For those babies/children with a motor delay, their therapy program will likely have a basis in Cuevas Medek Exercises. Cuevas MEDEK Exercise® (CME®) was created by Ramon Cuevas (Chile). The basic CME assumption is that in a gravitational environment, we require postural control and the ability to pull up against gravity, to stabilize our body in space. Gravity is considered the main stimulus that triggers the neuromuscular system to react.
CME relies strongly on the vestibular and proprioceptor systems. Children who receive CME therapy are known to have strong postures and core strength.
After reviewing the results of the initial assessment, the CME therapist will be able to clearly identify which are the absent motor functions according to the child’s chronological age. With this information, the CME therapist will then be able to choose the appropriate CME exercises for the child. Exercises begin on a table. Then, if the child is able to stand with thing/ankle support, the floor is used.
Floor exercises involve the CME boxes, which can be configured in various ways to challenge the child’s sense of balance. Exercises are repeated until the reaction of the brain becomes automatic and the body reacts normally to situations where the child is required to keep its balance.
A CME therapy program consists of a range of CME exercises that provoke the child to respond with a motor reaction that he/she was not previously able to produce. According to the standards of CME therapy, if an exercise is deemed not to be challenging for a particular child, then it is not an appropriate exercise for that child.
CME therapy exposes the child to the natural influence of the force of gravity with gradual progression to distal support. The CME therapist will gradually move their point of contact on the child’s body more distally as the child can safely tolerate and according to the underlying recovery potential of the brain.
For example, upon assessing a 12 month old who cannot stand, the CME therapist would first support the child in standing by one thigh and the opposite side of the trunk, after which the therapist would gradually move to support by thighs, then below knees, later to ankles, and eventually to the soles of the child’s feet. It is this progression of support that maximally challenges the neuromuscular system and provokes the natural recovery potential of the brain.