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

Aims:<br/>1. Define CME<br/>2. Determine the therapeutic claims of CME<br/>3. Identify the effects of CME<br/>4. Outline the perceptions and beliefs surrounding CME<br/>5. Investigate adverse events associated with CME.<br/><br/>Design:<br/>Systematic scoping review.<br/><br/>Method:<br/>A systematic search of eight databases (PubMed, ProQuest, Web of Science, CINAHL,<br/>Medline, Cochrane Library, Embase, Google-Scholar), using pre-defined search-terms<br/>was completed March 2024. Critical appraisal tools: MMAT and JBI. Relevant<br/>quantitative and qualitative data were extracted, descriptively synthesised, thematically<br/>analysed and reported following PRISMA-ScR guidelines.<br/><br/>Results:<br/>From 238 records screened, 110 were included; 17 research articles/reviews and 93<br/>grey literature items. Four case reports and a single non-randomised controlled trial<br/>with poor methodological-quality ratings (20-40%) provided CME intervention and<br/>reported associated outcomes. <br/>CME was defined as intensive therapy intervention using specialised equipment to<br/>prevent developmental delay in patients with various conditions, and claims to improve<br/>motor skills, motor control, posture, gait, and mobility. There was a paucity of reporting<br/>of adverse events from CME in the empirical literature.<br/><br/>Conclusion:<br/>At the present time, there is a lack of high-quality evidence to support the effectiveness of CME.<br/>Key practice points:<br/>• 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.<br/>• 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.