Ask an Expert Series: Questions and Answers on Cuevas Medek Exercise

Total Education Solutions (TES) created a question and answer series on our Instagram page called Ask an Expert. Our Physical Therapist, Cassie Rice, answered the most common questions regarding Cuevas Medek Exercise. Cassie Rice, PT, is a physical therapist who graduated with her doctorate degree from Bellarmine University in Louisville, KY in 2013. She worked in short-term rehab for two years before returning to pediatrics. She always loved pediatrics and enjoyed her internship experience in pediatric outpatient clinic. She has worked in pediatrics since 2016 and joined the TES Therapy team in Michigan in 2018. Last year, she received her certification in CME level one and she has been excited in launching the CME therapy program at TES. She loves to challenge and creatively inspire kids with her background in taking and teaching dance, her love for movement activities and creativity has been a huge passion in her career.

We compiled the questions and answers or you can click here to see the Q&A on our Instagram page!

Here is a short video of one of our CME patient’s experience at TES and his mom’s wonderful testimonial.

1. What is CME?

CME stands for Cuevas Medek Exercises. CME was developed by Ramon Cuevas in the 1970s. Medek meaning a dynamic method of motor stimulation. It is a treatment approach using a method of exercises that will provoke the automatic postural responses from motor delayed children. The exercises developed with the theory that the more distal support applied by the therapist over the child’s body segments, stronger functional antigravity reactions are provoked. This means the further from the center of the child’s body that we give support, the more their brain and body have to work and respond against gravity to provoke the responses for motor output; walk, stand, sit, etc.

The principles of each exercise to provide distal support, expose the body to gravity, to provoke automatic responses of functional-postural motor control and absent motor functions

2. Who could benefit from CME?

Children delayed in motor development due to neuro muscular limitations. This can include children with CP, Down’s syndrome, genetic chromosomal abnormalities, Rett syndrome, Pitt Hopkin’s, and many other diagnoses.

Delays in gross motor milestones including pushing up on tummy, sitting control or transition to sitting, rolling, crawling, standing, walking, etc.

Children should be evaluated to determine if CME is the right fit for them and reassessing progress with goals continues to be made with each session

3. How many sessions does a kid need and how long do they last?

Each kid will vary on sessions required due to progress and intensity. Models of intensity include 1-3/ week for a more traditional approach to daily intensive therapy for 1-3 weeks. Sessions are typically 45 minutes to 1 hour

4. What are your most rewarding experiences with a patient?

Every day is rewarding in CME. For children who CME is appropriate and are making progress, progress may be seen every day. Exercises that were hard the last session, they are completing consistently the next session, as CME teaches the brain and body to learn and do the work on their own. As a PT, I have a special love for when children are finally able to walk independently. It is such a major mobility milestone for PT and a major milestone for parents for independence in their child. Check out our CME video with Amy Crowder to see our most recent success story with a little one learning to walk with CME!

5. What type of motor problems could be treated with CME?

Neuro motor delays-Gross motor delays including head control, pushing up on tummy, sitting and transitions, rolling, crawling and walking…and many more!

6. How is CME part of Physical Therapy?

CME is a treatment approach that PTs can get certified in. There are levels of certification that increase the knowledge of exercises and approaches that can be used for CME sessions. CME has a specific assessment and exercises developed to follow the philosophy and technique for optimal results.

7. What happens during CME?

First session will be an assessment of placing a child in positions of gravity resistance and assessing the neuromotor response.

The following sessions will be repetitions of exercises (usually 3-5 reps of each) following the same principle of placing the child in gravity resistance and distal support with guiding movements and allowing the brain to automatically respond with neuromotor output.

Most assessment motor functions have multiple exercises to provoke motor development so each session may have similar or different exercises

8. Is CME only for children?

This is a good question I may pose to Ramon. He has worked with older children than many clinicians certified. The idea of automatic response is present throughout life, but often as adults the reactions are hard to provoke if not present. The exercises are tailored toward developmental goals typical for ages of children. However, the biggest reason for CME development specific for children is the handling and positioning techniques required limit by therapist size and strength to reach and support appropriately.

9. Do you use any type of equipment during CME?

Yes, there are specifically designed equipment that though simple in appearance has multi-functional uses to provided probably countless configurations for all the variety of exercises developed and still being developed by Ramon.  At our clinic and on our CME website you can see some of this equipment including wooden boxes/steps of different heights with notches designed for configurations with the wooden bar/board and a platform.

Please visit our CME page for more information on how our CME services can help your child thrive.