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Is CME (Cuevas MEDEK Exercise) the best treatment for my child’s movement disorder?

CME(Cuevas MEDEK Exercise) or the Dynamic Method of Kinetic Stimulation (MEDEK) is a is a form of physiotherapy created and developed by Chilean physical therapist, Ramon Cuevas. This form of physiotherapy focuses on improving the gross motor skills of young children with physical disabilities and movement disorders.
Cuevas-Medek-Exercises, also know as CME or Medek treatment, consists of a series of very specific exercises designed to strongly provoke the child’s automatic righting responses. MEDEK therapy focuses on training young children on core movements leading to sitting, standing, and walking.
Muscles are trained to do these movements rather than being exercised in isolation. Movement therapy operates on the assumption that movement affects the development of the brain. The child learns to work against the influence of gravity, which is thought to be the driving force behind successful movement. As movement responses to the exercises improve, the child develops better motor skills such as head and trunk control, standing and walking.
Practitioners of MEDEK and patients who have participated in this therapy claim children with gross motor delay showed better than expected improvement in:
Improving the gross motor skills of young children with physical disabilities and movement disorders from the age of 4 months and up.
Exposing the child to the natural influence of the force of gravity with gradual progression to distal support.
Provoking automatic postural reactions that contribute to the postural control, needed for functional tasks.
Training movements that lead to sitting, standing, and walking.
During CME or MEDEK, the therapist physically manipulates the child to stretch out tight muscles and train the muscles in groups. These manipulations eventually lead to the child gaining control over his or her trunk. This is necessary to perform basic gross motor activities such as sitting, standing, and walking.
Sessions begin on a table. Then, if the child is able to stand with ankle support, the floor is used. Exercises are repeated until the reaction of the child’s brain becomes automatic and the body reacts normally to situations where it is required to keep its balance.
How do I know if CME is the best treatment for my child?
This therapy can be applied to any child with any kind of physical developmental delay. Therapy can begin immediately from birth until the child achieves and controls independent walking.
Below is a list of exceptions:
Any diagnosis of degenerative nature affecting the neuro-muscular tissue (progressive diseases).
Diagnosis of Osteogenesis Imperfecta.
Uncontrolled seizures.
What makes CME therapy so different?
CME provokes the appearance of absent and automatic motor functions. Every exercise requires input by the therapist and an active motor output on the part of the child. Motor activities are stimulated to elicit new actions and reactions that the patient could not perform previously. Once these actions are learned, based skills such as sitting are developed.  Careful selection of exercises ensures that new motor skills are developed instead of facilitating (or making easier) what the child is already capable of doing.
The child’s cooperation and motivation are not required to make progress with CME. In fact, distraction is key. Not motivation. Patients are placed in positions where their natural recovery instincts are triggered until the child can complete an action of their own accord.

Skills are developed by exposing body segments to the influence of gravity force with the gradual progression to controlling the child with the use of distal support. Holding the child as low down on their body as possible provokes the absent anti-gravity control, enabling the child to hold themselves up against gravity. This helps to gain consistent control in sitting, kneeling and standing. The therapist acts as a temporary surrogate nervous system to help the child control their own balance, keeping their weight over their base of support.

ROM (Range of Motion) exercises are incorporated in dynamic and active exercises. Active and dynamic stretching is done on a warm muscle in a functional way maximizing therapy time and stretching activities. There is no passive range of motion in CME.
To learn more about this form of physiotherapy contact Moriarty Physical Therapy to schedule a free exploratory examination with one of our doctors.


Moriarty Physical Therapy is the premier physical therapist provider here in the Hudson Valley with centers located near you. To find out more about physical therapy or to book your first appointment with a physical therapist, contact Moriarty Physical Therapy at (845) 454-4137.


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