Exploring the effectiveness of Cuevas Medek Exercises (CME) in paediatric populations: A systematic scoping review

Aims:
1. Define CME
2. Determine the therapeutic claims of CME
3. Identify the effects of CME
4. Outline the perceptions and beliefs surrounding CME
5. Investigate adverse events associated with CME.

Design:
Systematic scoping review.

Method:
A systematic search of eight databases (PubMed, ProQuest, Web of Science, CINAHL,
Medline, Cochrane Library, Embase, Google-Scholar), using pre-defined search-terms
was completed March 2024. Critical appraisal tools: MMAT and JBI. Relevant
quantitative and qualitative data were extracted, descriptively synthesised, thematically
analysed and reported following PRISMA-ScR guidelines.

Results:
From 238 records screened, 110 were included; 17 research articles/reviews and 93
grey literature items. Four case reports and a single non-randomised controlled trial
with poor methodological-quality ratings (20-40%) provided CME intervention and
reported associated outcomes.
CME was defined as intensive therapy intervention using specialised equipment to
prevent developmental delay in patients with various conditions, and claims to improve
motor skills, motor control, posture, gait, and mobility. There was a paucity of reporting
of adverse events from CME in the empirical literature.

Conclusion:
At the present time, there is a lack of high-quality evidence to support the effectiveness of CME.
Key practice points:
• Clinicians who continue to use CME without evidence of effectiveness, should work with researchers to establish evidence and transparently report adverse events to their registration body.
• Clinicians should meet their clinical practice obligations to utilise evidence-informed practice and share with parents, the lack of evidence for effectiveness of CME during shared decision-making conversations about treatment.