Cuevas Medek Exercises (CME)

Original Editor - Sehriban Ozmen

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Description[edit | edit source]

Cuevas Medek Exercises (CME) is a psychomotor therapy approach developed by Physiotherapist Ramon Cuevas, used in paediatric physiotherapy since 1972, and increasingly influences clinicians and their patients. [1][2]

MEDEK is an acronym for a Spanish phrase translated into English as "Dynamic Method For Kinesthetic Stimulation". [3]

Indication[edit | edit source]

This approach aims to improve motor developmental delay caused by central nervous system disorder in children aged three months and above. [1][4]

Features[edit | edit source]

  • The main feature of the approach is to expose the child to antigravity positions, provoking the postural control response that normally would not be self-generated due to the damaged central nervous system. [2][5]
    • An example exercise to explain this feature would be while the therapist holds the child in mid-air in the upright standing position by the ankles child will fight against gravity to avoid falling and show balance reactions and be able to learn the vertical control of the head and body. [5][6]

[7]

  • The main effect mechanism is to create new neuronal networks in the damaged central nervous system by using scientific parameters related to neuroplasticity (such as repetition, progression, meaningful exercises, and an enriched environment). [8][5]
  • This approach applies the progressive distal holding principle, in which hand positions progress from proximal to distal. This is because of a biomechanical fact that the farther the therapist's support point the stronger the postural response. [4][9]
  • Since it includes antigravity posture, ROM, weight-bearing, and stretching factors integrated into functional exercises, it can ensure improvement in agility, flexibility, balance and coordination. [4]
  • The special equipment of this approach includes a treatment table to use from the head control exercises until the child can maintain an assisted standing position and a set of boxes to stimulate standing balance reactions. [4]
  • It differs from classical approaches in the following aspects:
    • External supports such as splints or walkers are not used. Instead, the child's brain is forced to create an appropriate response. [3]
    • It does not important if the patient is motivated, cooperative or concentrated. In addition, the emotional state does not prevent the continuation of therapy. [5][3]
    • It does not hesitate to place a child with hypertonus or severe spasticity in lower limbs into a standing position. On the contrary, it forces the child to an orthostatic position to develop vertical control of the body. [3][5]
    • The child's condition is not essential for therapy, rather it takes into account the parent's interpretation of the child's motor development. [3]
    • Stretching is dynamic, not static. These dynamic stretches embedded in functional exercises are much more effective than the static stretches in Bobath. [3]
    • Certain muscle groups are not worked alone, but by performing postural and functional tasks. [5]
    • It is a practitioner-specific practice, not task-specific. [6]

Clinical Evidence[edit | edit source]

There are few published scientific articles [2][5][8] [10][11] and patient stories on the effects of CME.

Resources[edit | edit source]

[12]
[13]

References[edit | edit source]

  1. ↑ 1.0 1.1 Cuevas Medek Exercises. Cuevas Medek. [Internet]. c2023. Available from:https://cuevasmedek.com/
  2. ↑ 2.0 2.1 2.2 Ramires de Oliveira G, Fabris Vidal M. Developmental outcomes in a child with corpus callosum abnormalities and congenital heart disease after Cuevas Medek Exercises: A case report. Clinical Case Reports. 2021 Aug;9(8):e04637.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Vanderminden JA. The social construction of disability and the modern-day healer. University of New Hampshire; 2009.
  4. ↑ 4.0 4.1 4.2 4.3 Cuevas Medek Exercises. What is Cuevas Medek Exercises?. [Internet]. c2023. Available from:https://cuevasmedek.com/what-is-cuevas-medek-exercises/
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Mitroi S. Stimulation of triple extension tone and orthostatic balance in the child with cerebral palsy through exercises specific to Medek method. Physical Education, Sport and Kinesiology Journal. 2016 Jan;1(43):48-51.
  6. ↑ 6.0 6.1 Novak I, Morgan C. High-risk follow-up: early intervention and rehabilitation. Handbook of clinical neurology. 2019 Jan 1;162:483-510.
  7. ↑ marceladevivo. Ramon Cuevas CME Medek 6-14-09 Aerial standing and balance. Available from: https://www.youtube.com/watch?v=z_AdHhklcVA
  8. ↑ 8.0 8.1 de Oliveira GR, Fabris Vidal M. A normal motor development in congenital hydrocephalus after Cuevas Medek Exercises as early intervention: a case report. Clinical Case Reports. 2020 Jul;8(7):1226-9.
  9. ↑ Cuevas R. Cuevas medek exercise. Chile: Cuevas Medek Exercise International Center. 2012.
  10. ↑ Silva BS, de Jesus Alves AL, de Lima Corradi MA. Aplicabilidade do método Cuevas Medek Exercises em paralisia cerebral: relato de caso. Brazilian Journal of Health Review. 2021 Mar 26;4(2):6580-7.
  11. ↑ Ferreira AD, Gerzson LR, de Almeida CS. O efeito da terapia Cuevas Medek Exercises na displasia do desenvolvimento de quadril em paciente com paralisia cerebral: estudo de caso. Fisioterapia Brasil. 2021;22(6):895-903.
  12. ↑ Wings Therapy Center. 𝘾𝙪𝙚𝙫𝙖𝙨 𝙈𝙚𝙙𝙚𝙠 𝙀𝙭𝙚𝙧𝙘𝙞𝙨𝙚𝙨® (𝘾𝙈𝙀): 𝘽𝙚𝙨𝙩 𝙏𝙝𝙚𝙧𝙖𝙥𝙮 𝙛𝙤𝙧 𝘽𝙖𝙗𝙞𝙚𝙨 𝙖𝙣𝙙 𝙔𝙤𝙪𝙣𝙜 𝘾𝙝𝙞𝙡𝙙𝙧𝙚𝙣. Available from: https://www.youtube.com/shorts/TZdnCIkoZaQ
  13. ↑ marceladevivo. Ramon Cuevas CME Medek 6-16-09 Sitting parallel on thin board with legs crossed. Available from: https://www.youtube.com/watch?v=eN2eMyODYsE
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