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CME®


Definition

CME®, the acronym for Cuevas Medek Exercises®, is a psychomotor therapy approach for infants suffering abnormal developmental motor evolution caused by a known or unknown non-degenerative syndrome affecting the Central Nervous System.

This therapy can be applied to children from the age of 3 months until they achieve and control independent walking. Because the CME® certified therapy practitioner needs to expose the infant to the influence of gravity, by providing progressive distal support, the use of this therapy may be limited by the child’s size and weight.

This approach was created and developed by Ramón Cuevas, Chilean kinesiologist, during the early seventies in Caracas, Venezuela.

The fundamental assumption of CME® Therapy is that developmentally compromised infants need to reinforce their natural recovery potential and activate their genetic code that could lead them into motor freedom. This underlying property of the Central Nervous System, continues to propel the developmental process even after the sequelae are established.

The natural reaction of the “recovery potential” alone, cannot lead the compromised child out of the abnormal motor developmental situation. Therefore it is crucial to begin motor therapy at the same time the first signs of delayed motor function appears. CME® assessment protocol allows the therapists to recognize immediately any signal of delayed motor condition between the age of four to eight months.

The final level of motor independence achieved by the motor delayed child will depend on the following facts:

1) The existence of brain’s recovery potential, resident on the 1.4% of exclusive human genetic material.
2) The early recognition of the motor developmental abnormality, using the CME® assessment.
3) The timely application of CME® Therapy.

Ramon Cuevas

Ramón Cuevas KGO/PT.
CME® Therapy creator.

Ramón Cuevas graduated Summa Cum Laude in Kinesiology (Physical Therapy) from the University of Chile in 1969, Santiago, Chile. In 1972, Ramón Cuevas began developing the CME® Therapy approach (formerly known as MEDEK® between the years 1973 to 2000), and culminates his creation in 1976, presenting a paper titled Método Dinámico de Estimulación Motriz (MEDEM®) at the 4th. International Congress of the American Association of Mental Deficiency, Washington University, Washington D.C, August 1976.

In 1973, Ramón Cuevas participated in the creation of the first Early Intervention Centre in Caracas, Venezuela. Ramón Cuevas has 43 years of experience in the assessment and treatment of children suffering of developmental motor delayed condition cause by a huge variety of diagnosis, except for those children suffering of a DEGENERATIVE NEURO-MUSCULAR DISEASE.

Currently Ramón Cuevas, is associated with his son Alexis Cuevas; Psychologist and a certified CME® Level V Instructor, with whom he teaches CME® courses around the world and has participated in CME® presentations in Chile, Venezuela, Argentina, Brazil, the United States of America, Canada, France, England and Belgium.

Alexis had a CME® Level I course in August 2014 in Sao José dos Campos, Brasil, which was a total success, with parents and students showing their happiness having participated in this life changing experience. In july 2015 the first CME® Level I regular course was done in Chile, the students had the opportunity to hear Ramón Cuevas present the first part of the CME® theory. Alexis continued with the 4 day course.

In August 2015, the first CME® level I tutorial course in Switzerland was dictated by Alexis Cuevas, those where 2 weeks of intensive CME® therapy with 2 students learning CME® therapy per week, the place chosen was the CHUV; Centre Hospitalier Universitaire Vaudois in Laussane. Recently in november 2015, the first CME® Level I course in Curitiba, Brazil was done. 17 students showed that independent of the work prior to the course, CME® actually makes the difference.

In 2000, Ramón Cuevas established the Cuevas Medek Exercise Continuing Education Program® (CMECEP®) in order to heighten the quality of the CME® therapy courses for professionals who work in pediatric rehabilitation.

Ramón Cuevas has published numerous articles and has participated in the publication of books for parents on the subject. Ramón Cuevas lives and practices in his centre in Santiago, Chile, and travels abroad to teach CME® courses personally, in order to share with the participants the most updated evolution of CME® therapy.

Characteristics

CME® Therapy:
1. Provokes the appearance of “absent automatic” motor functions, exposing the child to the influence of gravity force, by using progressive distal grasping and absorbing the emotional negative reactions. All the necessary stretching is done within the protocol of the exercise.
2. Child’s cooperation and motivation are not requisites in CME® Therapy.
3. Expose the child to the natural influence of the force of gravity with gradual progression to distal support.
4. Stretching maneuvers are integrated into the CME® Therapy.
5. High muscle tone condition in the lower extremities is not an obstacle to stimulate standing position control.
6. A trial period is proposed to demonstrate the short term results of CME® Therapy.

Exercises

CME® therapy is composed of more than 3000 exercises, each exercise represents a particular biomechanical challenge for the child.

Each therapy exercise demands an active response from the child and always the choice of the exercise is directly related to the child’s reaction potential. The “art” portion of CME® therapy depends on the ability of the CME® therapy practitioner to choose and apply the optimal sequence of exercises during the therapy session, in order to “provoke” new spontaneous postural-functional reactions.

The “science” portion of CME® therapy resides in the new responses emerging from the immature brain.

CME® therapy proposes a trial period of eight weeks of daily treatment in order to prove that the therapy program can help the child to progress. The main goal for these 8 weeks of treatment is to achieve at least three of the goals established at the CME® therapy assessment.

By using these three goals as a criteria, parents will have a concrete method to evaluate the effectiveness of the CME® therapy approach for their child. CME® Therapy is the only therapy approach committed to this standards of effectiveness.

The current CME® Therapy Manual shows 99 exercises, chosen from approximately 600 that compose the current total amount of exercises.

Contraindications

There are a few contra indications to using CME® therapy:

1. Any diagnosis of degenerative nature affecting the neuro-muscular tissue (progressive diseases).
2. Diagnosis of Osteogenesis Imperfecta.
3. Uncontrolled seizures.
4. Child younger than 3 months of age, except when the therapist in charge is CME® II or CME® III graduate.
5. To use this manual as a therapy guide, in disregard of the DISCLAIMER, by any Physical Therapist, Occupational Therapist or Psychologist, not in possession of a CME® diploma level I, level II or level III, awarded by the Cuevas Medek Exercises Continuing Education Program®, and signed by Ramón Cuevas and Alexis Cuevas.
6. To use the inserted information to treat a child without the advice of a CME® certified therapist.

On Down Syndrome

The next graphic illustrates the results obtained with 16 Down syndrome children stimulated with CME® Therapy by Ramón Cuevas in the Institute INVEDIN in Caracas, Venezuela, between 1973 and 1975, in which all of them began motor therapy from the ages of two to three months old. None of the children were affected by any heart correlated condition or any other complication, except for the Down syndrome clinic symptoms.

The average frequency of the CME® Therapy session was of 3 times per week (30 minutes per session) plus the home program exercises for the parents, recommended to be done once daily.

The collected data was done retrospectively in 1975, and it is not part of any scientific study to corroborate the efficacy of CME® Therapy, nevertheless it represents the objective and veritable results obtained in a small group of Down syndrome population treated with CME® Therapy during three years. Not all of the children began the treatment at the same time, but all of them started therapy between January 1973 and March 1974.

The dark line shows the standard normal curve of motor evolution along the first 2 years of age, which is universally accepted and fully demonstrated by different authors of developmental motor scales. The blue line illustrates the average motor evolution of a population of 40 Down syndrome children, which were treated with the conventional motor therapy approaches but not under the early stimulation concept.

This information for obtaining the average curve was collected from the files of the 40 children assisting to the special school of the Institute and all of them were older than 6.

The gray curve is the average motor evolution of the Down syndrome group treated with CME® Therapy and is clearly better than the curve of motor progress shown by the older Down syndrome children treated in the Institute before the implementation of CME® Therapy.

The final conclusion from this retrospective study was that early treatment produces a substantial motor progress in children with Down syndrome with positives effects in the other areas of the development process, and that the CME® Therapy also contributes to push the motor evolution curve closer to the normal one.