Ginny Paleg, Dayna Pool, Álvaro Hidalgo-Robles, David Frumberg, Roslyn Livingstone, Diane Damiano
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Where's the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises.
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are promoted as innovative neurorehabilitation methods for children with neurological disabilities, yet both rely on outdated reflex-hierarchical models rather than contemporary motor learning principles.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.
期刊介绍:
Pediatric Physical Therapy is an indexed international journal, that publishes peer reviewed research related to the practice of physical therapy for children with movement disorders. The editorial board is comprised of an international panel of researchers and clinical scholars that oversees a rigorous peer review process. The journal serves as the official journal for the pediatric physical therapy professional organizations in the Netherlands, Switzerland, New Zealand, Canada, and the United States. The journal includes articles that support evidenced based practice of physical therapy for children with neuromuscular, musculoskeletal, cardiorespiratory and developmental conditions that lead to disorders of movement, and research reports that contribute to the foundational sciences of pediatric physical therapy, ranging from biomechanics and pediatric exercise science to neurodevelopmental science. To these ends the journal publishes original research articles, systematic reviews directed to specific clinical questions that further the science of physical therapy, clinical guidelines and case reports that describe unusual conditions or cutting edge interventions with sound rationale. The journal adheres to the ethical standards of theInternational Committee of Medical Journal Editors.