PR are brain stem mediated complex automatic movement
patterns which are evoked through touch or changes
in body position [21,22]. The disappearance of PR are a
sign of central nervous system (CNS) development as it
indicates cortical inhibition, which is necessary for voluntary
movement [23]. The presence of PR in adults have
been associated with neurological disorders such as Alzheimer’s
and dementia [24,25]. It is also theorized that the
recurrence of PR in adults may be an inherent consequence
of usual aging [25]. As CLBP has been associated
with atrophy of CNS gray matter, and specifically
GABAergic inhibitory interneurons [26], then PR may resurface
due to a decrease level of inhibition on the brainstem
neurons responsible for the autonomic movement
patterns. It may be possible that CLBP lead to alterations
in the CNS and that the presence of PR is an indication of
this change. Likewise this presence may explain why some
individuals with CLBP have difficulty learning how to perform
the hollowing maneuver. However, research is scant
on this topic and more research is necessary to substantiate
this possibility