Cuevas Medek Exercises in the functional rehabilitation of Periventricular Leukomalacia: case report

Abstract

Periventricular leukomalacia (PVL) is a neurological condition associated with prematurity that affects postural control and motor coordination. We present the case of a 4-year-old female patient, born at 31 weeks’ gestation, with a medical diagnosis of PVL and severe motor delay. Functional assessment was performed using observational screening of psychomotor development and the CME Protocol. Conventional physical therapy was completed prior to the start of CME. Speech-language therapy (weekly sessions) and ophthalmological follow-ups continued. An individualized motor intervention based on Cuevas Medek Exercises (CME) was implemented over 18 months, at a frequency of one to two 45-minute sessions per week. The CME Protocol score increased from 33 to 65 points, corresponding to an internal motor age equivalence of 4.4 to 8.6 months. Progress was observed in postural control, sitting, sitting upright, assisted standing, and the initiation of assisted walking. The findings describe a favorable functional outcome; however, the single-case design, biological maturation, concurrent interventions, and the absence of standardized measures preclude attributing causality to CME. The mother provided written informed consent for the intervention and publication.