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                           MEDEK CUEVAS METHOD LEVEL I and II


1. Provokes the appearance of the absent motor functions.

The usual approach of traditional therapy is to provide as much help as possible in order to lessen the labor of moving, furthermore to make the children repeat motor functions which they are already in control of.

A classic example of this assertion is the case of a delayed child older than one year, who is not able to stand independently, and can only maintain the standing position  by grabbing any support with two hands. The traditional therapeutic step will be to employ the use of walking devices such as frame walkers, parallel bars, adapted toys, etc, in order to continue training the child to maintain the standing posture through hands support.

Continuing with this example and according to the first attribute of C.M.E. therapy, the main goals of the exercise program will be to provoke the appearance of the absent standing reaction without hands support.

After a careful motor examination with the C.M.E. motoric test, the therapist will set up the program following the guidelines given by the evaluation results, and the balanced exercise plan will be set up.

Free standing is the main goal, however, other exercises will be incorporated in the plan to provoke the absent motor reactions that precede the free standing, as well as the ones that depend on free standing, such as free steps, going up and down small obstacles independently and other related absent functions.


2. Provokes the automatic responses of function-postural motor control.


3. Exposes the body segments to the influence of  Gravity force.

CME therapy applies a step-by-step escalation of gravity force influence in the exercise program, in this way; it is possible to upgrade the child's neuro-muscular response by the gradually enhanced difficulty of the exercises. This provokes the child systems to take gradual control of the new postures and movements.


4. Promotes the use of distal support rather than hand-to-hand contact or the use of walkers.

If a typical child is put in to walker before one year of age, it is highly possible that he will take free steps close to the year or a little later, even if he does not use a walker, he will be walking free around the same time.

For decades traditional physical therapy has applied this experience to the pediatric rehabilitation field and recommends the use of walkers as a therapeutic measure with this thinking: if it is working for the typical children it will work also for the delayed ones. But, unfortunately it is not usually the case, because the lack of standing and walking stability is not ''corrected'' by the mechanical device, rather it is masked by the artificial and easy compensation provided by the walker.

As long as special children are not exposed to the experience of postural freedom, their brains cannot leap to the next stage of evolution because they are ''SPECIAL'', that means different than the average typical children, and their rhythm of evolution is different because their condition of being ''special'' is caused by some degree (minimal, medium or major) of neurological alteration from a known or unidentified source.

Nevertheless, there always exist in the child's brain a recovery potential which is a latent power of the developmental improvement, and this is the target of CME therapy. To provoke this dormant energy, CME uses specific dynamic exercises based on distal grasp in order to place the child in standing position and force the systems to recognize the posture and react accordingly.

The child is seized by the lowest support that he/she can tolerate, such as held by thighs, by below knees, by ankles or even by hands under soles, and through all of these options the child will react by holding the standing position from short to long periods of time with their hands free.


5. The necessary stretching and range of motion maneuvers, are integrated in specific exercises in the CME program.

To maintain the mobility or range of motion of the joints, is an important goal in pediatric physical therapy especially for the lower limbs join: hips, knees and ankles.

In the CME therapy program all the necessary stretching maneuvers required by any given child, are performed in the functional exercises in which 3 fundamental elements are always involved: range of motion, antigravity postural reaction and weight bearing. In this way the child’s brain will receive better proprioceptive information by the combination of these  3 components.


6. The CME approach buffers the child’s negative emotional reactions.

The special child does not adapt quickly to new environments or when confronted to new biomechanical experiences, because the immature developmental condition lowers her/his threshold of emotional tolerance. This is an important issue that therapists and parents need to learn to handle, in order to not become inhibited to apply the CME program.


7. Hyper tonicity in lower limbs at early ages do not inhibit the prompt use of standing position exercises.

CME  proposes s different model based on:

  • Early and accurate motor assessment to identify the motor deficiency in order begin immediately with the exercise program, while the search for the cause of the motor delayed condition is in progress.
  • Immediate stimulation of standing posture if the child is older than 7 months of age, with the purpose of developing the primary vertical posture which is the base of any further motor activity.
  • Stretching exercises for the ankles, knees and hips in standing position in order to avoid the early use of orthotics.


8. Trial period

After the initial motor assessment and with direct parent participation, 2 or 3 basic absent motor functions are chosen as primary goals to be achieved within the first 8 weeks of application of the CME therapy program which should be done twice a day, seven days a week. If the goals are achieved the parents are advised to continue with the CME program, otherwise they are encouraged to continue searching for other options of physical therapy.