1253137.
TELE-HERI, B.; CSAPO, K.; SZABO, J.; PAPP, C.; GESZTELYI, R.; ZSUGA, J. Effects of a 6-month exercise intervention on primitive reflexes in children with developmental language disorder. Children, v. 12, 2025. DOI: https://doi.org/10.3390/children12121616.
TEPPITAK, W.; NOPPARAT, C.; THICHANPIANG, P.; KAOKHIEO, J.; KUNWITTAYA, S.; PERMPOONPUTTANA, K. Assessing primitive reflex retention and its effect on motor proficiency in Thai preschoolers. Human Movement, 2025. DOI: https://doi.org/10.5114/hm/203539.
TIBICHI, D.; CIOBANU, D.; IANC, D. A study regarding the role of physical therapy in improving gross motor function and the integration of the archaic reflexes in children with cerebral palsy. Romanian Journal of Physical Therapy, 2024. DOI: https://doi.org/10.61215/RJPT.2024.30.52.23.
WANG, M.; YU, J.; LI, H.; ZHAO, C.; LI, Y.; YANG, X. Development of the children's primitive reflex integration assessment scale. Frontiers in Psychology, v. 16, 2025. DOI: https://doi.org/10.3389/fpsyg.2025.1495990.
YILDIZ, M.; ELIÖZ, M.; ÇEBI, M.; ŞIMŞEK, L. The relationship between motor skills and primitive reflexes in children with special needs. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin, 2025. DOI: https://doi.org/10.1055/a-2785-4991.
Publicado
2026-07-16
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