1.
 It is a pediatric physiotherapy approach based on dynamic challenging exercises manually applied for children affected on their developmental motor functions.This approach provides very concrete guidelines to stimulate babies in a total safe way, starting from two months of age to many years after birth.
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2.
 C.M.E. therapy concept was created and developed by the physical therapist Ramon Cuevas.













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3.
 It is the acronym composed by the first letters in spanish of the phrase:
Metodo Dinámico de Estimulación Kinesica (MEDEK)
In english this sentence can be translated as "dynamic method for kinestetic stimulation".











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4.

  1. C.M.E. aims to provoke in children’s brain the automatic responses of postural and functional motor control.
  2. C.M.E. exposes body segments to gravity force influence.
  3. C.M.E. promotes the use of the maximum possible distal grasp on children’s body.
  4. C.M.E. challenges the children’s neuro-muscular system in order to force the appearance of non-obvious motor functions.
  5. C.M.E. integrates range of motion exercises into the global functional maneuver.
  6. High tone conditions is not a limitation to use C.M.E. therapy.
  7. During the C.M.E. session, children´s emotional irritability is a total acceptable reaction and should not be a negative factor for the goals of the therapy.

For C.M.E. therapy the child`s intellectual disabilities are not a limitation to use the exercises program.









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5.

Any degree of developmental motor delay caused by:

  • Cerebral palsy
  • Hypotonic condition
  • Motor-delayed condition caused by any non-degenerative desease.










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6.

The Assessment protocol was developed in 1972 by Ramon Cuevas as an important component of the original concept of C.M.E. exercises. During a four years period, this assessment was under experimental scrutiny as a curricular part of the research project A.R.Y.E.T. spanish acronym which stands for “high risk and early stimulation”. This project was sponsored by the Neumann foundation and the Clinic University Hospital in Caracas, Venezuela from 1977 to 1980.
The C.M.E. assessment format contains 41 items ranging from the most elemental head control reactions until basic deambulatory activities and balance control.

The C.M.E. Protocol describes the four possible scores for each item in full detail.











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7.
 After C.M.E. initial assessment, some specific goals of postural-functional motor progress are settled to be obtained during the “trial period” of eight weeks of regular treatment. Parents are encouraged to participate in the goals setting. Only if the goals are achieved, C.M.E. therapy should continue to be used, otherwise, parents need to look for other options of therapy in order not to spend time and resources in an endless therapy.













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8.

Therapy fluctuated from a minimum of 30 minutes to a maximum of 45 minutes. In small babies at the begining the sessions can be done only for 20 minutes. The ideal situation is to repeat the session twice a day with interval of 4 hours or more in between both sessions.

According to community resources that parents can get, their intervention can be reduced in a proportional scale with the therapist visits.












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9.
 First of all, parents should know that the only merit of any given therapy is the capacity to produce functional improvement of posture and movement in a short term basis, because the middle and the long term improvement relays mainly in the capacity of the child's brain to assimilate, to integrate and to reproduce the incoming information.

It is a scientific widely proved fact that the external stimuli acting over the sensory systems (proprioceptors), originates impulses which have a significant influence on the development of the brain. So Cuevas-Medek-Exercises therapy can be considered as an efficient "factory" of powerful external stimuli for the developmental delayed child's brain. The CME therapy program can drive the child's recovery potential to the maximum functional improvement, because in each exercise the child experiences new sensations through new postures and movements which he cannot do by himself neither through the conventional therapy exercises.











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10.

 For parents:

- Motor-functional assessment for developmental delayed children, to determine the current level of   motor evolution related to the chronological age.
- Set the short term goals to be achieved within the first 8 weeks of treatment with the CME therapy.
- Set up the immediate program of CME therapy to by applied personally by Ramon Cuevas (CME   therapy creator) for an intensive period of 2 weeks. The program is applied on a regular schedule of   two sessions of 45 minutes per day for the first 10 sessions. After that initial period of intensive   stimulation of 5 days in a row, and from day 6, the parents are carefully trained in the CME therapy   home-program. The latter program includes a video which illustrates in full detail each   recommended exercise.

For professionals:

- Special tuition for those therapists who are already graduated from courses level I and II, willing to   upgrade their knowledge and skills as C.M.E. practitioners.
- Consultations about the C.M.E. therapy program of any given patient under your care will be   answered within 48 hours.		 back