Cuevas MEDEK Exercises (CME) (formerly MEDEK) is a psychomotor form of physical therapy for infants and children experiencing delayed motor development. The origin of this delay is impairment impacting the child’s central nervous system (CNS), which is comprised of the brain and spinal cord. Although it is not necessary for a child to have a formal diagnosis of a CNS abnormality at the time that therapy is initiated, the following is a list of diagnoses for which CME may be appropriate:
- Global Developmental Delay
- Cerebral Palsy
- Genetic disorders (such as Down Syndrome, Rett Syndrome, Angelman Syndrome, etc)
- Spina Bifida
- Seizure disorders (for children under medical supervision)
- Risk of motor delay related to premature birth and/or hypoxic brain injury
CME therapy focuses on the brain and it’s natural recovery potential. All humans possess a genetic blueprint, which not only determines individual physical features such as hair and eye colour, but also drives the brain’s motor control system. While the interaction of this genetic blueprint, the aging process (as the child develops month to month), and the natural recovery potential of the brain will allow the child with CNS impairment to develop, CME practitioners strongly believe that high quality neuromuscular stimulation is required to allow these children to achieve their maximum level of motor independence.
The overarching goal of CME therapy is to develop functional motor control in order to achieve the maximum level of motor independence. However, in order to achieve milestones such as independent sitting, standing and walking, a child must first possess the ability to extend their body against gravity. The CME practitioner works to develop antigravity extension in each child by maximally challenging the neuromuscular system. This is achieved by providing 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 provoked to create new motor functions that the child had not previously been able to control. Provoking absent motor functions by the use of distal support is integral to CME therapy. Keeping the characteristics of CME therapy in mind, as initial assessment moves to regularly scheduled therapy sessions, the CME practitioner must also revisit the assessment with each client in order to ensure that therapeutic goals are being achieved. Learn more about the characteristics of CME therapy.
Several factors may influence the 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.
CME therapy is the creation and life’s work of Kinesiologist and Physical Therapist,
Ramon Cuevas. To learn more, visit the CME International Center website at