Specific physiotherapy - Le Metayer

General overview

Michel Le Metayer obtained his state diploma as a masseur-physiotherapist in 1952. He carries out research on the rehabilitation of children with cerebral palsy and develops Motor Evolution Levels. In 1978, he founded APETREIMC (Association for the Therapeutic Education and Rehabilitation of Children with Cerebral Palsy). 
His book Rééducation Cérébro-Motrice du Jeune Enfant, Education Thérapeutique is considered as the reference in the field of neuromotor rehabilitation of cerebral-motor impaired children and taught to physiotherapists who specialize in working with his children, via the Institut de Motricité Cérébrale (Institute of Cerebral Motricity).

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Main objectives of the method
  • Improve motor function. For example, the therapist guides the child towards walking by following predefined and codified steps, starting from the lowest postures (toning the torso, crawling, then walking). To do this, especially during the first steps, he may use props such as splints. 

Specificities of the method

The levels of motor development were deduced from the motor skills observed by Le Metayer in humans, which are innate and not intended to disappear as the child grows older.
These motor acquisitions are disrupted in children with CP, and the role of the physiotherapist is to restore them. 

The main functions to be acquired are : 

  • the postural function, omnipresent in the organization of any movement.

  • the anti-gravity function, which ensures support, maintenance, recovery

  • the locomotion function: automatic running, crawling, turning over

 

For the acquisition of these functions, M. Le Métayer defines 12 levels of motor evolution (NEM) :

  • Dorsal decubitus 

  • Ventral decubitus: position of the sphinx 

  • Turns: back to stomach and stomach to back 

  • Reptation 

  • Position of the rabbit (kneeling): sitting on his buttocks and held by his hands. 

  • On erect knees: without hand support 

  • Sitting in beach position (position of the little siren): from rabbit position, sliding of the pool to the side 

  • Stable seating 

  • Position of the serving knight 

  • Squatting: with hand support, then without support 

  • Position of the bear: leaning on his hands and feet, the child raises his pelvis upwards. 

  • Four legs 

  • Passage to the standing position: often from the position of the serving knight 

  • Standing with support of both hands 

  • Standing with one-handed support 

  • Standing without support 

  • Walk

During a session, the therapist begins by helping the child to relax all his muscles. Then he tries to stimulate the child's reflexes according to his level of mobility. For example, for a child who does not move at all, he can use a boudin to strengthen his postural function. When learning to walk, the use of splints or gutters to guide the correct placement of the hips is possible.

Who is this method for ?

This method is specifically designed for children with cerebral palsy, hemiplegia, hemiparesis, cerebral motor disorders, etc.

What parents say about it

"In practice, the success of this approach is strongly conditioned by the involvement and character of the child. (https://enorev.fr/approche-therapeutique/methode-reeducation/)

Any remarks or comments ?

This work is based on a collaborative approach to sharing research and family experience.

If you have any comments, suggestions for modifications or corrections or clarifications to make, please let us know by email at contact@leneurogroupe.org