Episode 254 (Paleg, Pool, Hidalgo-Robles, Frumberg, Livingstone)

Where’s the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises. Paleg, Ginny PT, MPT, DScPT; Pool, Dayna PT, PhD; Hidalgo-Robles, Álvaro PT, MSc; Frumberg, David MD; Livingstone, Roslyn OT, MSc(RS); Damiano, Diane PT, PhD Open Access! https://journals.lww.com/pedpt/fulltext/9900/where_s_the_evidence__challenging_therapists_to.204.aspx 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are promoted as innovative neurorehabilitation methods for children with neurological disabilities, yet both rely on outdated reflex-hierarchical models rather than contemporary motor learning principles.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 non evidence-based methods.