NISE-Stim Course for the Trunk (Level 2A)

and

NISE-Stim for Tone Modulation

from Hypotonia to Spasticity and Dystonia (Level 2B) 

NISE-Stim 2 Certification

by Gerti Motavalli, PT, MPT — Founder of NISE-Stim

Deepen Your Skills in Postural Correction

& Tone Modulation

🔹 Be among the first to achieve Advanced NISE-Stim 2 Certification
Join us for this comprehensive 8-hour, in-person training focused on advanced clinical strategies to improve posture, tone regulation, and functional outcomes in children with complex neuromotor challenges.

💡 What You’ll Learn
Advanced techniques for treating scoliosis, kyphosis, and lordosis
In-depth methods to excite or dampen nerve activity to:
• Increase muscle activation and strength in low-strength conditions (e.g., SMA, DMD) and severe hypotonia
• Modulate high tone in spasticity, dystonia, and mixed tone presentations
Clinical reasoning for targeted muscle activation and postural alignment

🔌 Who Should Attend
This course is exclusively for therapists who have completed NISE-Stim 1 (please request the online NISE-Stim 1 course if you haven't taken it yet) and want to expand their expertise in spinal stimulation for tone modulation and spinal alignment.

🕐 Course Details
Day: Sunday
Time: 8:00 a.m. – 5:00 p.m. (8 hours)

Day: Monday                                                                                            Time: 8:00 a.m. – 2.45 p.m. (6 hours)

Location: RISE Pediatric Therapy
4554 E Inverness Ave
C-1
Mesa, AZ 85206
Course Length: 14 hours, in-person

💰 Tuition
Early Bird: $660
Regular: $690

📧 Course Coordinator
Denise Labriola-Berry, PT, DPT, ATACP, CME II
Owner/Physical Therapist
Adaptive Movements Pediatric Therapy

Cell: 480-223-7736 or denisegetsampt@gmail.com

🔗 Learn more at: spinalstim.net
Follow on Instagram: @spinalstimgerti

This course is approved in FL which will most likely appove it for the following states as well:

AL | AK | AR | AZ | DC | CO | CT | FL  DE | GA | ID | IN | IA | KS | KY | ME | MA | MI | MO | MT | MD | MS | NM | 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. 

The following states are not pre-approved: TX, CA, MN, NJ, NV, NY, OH, OK, WV.

Participants licensed in states not pre-approved may file for individual approval by themselves.

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.

Program Objectives:

By the end of this 14-hours training, participants will be able to:

Adjust advanced NISE-Stim parameters for optimal clinical outcomes
Apply targeted stimulation protocols for lordosis, kyphosis, and scoliosis
Design treatment strategies for children with hypotonia (e.g., SMA, DMD)
Manage spasticity and dystonia using tone modulation techniques
Assess spinal alignment and trunk control to guide electrode placement
Practice hands-on with children presenting postural and tone-related conditions
Experience self-treatment to better understand patient response
Receive expert feedback to refine technique and clinical decision-making

                                                        

 

Class Schedule (subject to change)— Advanced NISE-Stim 2 Certification

 

Day 1 – Postural Correction & Advanced Setup (8 Hours)
8:00 – 9:30 AM
Lecture & Hands-On – Advanced E-Stim Adjustments
An in-depth session on how to fine-tune stimulation parameters for specific clinical goals using NISE-Stim. Includes guided hands-on application.

9:30 – 10:30 AM
Lecture & Hands-On – Lordosis
Learn and practice targeted stimulation strategies for improving trunk alignment and reducing excessive lumbar extension.

10:30 – 10:45 AM – Break

10:45 – 11:45 AM
Lecture & Hands-On – Kyphosis
Explore treatment techniques to improve upper trunk extension and correct postural collapse.

11:45 AM – 12:45 PM
Demo Treatment – Gerti Motavalli
Live demonstration treating lordosis and kyphosis, with discussion of stimulation parameters and patient setup.

12:45 – 1:15 PM – Lunch Break

1:15 – 2:30 PM
Lecture & Hands-On – Scoliosis
Comprehensive training on managing scoliosis using NISE-Stim. Learn to improve flexibility and alignment toward the midline.

2:30 – 3:30 PM
Demo Treatment – Gerti Motavalli
Live scoliosis treatment demo with clinical reasoning discussion.

3:30 – 3:45 PM – Break

3:45 – 5:00 PM
Hands-On – Trunk Alignment Practice with Children
Participants work directly with 4–5 children presenting with scoliosis, kyphosis, or lordosis to apply individualized trunk stimulation techniques.

Day 2 – Tone Modulation & Functional Control (6 Hours)
8:00 – 9:30 AM
Lecture & Hands-On – Hypotonia, SMA & Weakness
Learn how to activate low-tone muscles and improve endurance and function in children with SMA and generalized weakness.

9:30 – 10:30 AM
Lecture & Hands-On – Spasticity
Strategies to inhibit high tone and enhance voluntary movement control.

10:30 – 10:45 AM – Break

10:45 – 11:45 AM
Lecture & Hands-On – Dystonia
Techniques to reduce overflow, twisting, and co-contractions through precise inhibitory stimulation setups.

11:45 AM – 12:45 PM
Demo Treatment – Gerti Motavalli
Live tone modulation treatment showcasing stimulation adjustments and clinical reasoning.

12:45 – 1:15 PM – Lunch Break

1:15 – 2:15 PM
Hands-On – Tone Modulation with Children
Participants practice tone modulation techniques for spasticity, dystonia, and mixed tone presentations.

2:15 – 2:45 PM
Summary & Q&A
Review, discussion, and clinical insights to conclude the course.

Research:
Motavalli, Gerti, Jan J. McElroy, and Gad Alon. "An exploratory electrical stimulation protocol in the management of an infant with spina bifida: a case report." Child Neurology Open 6 (2019): 2329048X19835656.

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. https://doi.org/10.1109/TBME.2024.3522317
 

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

 

 

Please note that in the event of unforeseen circumstances, such as sudden severe illness or canceled flights, that prevent me from attending the course, I will refund the course fee in full. However, I cannot be held responsible for any additional expenses that participants may incur, such as travel or accommodation costs.