NISE-Stim for Tone Modulation from Hypotonia to Spasticity and Dystonia

NISE-Stim 2B Certification

 

Deepen Your Skills in Tone Modulation
🔹 Be among the first to achieve Advanced NISE-Stim 2B Certification
Join me for this intensive 4-hour advanced training designed to expand your clinical expertise in tone regulation for children with complex neuromotor challenges.

💡 What You’ll Learn
Practical, evidence-based strategies to excite or dampen nerve activity for individualized outcomes:

Hypotonia & Weakness – Increase muscle activation and strength in severe hypotonia.
Spasticity & Dystonia – Modulate high tone and address mixed tone presentations with precision.
Postural Alignment – Apply advanced clinical reasoning for targeted muscle activation to support improved postural control and functional performance.

🔌 Who Should Attend
This advanced course is exclusively for therapists who have completed NISE-Stim 1. You may choose to take level 2A NISE-Stim for the trunk first or after this course.
👉 If you haven’t yet taken NISE-Stim 1, you may request access to the online course before registering.

Perfect for therapists seeking to expand their skills in tone modulation and spinal alignment using NISE-Stim.

🕐 Course Details
Date: Sunday, February 15, 2026
Time: 10:00 a.m. – 2:15 p.m. EST (New York)
• UK (London): 3:00 – 7:15 p.m.
• Berlin: 4:00 – 8:15 p.m.
• Mumbai: 8:30 p.m. – 12:45 a.m.
• Sydney: 2:00 – 6:15 a.m. (next day) 
Location: Live Online Hands-on Webinar on Zoom
Course Length: 4 hours

 

Requirements:

Stimulators: Covered models include Chattanooga Continuum, Empi Continuum, Cefar Rehab x2, Richmar Twin Stim IV, or Beurer EM49. If you have another stimulator, please know how to program it.

Electrodes: Two packs of 2x3.5" (5x8 or 5x10 cm) electrodes are required.
Attire: Wear exercise clothes suitable for hands-on practice.

Other Notes: Please avoid wearing lotion, as it may interfere with electrode adhesion.

Special Notes:
This is an interactive, hands-on course. Your video will be on for personalized guidance, and you’ll have the chance to explore the impact of various treatments on your own body during the session.

Don’t wait—register now! Space is limited for this advanced training. Secure your spot today and join us for an in-depth journey into NISE-Stim trunk techniques.

For questions contact me directly. Let’s keep advancing together!

You Will Get:

PDF of the presentation

Certificate of completion

Continuing Education Credits: This course has been approved for 4 contact hours by the following entities: Redefine Health Education, a recognized approval agency of the Physical Therapy Board of California. Courses approved by other state boards are likely to be accepted for licensure credit in other jurisdictions based on the regulations noted in the left side of this certificate. Please reach out to your state licensing board to confirm. If you have a specific question about your course or certificate, please direct your inquiry to info@redefinehealthed.com.

Courses approved by other state boards in the following jurisdictions are likely accepted for licensure credit based on the state regulation:

AL | AK | AR | CO | CT | DE | FL  GA | HI | ID | IN | IA | KS | KY | ME | MA | MI | MO | MT | NE | NH | NC | ND | OR | PA | RI | SC | SD | TN | UT | VT | VA | VI | WA | WI | WY

Please reach out to your state licensing board to confirm the currency and accuracy of this information. If you have a specific question about CEU approval for this course in your state, please direct your inquiry to info@redefinehealthed.com.

The following states are not pre-approved: AZ, CA, DC, LA, IL, MD, MN, MS, NM, NV, NY, NJ, OH, OK, TX, WV

Participants licensed in states not pre-approved may file for individual approval using the instructions on this document: https://docs.google.com/document/d/1uINVSr-O7xE95OLRA5FjLYeAB3BjwxfS/edit

 

Biography:

Gerti Motavalli is a pediatric physical therapist with over 40 years of clinical experience across Germany, India, and the United States. She is the co-developer of the NISE-Stim protocol (Non-Invasive Spinal Electrical Stimulation) designed specifically for children with neuromotor impairments such as Spina Bifida, cerebral palsy, spinal cord injury, and brachial plexus injury.

In collaboration with Dr. Gad Alon, a world-renowned expert in electrical stimulation, Gerti developed the first surface spinal electrical stimulation protocol for children, published in Child Neurology Open and presented at major conferences including the Pediatric Physical Therapy Conference (CSM 2020), the Spina Bifida World Congress (2023), and the International Functional Electrical Stimulation Society (IFESS) Conference in the UK (2024).

Gerti currently treats children both in person and virtually, and has trained hundreds of therapists worldwide in applying spinal stimulation safely and effectively. Her courses combine strong clinical reasoning with hands-on practice and real case demonstrations, making them highly practical and transformative for pediatric therapists.

 

Schedule:

 

10:00 AM - 11:00 AM Spasticity reduction: Lecture and Hands-On Practice

11:00 AM-12:00 PM Dystonia modulation: Lecture and Hands-On Practice

12:00 PM-12:15 PM Break

12:15-1:15 Hypotonia: Lecture and Hands-On Practice

1:15-2:15 Treatment of demonstration children

This schedule provides a comprehensive learning experience, allowing time for in-depth lectures, extended hands-on practice, and a dedicated Q&A session to address any remaining questions.

Program Objectives:
Upon completion of this advanced training, participants will be able to:

• Apply advanced stimulation techniques to reduce spasticity, modulate dystonia, and support improved postural control.
• Develop and implement individualized protocols for children with hypotonia to enhance motor unit recruitment, trunk stability, and functional strength.
• Integrate clinical reasoning with electrode placement skills to optimize tone modulation and postural alignment across complex neuromotor presentations.
• Demonstrate competency in clinical practice by observing and participating in treatment of children with spasticity, dystonia, and hypotonia.

 Articles about electrical stimulation in pediatrics:

Published specifically about this surface spinal electrical stimulation treatment Gerti Motavalli developed together with Dr. Alon

An Exploratory Electrical Stimulation Protocol in the Management of an Infant With Spina Bifida: A Case Report Gerti Motavalli, MPT1 , Jan J. McElroy, PT, PhD, PCS2 , and Gad Alon, PhD, PT3Ø  Search: Child Neurology Open Sage Pub Electrical Stimulation https://journals.sagepub.com/doi/pdf/10.1177/2329048X19835656

The application of functional electrical stimulation and noninvasive spinal cord electrical stimulation (transcutaneous spinal cord stimulation) protocols to a 6-month old infant with myelomeningocele has not been previously reported in the medical literature. The observed gradual development of previously absent sensory and motor responses in this infant was novel, surprising, and encouraging. Functional electrical stimulation and spinal cord electrical stimulation are well tolerated and have minimal, transient adverse events when applied to infants with spina bifida. The initial positive outcomes and safety of the novel application of electrical stimulation for this case infant provide a basis for further research into a new intervention approach which could enhance development for infants born with spina bifida.

 

Transcutaneous spinal cord stimulation (tSCS) is emerging as a promising non-invasive intervention for reducing spasticity in children, particularly those with cerebral palsy (CP) and spinal cord injury (SCI). Recent studies demonstrate both neuromodulatory benefits and improvements in motor control, making it a viable option for pediatric neurorehabilitation.

A 2023 pilot study by Shrivastav et al. (Transcutaneous Spinal Stimulation and Short-burst Interval Treadmill Training in Children with Cerebral Palsy: A Pilot Study, IEEE Transactions on Biomedical Engineering doi: 10.1109/TBME.2024.3522317) investigated the combination of tSCS with short-burst interval treadmill training in children with CP. The results showed sustained reductions in spasticity for up to 8 weeks post-intervention. These improvements were accompanied by enhancements in walking function, suggesting a dual benefit of the intervention.
 

Building on this, a 2024 study by the same group Shrivastav et al. Transcutaneous Spinal Stimulation and Short-Burst Interval Treadmill Training in Children With Cerebral Palsy: A Pilot Study, IEEE Transactions on Biomedic... >Volume: 72 Issue: 5 reinforced these findings. In this multi-session protocol, improvements in spasticity were consistently observed, further supporting the feasibility of integrating tSCS into pediatric therapy regimens.

An earlier controlled study by Solopova et al. (2017) Effects of spinal cord stimulation on motor functions in children with cerebral palsy, Neuroscience Letters, Volume 639, 3 February 2017, Pages 192-198 provided foundational evidence for spinal cord stimulation in children with spastic diplegic CP, reporting motor function improvements after stimulation at two spinal levels. EMG data confirmed decreased spastic responses post-stimulation.

In a broader review of tSCS application across age groups, Singh et al. (2023) Transcutaneous Spinal Stimulation From Adults to Children: A Review, Top Spinal Cord Inj Rehabil (2023) 29 (1): 16–32. https://doi.org/10.46292/sci21-00084 discuss how neuromodulatory principles effective in adults appear to translate well into pediatric populations, with similar reductions in spasticity and potential for motor recovery.

Although tSCS studies in pediatric SCI populations are still sparse, preliminary research
like Singh et al. (2024) Safety and Feasibility of Cervical and Thoracic Transcutaneous Spinal Cord Stimulation to Improve Hand Motor Function in Children With Chronic Spinal Cord Injury, Neuromodulation: Technology at the Neural Interface, Volume 27, Issue 4, June 2024, Pages 661-671 has confirmed its safety and feasibility in children with chronic SCI, laying groundwork for future clinical use.
 

Together, these studies signal a growing consensus: tSCS can safely reduce spasticity and enhance function in children, especially when combined with gait training or neurodevelopmental therapies.