About Cuevas Medek Exercises

Before I continue posting videos, I thought I should talk a little bit more about this therapy, how it works, its premises, etc. I’ll share some of what I learned from Ramon and just put together what I learned from his site and other parents.

Back in the 70’s, Ramon was a regular physical therapist working in Venezuela. A couple of years into his practice, he was depressed because he felt the kids were not improving. Some did improve a little, but it was mostly as a result of age and time, not because of his efforts. So he decided to start experimenting with different exercises. He wondered what would happen if he “removed support” and challenged the kids to do more advanced exercises. What he found was very promising. After a few months, he was ready to share his findings with other therapists and CME began.

One of Ramon’s major findings was that the more he removed support to the child, the more the child’s brain would provide the necessary information for the child to do the work himself. So for example, if I give Nathan full support to sit up, his brain will rely on this support and will never give the command to his body to sit up on his own, without support. Same with balance. A child that has never needed to balance on his own will have difficulty balancing, because those motor pathways in the brain are not activated. Ramon’s exercises created situations where the brain had to provide this information to the child by necessity. He explained to me that children with brain injuries and neurological disorganization will often need stimuli in order to activate these neural pathways.

One of the main premises, and one of the most amazing things that I heard him say, is that every human being has the genetic imprints to do certain things by a certain time – by 3 months you roll, by 8 months you crawl, by 15 months you walk. That information is present even in the most brain injured individual. So Ramon decided to figure out a way to activate the data in those cells so that they become accessible to the brain’s command center. He explained to me that there is not much wrong with Nathan’s muscles. Of course they’ve atrophied a bit from lack of use, and he has general weakness. But the main problem is the brain is not giving the body the proper signals to hold his head up in the middle, to bear weight on his legs, etc. Removing support, making them pull up against gravity, creating a sharp “need” in the brain – he found these situations activated dormant cells and neural pathways. Then, with enough frequency and intensity, the brain would establish those pathways and they would become fully available to the child.

Ramon’s therapy is based on the principle of brain plasticity and neurological organization. He doesn’t like to use the term plasticity because plastic isn’t malleable – once a plastic is completed, it is stuck, fixed, unchangeable. He said the brain, on the other hand, is wonderfully malleable and constantly changing and organizing. So his job is to create situations to mold the brain to respond in a certain way to certain situations. He does each exercise 3-5 times, depending on the child’s response, to give the brain enough intensity for the stimuli to have an impact.

If the impact is repeated too often, then the brain shuts down and can’t assimilate the information. If the impact is too weak, then it doesn’t change. If he does the same exercise too many times, the brain “acclimates” to the stimuli and ceases to notice. So as one of its basic premises, CME keeps the brain activated and engaged during each session.

But I digress, let me return to the history. He created his series of exercises and called the therapy Medek. He was having such amazing success that he kept on creating exercises and improving and modifying his methods. Then in the year 2000 he changed the name from Medek to Cuevas Medek Exercises, or CME. He then created training seminars and a certification course to train other physical and occupational therapists how to do the same work.

Each medek exercise has a particular goal, but often, many goals are achieved with the same exercise. For example, one exercise may target trunk control, but it is done in such a way where the child also works on balance and head control. In some cases, the goal is standing and strengthening the knees, in another the thighs, in another the object may be balance. Ramon has over 900 exercises that he has created to stimulate kids at all levels and stages of development.

I witnessed the amazing variability and adjustability of his therapy. Ramon was like a magician. For example, he wanted to do an exercise called “horsey” with Nathan. He tried it one way and Nathan just wasn’t strong enough. So he then tried it a different way and got a better response. Then he added a wrap to give Nathan a bit more support and finally was able to evoke the desired response.

He explained to me that it is important for the therapist to be attuned with the child and to read the child’s signals very well. There is definitely an important rapport between the child and therapist and the child’s success depends entirely on the therapist or parent’s sense of security and certainty in the exercises. He explained that if a child doesn’t “kick in” in a particular exercise – it’s not his fault, ever – it’s the therapist’s fault. The therapist has to make sure he/she is doing the exercises right to evoke the correct response. This was KEY for us because we had been doing a home program that wasn’t very effective. We went through the motions of the exercises whether he kicked in or not. Now we know that if he’s not “activating” then we’re doing it wrong or have to try the same exercise a different way, or a different exercise.

Another benefit of the therapy is increased neurological organization. As these motor pathways start to be created and expanded, the brain achieves more functions. Kids start gaining better use of their hands, they start gaining better cognitive development. Ramon doesn’t claim that this is directly due to CME, but he does believe strongly that with improved neurological organization come many benefits.

He did tell me that his success ratio is about 75%. 3 out of 4 children will respond very well. 1 child will not respond. The level of success of the 3 kids that improve depends on many things of course. Some children can learn to walk completely normally, others continue to work on balance, others gain head and trunk control but may not be able to walk. This depends on the plasticity of the child’s brain, the age at which he/she started, whether a home program is followed, how many CME sessions the child does, etc.

Ok that is enough for now. I will write a few more posts as I remember things 🙂