Cuevas MEDEK Exercises (CME) is a treatment approach used to develop gross motor skills in infants and children with motor delay. Children whose birth history may place them at risk of gross motor delay (e.g. premature birth), or those who have been diagnosed with Down Syndrome, cerebral palsy, hypotonia or global developmental delay or have an acquired brain injury, may benefit from CME.
The goal of CME therapy is to develop functional motor control in order to achieve the maximum level of independence in sitting, standing and walking. However, in order to achieve these milestones, a child must first possess the ability to extend his/her body against gravity (antigravity extension) and to stabilize his/her body in space.
Ramon Cuevas, creator of CME, believes that antigravity extension and stability are developed by maximally challenging the neuromuscular system. Therefore, in CME therapy, the therapist will use the most distal point of contact on the child’s body that is tolerated at each moment. By doing so the body segments are exposed to the influence of gravity and the brain’s automatic responses are stimulated in order to produce the desired reaction.
Several factors may influence the final outcome of therapeutic intervention using CME. One of these factors is the child’s age at the time that therapy is initiated. It has been well documented that development of the brain structures is influenced by activity, therefore early assessment and intervention is ideal. However, CME has been used to treat school-aged children and therefore may be explored as a treatment option for older children as well. Other factors that may influence the final outcome of therapy include the degree of physical disability, the frequency of intervention and the level of experience and skill of the therapist.
In order to increase the frequency of intervention, a home program is taught to the child’s parents/caregiver. This home program consists of six to eight exercises specifically chosen by the treating therapist to meet the needs of the child. Families are instructed to complete the home program on a daily basis. The acquisition and integration of a new skill requires practice, therefore repetition of the exercises is an important aspect of treatment. As the child progresses, the therapist will modify the treatment plan and teach new exercises to the family on an ongoing basis. Parents often comment that they appreciate the structured nature of the CME home program and the fact that the purpose of each exercise is discussed in relation to the therapeutic goals for their child.
