<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2072-8174</journal-id>
<journal-title><![CDATA[Revista del Nacional (Itauguá)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Nac. (Itauguá)]]></abbrev-journal-title>
<issn>2072-8174</issn>
<publisher>
<publisher-name><![CDATA[Hospital Nacional (Itauguá)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2072-81742026000100303</article-id>
<article-id pub-id-type="doi">10.18004/rdn2026.e1800203</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Método Cuevas Medek Exercises en la rehabilitación funcional de la Leucomalacia Periventricular: reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Cuevas Medek Exercises in the functional rehabilitation of Periventricular Leukomalacia: case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Ponce]]></surname>
<given-names><![CDATA[Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oyarzún-Zapata]]></surname>
<given-names><![CDATA[Camila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barrera-González]]></surname>
<given-names><![CDATA[Darío Waldemar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Boostneurotherapy SPA  ]]></institution>
<addr-line><![CDATA[Santiago ]]></addr-line>
<country>Chile</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Autónoma de Chile Facultad de Ciencias de la Salud Carrera de Kinesiología]]></institution>
<addr-line><![CDATA[Talca ]]></addr-line>
<country>Chile</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>18</volume>
<fpage>303</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2072-81742026000100303&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2072-81742026000100303&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2072-81742026000100303&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La leucomalacia periventricular (LPV) constituye una lesión neurológica asociada a la prematuridad, con repercusiones en el control postural, la coordinación motora y la adquisición de habilidades motoras gruesas. Se presenta el caso de una paciente chilena de 4 años, nacida a las 31 semanas de gestación, con diagnóstico médico de LPV y retraso motor grave. La evaluación funcional se realizó mediante un tamizaje observacional del desarrollo psicomotor y la Pauta CME; no se aplicaron escalas funcionales estandarizadas. La kinesioterapia convencional había finalizado antes del inicio de CME. Durante el seguimiento continuaron la atención fonoaudiológica, con frecuencia semanal, y los controles oftalmológicos según requerimiento. Se desarrolló una intervención motora individualizada basada en Cuevas Medek Exercises (CME) durante 18 meses, con una frecuencia de una a dos sesiones semanales de 45 minutos. El puntaje de la Pauta CME aumentó de 33 a 65 puntos, correspondiente a una equivalencia interna de edad motora de 4,4 a 8,6 meses. Se registraron avances en control postural, sedestación, verticalización, bipedestación asistida e inicio de pasos con asistencia. Los hallazgos describen una evolución funcional favorable durante el periodo de seguimiento, pero el diseño de caso único, la maduración biológica, las intervenciones concurrentes y la ausencia de medidas estandarizadas impiden atribuir causalidad a CME. La madre otorgó consentimiento informado escrito para la intervención y el uso de imágenes y grabaciones con fines de publicación. Por tratarse de un reporte de caso único, los resultados tampoco pueden transferirse ni generalizarse a otros pacientes con LPV.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Periventricular leukomalacia (PVL) is a neurological lesion associated with prematurity, affecting postural control, motor coordination, and the acquisition of gross motor skills. We present the case of a 4-year-old Chilean patient, born at 31 weeks gestation, with a medical diagnosis of VVL and severe motor delay. Functional assessment was performed using observational screening of psychomotor development and the CME (Cuevas Medek Exercises) protocol; standardized functional scales were not used. Conventional physical therapy had ended before the start of CME. During follow-up, speech therapy continued weekly, and ophthalmological checkups were performed as needed. An individualized motor intervention based on the Cuevas Medek Exercises (CME) was implemented over 18 months, with one to two 45-minute sessions per week. The CME score increased from 33 to 65 points, corresponding to an internal motor age equivalence of 4.4 to 8.6 months. Improvements were observed in postural control, sitting, standing, assisted standing, and assisted stepping. The findings describe favorable functional evolution during the follow-up period, but 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 the use of images and recordings for publication. As this is a single-case report, the results cannot be extrapolated or generalized to other patients with periventricular leukomalacia (PVL).]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[leucomalacia periventricular]]></kwd>
<kwd lng="es"><![CDATA[Cuevas Medek Exercises]]></kwd>
<kwd lng="es"><![CDATA[rehabilitación neurológica]]></kwd>
<kwd lng="es"><![CDATA[desarrollo infantil]]></kwd>
<kwd lng="es"><![CDATA[función motora gruesa.]]></kwd>
<kwd lng="en"><![CDATA[periventricular leukomalacia]]></kwd>
<kwd lng="en"><![CDATA[Cuevas Medek Exercises]]></kwd>
<kwd lng="en"><![CDATA[neurological rehabilitation]]></kwd>
<kwd lng="en"><![CDATA[child development]]></kwd>
<kwd lng="en"><![CDATA[gross motor function.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Kung]]></surname>
<given-names><![CDATA[HC]]></given-names>
</name>
<name>
<surname><![CDATA[Mathews]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hoyert]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Strobino]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Guyer]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Annual summary of vital statistics: 2006]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2008</year>
<volume>121</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>788-801</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Khurana]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Shyamsundar]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Taank]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Periventricular leukomalacia: an ophthalmic perspective]]></article-title>
<source><![CDATA[Med J Armed Forces India]]></source>
<year>2021</year>
<volume>77</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>147-53</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barak]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Silberg]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Gerner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Eisenstein]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bardach]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Yissar]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Functional neurological symptom disorder: preliminary findings of factors associated with walking ability post integrative pediatric rehabilitation]]></article-title>
<source><![CDATA[J Pediatr Rehabil Med]]></source>
<year>2022</year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>433-46</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramires de Oliveira]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Fabris Vidal]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Developmental outcomes in a child with corpus callosum abnormalities and congenital heart disease after Cuevas Medek Exercises: a case report]]></article-title>
<source><![CDATA[Clin Case Rep]]></source>
<year>2021</year>
<volume>9</volume>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández-López]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández-Fidalgo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Geoffrey]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Stucki]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Cieza]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Funcionamiento y discapacidad: la clasificación internacional del funcionamiento (CIF)]]></article-title>
<source><![CDATA[Rev Esp Salud Pública]]></source>
<year>2009</year>
<volume>83</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>775-83</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Volpe]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurobiology of periventricular leukomalacia in the premature infant]]></article-title>
<source><![CDATA[Pediatr Res]]></source>
<year>2001</year>
<volume>50</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>553-62</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cha]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Na]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[HK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cystic periventricular leukomalacia worsens developmental outcomes of very-low-birth weight infants with intraventricular hemorrhage-a nationwide cohort study]]></article-title>
<source><![CDATA[J Clin Med]]></source>
<year>2022</year>
<volume>11</volume>
<numero>19</numero>
<issue>19</issue>
<page-range>5886</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Qi]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Teng]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mo]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Structural covariance alterations reveal motor damage in periventricular leukomalacia]]></article-title>
<source><![CDATA[Brain Commun]]></source>
<year>2024</year>
<volume>6</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>fcae405</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buvaneswarran]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[YL]]></given-names>
</name>
<name>
<surname><![CDATA[Liang]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Quek]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Active treatment vs expectant management of patent ductus arteriosus in preterm infants: a meta-analysis]]></article-title>
<source><![CDATA[JAMA Pediatr]]></source>
<year>2025</year>
<volume>179</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>877-85</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fort Vanmeerhaeghe]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Romero Rodriguez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rol del sistema sensoriomotor en la estabilidad articular durante las actividades deportivas]]></article-title>
<source><![CDATA[Apunts Med Esport]]></source>
<year>2013</year>
<volume>48</volume>
<numero>178</numero>
<issue>178</issue>
<page-range>69-76</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ueda]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Aravamuthan]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Pearson]]></surname>
<given-names><![CDATA[TS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dystonia in individuals with spastic cerebral palsy and isolated periventricular leukomalacia]]></article-title>
<source><![CDATA[Dev Med Child Neurol]]></source>
<year>2023</year>
<volume>65</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>94-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paleg]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Pool]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Hidalgo-Robles]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Frumberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Livingstone]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Damiano]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Where&#8217;s the Evidence? Challenging therapists to stop legitimizing dynamic movement intervention and cuevas medek exercises]]></article-title>
<source><![CDATA[Pediatr Phys Ther]]></source>
<year>2026</year>
<volume>38</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>138</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Landa]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gerner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Eisenstein]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Barak]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric functional neurological symptoms disorder: walking ability and perceived exertion post-pediatric rehabilitation]]></article-title>
<source><![CDATA[Int J Environ Res Public Health]]></source>
<year>2023</year>
<volume>20</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>1631</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
