a blog about raising a daughter with cerebral palsy and learning unexpected lessons along the way

Saturday, January 30, 2010

Growing Stronger with CME

Oia has been practicing CME (Cuevas Medek Exercises) since August. The moment I saw her engaged in this therapy, I was hooked and became an instant believer in this method of physical therapy. The method, or theory behind the exercises, makes total sense to me. In just 4 sessions of CME, we saw immediate results; noted not only by Rob and I but by both PT's who were initiating this therapy with Oia.

Oia has been receiving PT since she was 7 1/2 months old. Progress was sloooooow (or at least felt that way) for the first year of PT. Understandably so as it takes a lot to strengthen a body that has been weakened by cerebral palsy. We did a variety of weight bearing activities, core strengthening and muscle building exercises along with specific movements to help trigger Oia's protective responses (which she almost had none of). We realized how important these activities and skills were as they are the foundation for sitting, crawling, and walking and any other movement for that matter. However, once Oia began CME in August, she began to walk, with close supervision only, in just a matter of 3-4weeks. Granted, the new mobility came after a year of hard work and therapy that got her to that point but CME tapped into her central nervous system and quickly brought her mobility to the next level. I swear it felt instantly. I wanted to find a way to stand on top of the world, with the biggest megaphone I could find, and shout to all the world about this therapy. Really. The wonderful thing about CME is that it can be adapted for ALL abilities.

Currently, Oia gets PT 2x/wk. Each session is an hour of CME. It's very intense and orthotics are not worn during the sessions. The equipment is fairly simple but can be configured in many arrangements to target specific areas. Our biggest focus for Oia right now is to help her to stand as straight and tall as possible (left leg supports most of her weight). Her right knee/leg tends to bend inward, or cave in, because the right side of her hip is tilted below the left side of her hip. It's complicated but Oia is making subtle improvements to her stance.

The first video is Oia on what I call the double balance beam. It is set up to 'rock' back and forth with each step. This 'rock' creates a more challenging surface that forces her to shift weight evenly from side to side. The hand placement of the therapist determines the level of support for Oia; the lower the hand placement on Oia's legs means the less support she receives thus making Oia work harder to remain balanced. She tolerates this exercise well.

This exercise is another way to challenge Oia's weight shift and balance. The wobble board teeters with each step which again, forces Oia to make body corrections to remain balanced. Note the lower hand placement from our PT.

Last video is the same wobble board but in a stationary position this time. The board is placed on a tilt and covered with fabric that allows Oia's feet guide over the surface. Again, just another way to hone in on balance and weight shifts. You'll notice Oia's arms extended in front of her as she kind of jerks or catches herself when she feels her balance is in jeopardy. This 'catching' is exactly what we want to happen.

Way to go, Oia!

(I realize that there are many forms of therapy out there and what works well for one child may not necessarily work the same for another. I respect that. As a family searching for therapy, you have to do what 'feels right'. If, however, anyone is intersted in learning more about CME, you can start at www.cuevasmedek.com)


  1. I know another family who has done this therapy and seen great results.

  2. YEAH, Oia! She is such a doll! Even though they have very different skin and hair colors, her little face reminds me of Faith, when she was her age, so much. Something about their eyes and nose. She is perfectly adorable! So happy for you guys! I am not familiar with this but will be researching it. Very cool!

  3. I'm cryinglike a baby...so proud of you and Oia

  4. That is so awesome and she looks so proud of herself! That is such hard work and she is getting it!

  5. Great video, thanks for sharing. I have never heard of this, but will be researching it soon. It sounds like an amazing way to do therapy.

    You asked about advice for your daughter's upcoming surgery and I have been thinking back to Gracie's first surgery.

    Some basic, generic, advice that I have is to try to be caught up with housework, laundry and grocery shopping. I don't like to think about that when Gracie is recovering. Also, have some children's tylenol on hand. That is what we were always given for pain after surgery.

    I was not prepared for the wait that we had before the surgery. It felt like we say and waited forever, while the docs and nurses came and asked questions. If Oia has some favorite toys, blankets, or a Lovey, that might help pass the time.

    Also, ask if she is able to take something back into surgery with her. Gracie was able to take a blanket and her glow worm. It helped me to have something to give her to comfort her when they came and took her from me. That was the hardest part.

    Overall, surgery went well and we saw great results after the first surgery. She felt a lot heavier when we got to hold her in recovery and that shocked me. We were able to leave really soon after she woke up, which freaked me out, but all was well.

    She recovered quickly that first time. It seems that the older she gets, the harder it is for her to recover.

    I will be thinking of you and praying for a easy surgery and quick recovery. Good luck and let us know how it goes!

    Debbi, feel free to email if you have any more quetions!

  6. Wow. This is just amazing! I haven't heard of CME and am beyond interested. We just started PT with an NDT certified therapist. Is CME covered by insurance? I'm going to find out right away if there's a CME therapist in Utah.