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Where's the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek
Ginny Paleg1, Dayna Pool, Álvaro Hidalgo-Robles
1McMaster University, Hamilton, Ontario, Canada (Dr Paleg); School of Health Sciences, University of KwaZulu Natal, Durban, South Africa (Dr Paleg, Ms Livingstone); The Healthy Strides Foundation, Perth, Australia (Dr Pool); School of Allied Health, Curtin University, Perth, Australia (Dr Pool); Facultad de Educación, Universidad Internacional de La Rioja, Logroño, Spain (Mr Hidalgo-Robles); Department of Orthopaedics, Yale, School of Medicine, New Haven, Connecticut (Dr Frumberg); Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada (Ms Livingstone); National Institutes for Health Clinical Center, Bethesda, Maryland (Dr Damiano).
None:
Dynamic Movement Intervention (DMI) and Cuevas Medek Exercises (CME) are promoted as innovative neurorehabilitation methods for children with neurological disabilities, yet both rely on outdated reflex-hierarchical models rather than contemporary motor learning principles. A review of the literature reveals that CME, despite 5 decades of use, is supported only by a few case reports and 2 small, biased comparative studies. DMI, introduced in 2021, has no published empirical evidence beyond a single conference abstract. Thus, both interventions remain at Sackett Level 5-no evidence. The ethical implications are substantial. Families often pay thousands for intensive, noncovered therapies that may displace meaningful participation in education and social life. Therapists have a professional responsibility to avoid legitimizing unproven practices and to prioritize interventions supported by robust evidence. Pediatric rehabilitation should shift toward child-led, functional, and task-specific approaches grounded in modern motor learning science, with professional bodies and insurers withholding endorsement of nonevidence-based methods.
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