CME therapy provokes the appearance of absent automatic motor functions.
After reviewing the results of the initial assessment, the CME practitioner will be able to clearly identify which are the absent motor functions according to the child’s chronological age. With this information, the CME practitioner will then be able to choose the appropriate CME exercises for the child. An appropriate program consists 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.
The child’s cooperation and motivation are not requisites in CME therapy.
The interplay between the genetic blueprint and environmental factors is responsible for driving much of early human development. As such, motor development manifests itself first spontaneously (eg. A child who takes their first steps doesn’t think to themselves before doing so, “I think that I’ll take my first steps now”.) and, through this initial experience, the child gradually then becomes conscious of their motor control and begins to use it in their daily life. Adding to this the challenges brought on by motor delay, the CME practitioner does not expect a child in their hands to be motivated or cooperative during their therapy sessions. Rather, it is the responsibility of the CME practitioner to find appropriate ways to support the child and gain the best response possible throughout the therapy session.
CME therapy exposes the child to the natural influence of the force of gravity with gradual progression to distal support.
The CME practitioner 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 child who cannot stand, the CME practitioner would first support the child in standing by one thigh and the opposite side of the trunk, after which the practitioner 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.
Stretching maneuvers are integrated into CME therapy.
To maintain and enhance joint mobility, in particular in the lower extremities, stretches are incorporated into the exercises. In this manner, rather than stretches being applied passively to the child (as in traditional physiotherapy programs), the child’s muscles are actively being stretched as they are having to control the extension of their trunk against gravity and are, most often at the same time, in a weight bearing position.
High muscle tone in the lower extremities is not an obstacle to stimulating control in a standing position.
In children with high muscle tone, in particular, weight bearing is a critical measure used to minimize and/or prevent the impact of orthopaedic issues such as hip subluxation/dislocation and contracture of the muscles in the lower extremities. The CME practitioner, therefore, does not shy away from the standing position, but rather uses it as a way to develop full trunk extension, while also working to properly align the child’s joints to the best of their capability in each exercise done with the child in a standing position.
A trial period is proposed to demonstrate the short term results of CME therapy.
Based on the findings of the initial CME assessment, 2 or 3 therapy goals are established and a trial period of 8 weeks of regularly scheduled CME sessions is proposed. If, following this trial period the goals are achieved, the family is advised to continue with CME therapy, otherwise they are encouraged to seek out other therapy options for their child. This is done in an effort to avoid the costly and disappointing cycle of endless therapy without results.