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Cuevas Medek Exercise (CME)

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About Cuevas Medek Exercise (CME)

Cuevas Medek Exercises, or CME, is a hands-on physiotherapy modality for infants and children with developmental delays. 


It’s a psychomotor physical therapy approach, which means that it focuses on the brain, its connection with the body, and neuroplasticity, which is the brain’s natural ability to recover and rebuild. 


The main feature of CME is that it makes the child work against gravity to develop automatic motor responses. A trained physiotherapist positions the child in a way that challenges them to react and adjust their bodies by themselves. Once the child develops the reactions and practices them, new neural connections are likely formed in the brain, increasing the chance of initiating the movements again. 


The goal of Cuevas Medek Eis to develop functional motor control and achieve maximum motor independence in sitting, standing, and walking. 

History of CME

CME was developed in Chile by Ramon Cuevas, who created the technique in 1972 and has been practicing it ever since. 


When Ramon began working in pediatric physical therapy, he found the common practices were lackluster. At the time, passive or facilitated exercises were the norm. Cuevas didn’t notice any motor improvement from his patients with these exercises; they weren’t learning new motor functions, they were just repeating what they had been shown. 


So, he developed Cuevas Medek Exercises to innovate pediatric physical therapy and rehabilitation by focusing on creating new motor functions. 


Fun fact: Well, the name Cuevas obviously comes from the founder… But MEDEK is an acronym for the Spanish phrase “Metodo Dinamico de Estimulacion Kinesica,” translated in English to “Dynamic Method for Kinesthetic Stimulation.”

How does CME work? 

Cuevas Medek Exercises focus on developing the child’s gross motor skills. It mainly puts the child into antigravity situations in order to provoke a response. 


The word provoke is important here – most typical physiotherapy facilitates a response. In CME, therapists position the child and wait for an active response from their brain. Repeating these exercises helps create the neural pathways for the child to develop these functional antigravity motor reactions. 


As the child repeats exercises and grows stronger, the physiotherapist will lower their level of support. For example, the therapist will initially support a standing child at the hips, then the knees, then the ankles. This is called “distal” support – moving support further down the limbs and away from the body as the child becomes stronger. 


The set of functional exercises integrate components of antigravity posture, range of motion, weight bearing, and stretching. In turn, this improves agility, flexibility, balance, and coordination in patients. 


If you really want to get the most out of CME, there are some keys to success, including: 


  • early intervention so muscles don’t weaken from lack of use

  • parents and caregivers continuing treatment exercises at home 

  • therapy intensive blocks, where the child has daily exposure to the exercises over 1-4 weeks

Who can benefit from Cuevas Medek Exercises? 

Any child who isn’t meeting their motor milestones can benefit from CME. At our Centre, CME works well for kids with:

  • Cerebral Palsy 

  • Global Developmental Delay

  • Spina Bifida 

  • Hydrocephalus 

  • Down Syndrome & other genetic disorders

  • Seizure disorders

  • Ataxia

  • Risk of motor delay due to premature birth and/or hypoxic brain injury


There’s a set of assessment exercises for children under 16 months which therapists can use to determine strengths, weaknesses, and use to develop a program. However, children of all ages and sizes can partake. There’s no size or weight limit, although some exercises are limited by size. 

Since the main factor is gravity, we want to make sure your kids are safe! Our therapists will only do what they are comfortable with, depending on their experience and relationship with the client.

What’s the difference between CME and DMI? 

While CME and DMI (Dynamic Movement Intervention) are similar in some respects, there is one key difference: 


DMI more frequently uses supports like Theratogs and AFOs, while CME challenges the child without them. 


Of course, we know that every kid is different and adjust each individual’s therapy program accordingly! We’re happy to offer both CME and DMI at the Canadian Centre for Development.

Trained by the Experts

Our entire physiotherapy team is personally trained by Simona DiMarchi – the most experienced CME trainer in the world. We are thrilled to share this modality with you.

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