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 an intensive, 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
Gain advanced clinical tools and hands-on experience in:

Treatment of scoliosis, kyphosis, and lordosis
Neuromodulation techniques to either excite or dampen nerve activity for:

Enhancing muscle activation and strength in SMA and severe hypotonia
Reducing high tone in spasticity, dystonia, and mixed tone presentations
Clinical reasoning for targeted muscle activation and optimized postural alignment

🔌 Who Should Attend
This course is exclusively for therapists who have completed NISE-Stim 1 and wish to deepen their expertise in spinal stimulation for tone modulation and spinal alignment.
If you haven’t taken NISE-Stim 1 yet, you can request the online NISE-Stim 1 course to get started.

🕐 Course Details
Day: Saturday
Time: 8:00 a.m. – 5:00 p.m.

Day: Sunday
Time: 8:00 a.m. – 2.45 p.m.

Location: Believe Pediatric Physical Therapy, LLC
5450 Lake Howell Road
Winter Park, Florida 32792
📞 (407) 679-7837

Course Coordinators:
Dayna Brunette, MS, PT, C/NDT
Trevor MacLaren, MSPT, C/NDT
📧 office@believetherapy.com

💵 Course Fees
Early Bird Discount (until April 2, 2026): $660
Group Discount (3+ participants): $660
Regular Registration (after April 2, 2026): $690

🎓 Continuing Education Credits: 14 contact hours

Florida: Our organization is a rule-approved CE provider of the PT Board of Florida (# 50-54090).

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 | GA | HI | ID | IN | IA | KS | KY | ME | MA | MI | MO | MT | NE | NH | NC | ND | OR | PA | RI | SC | SD | 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@ceuapproval.com.

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

Participants licensed in states not pre-approved may file for individual approval using the instructions on this document.

🔗 Learn More
🌐 spinalstim.net
📸 Follow on Instagram: @spinalstimgerti

 

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-hour training, participants will be able to:

1.     Apply advanced NISE-Stim® concepts by integrating updated spinal electrical stimulation principles and recent clinical developments into treatment planning.

2.     Design targeted treatment strategies for kyphosis, scoliosis, lordosis, hypotonia, spasticity, and dystonia using condition-specific stimulation approaches.

3.     Demonstrate proficiency in practical application of NISE-Stim® through accurate electrode placement, parameter selection, and hands-on trunk-specific stimulation techniques.

4.     Perform advanced trunk assessment and clinical reasoning to identify structural and functional impairments and tailor individualized NISE-Stim® protocols.

5.     Improve postural alignment, stability, and functional motor outcomes through integration of spinal stimulation with positioning and movement-based strategies.

6.     Demonstrate clinical competence and confidence by observing, participating in, and reflecting on live treatments of children with complex neuromotor presentations, including spasticity, dystonia, and hypotonia.

                                                        

 

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.