Newest Treatments in Pediatrics Using Surface Spinal and Functional Electrical Stimulation

NISE-Stim Certification Level 1

By Gerti Motavalli, MPT

Using non-invasive electrical stimulation in the treatment of children has proven to being safe and effective.It has been published in peer-reviewed publications by physical therapists and clinical researchers from around the world.

This 4 hour webinar is designed for clinicians interested in the most advanced application of non-invasive electrical spinal stimulation to maximize clinical outcomes in children with spinal bifida, spinal cord injuries, plexus paralysis and other neuromotor impairments. A portion of the course will focus on implementing the most effective treatment plans for improving gait, trunk control and upper extremity control through functional electrical stimulation. There will be instructions on testing muscle-nerve functioning, finding the best parameters for treatment and advancing treatment. “Hand’s On” sessions and videos of actual clinical cases will also be presented.

This is level 1 of the 3 part NISE-Stim (Non-invasive spinal electrical stimulation) Certification

NO PREVIOUS KNOWLEDGE OF ELECTRICAL STIMULATION IS NEEDED, BUT CLINICAL KNOWLEDGE IS NECESSARY!

A Chattanooga Continuum, EMPI Continuum, Twin Stim IV or Cefer Rehab X2 e-stim unit is strongly recommended for the course. That way the participants can practice on themselves or a partner using the lab segments provided. Participants outside the USA can buy a unit through my website, USA therapists can buy units trough Healthy You 

https://hyweb.com/gerti-pack/

Educational credits: 4 hours

This course is subcontracted to Redefine Health Education. RHE is a registered CE approval agency of the PT Board of California, a rule-approved CE provider of the PT Board of Florida (#50-32784), a licensed CE sponsor of physical therapy continuing education by the Illinois Department of Financial & Professional Regulation (IDFPR #216.000360), an approved CE provider of the PT Board of New Mexico, an approved CE provider of the PT Board of Oklahoma (#BAP202310010) and recognized by the New York State Education Department's State Board for Physical Therapy as an approved sponsor of PT/PTA continuing education. In addition to the aforementioned jurisdictions, courses approved by other state boards & APTA chapters will be accepted for licensure credit in all the jurisdictions listed on this webpage, pursuant to regulation: www.redefinehealthed.com/ceuinfo. If you have a specific question about CE credit for this course in your state, please direct your inquiry including the course title in which you are interested, to info@redefinehealthed.com.

BIOGRAPHY
Gerti Motavalli, MPT has worked for 40 years as a pediatric PT in Germany, India, and the USA. Together with Dr Gad Alon, PhD. PT, a world renowned researcher in the field of electrical stimulation, she developed the first surface spinal electrical stimulation protocol for children with Spina Bifida. The findings have been published in the research journal, Child Neurology Open and presented as a poster at the Pediatric Physical Therapy Conference (CSM) in the USA. Gerti Motavalli will be presenting a poster at the Spina Bifida World Conference in March, 2023 in Tucson, AZ, and presented at international conferences in Berlin Germany and Bath, UK in 2024. She now is treating children with Spina Bifida and other impairments in person and via online platforms across the world. Many of her previous course participants are successfully expanding the use of spinal electrical stimulation for patients with various central and peripheral impairments.

YOU WILL GET:

Recordings the webinar in 5 sections

PDF of the presentation

Muscle testing form

Treatment protocols

Certificate of completion

 

 

Schedule:

61 min: Electrical stimulation technology (electrical parameters, electrodes). What we must know about the stimulation systems.

30 min: Research Dr. Alon

33 min: Testing of muscle- nerve connection for upper and lower extremity with electrical stimulation

61 min: Introducing non-invasive spinal cord stimulation including treatment protocols and various placements and settings for spinal electrical stimulation

31 min: Functional Electrical Stimulation (FES) in sit to stand transitions and gait for children with various disabilities.

30 min: More treatment ideas, questions and answers

Program Objectives:
1, Describe the latest developments in non-invasive electrical stimulation, focusing on spinal electrical stimulation (SS) and functional electrical stimulation (FES) applied to the pediatric population.

2, Choose an advanced practice model to focus on patient- centered, personalized intervention.

3, Discuss templates for clinical decisions regarding screening, testing, and establishing outcome measures specifically tailored to the pediatric population.

4, Understand the most effective treatment plans for FES and SS.

Participants will be able to:
1. Explain the required stimulation parameters and appropriate protocols/procedures used in pediatrics.

2. Describe the advantages, limitations, contra-indications, and indications for the use of electrical stimulation in the management of pediatric patients.

3. Discuss the various mechanisms by which functional electrical stimulation and spinal electrical stimulation can affect the peripheral neuromuscular, peripheral vascular, skeletal as well as central nervous systems.

4. Select appropriate patients and implement surface spinal electrical stimulation in children with spina bifida or other neuromotor impairments.

5. Show (on a fellow participant) the application of 2 to 3 of the learned FES or Spinal stimulation protocols and procedures.

6. Advise caregivers how to properly use the stimulation at home in to achieve more effective and efficient outcome.   

 

Published articles about the use and safety of electrical stimulation with children

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, PT3

Child Neurology Open Volume 6: 1-6 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2329048X19835656 journals.sagepub.com/home/cno

Ø  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.

Other recent articles about spinal stimulation and functional electrical stimulation in pediatrics:

Goutam Singh, PT, PhD; Anastasia Keller, PhD; et al.
Safety and Feasibility of Cervical and Thoracic Transcutaneous Spinal Cord Stimulation to Improve Hand Motor Function in Children With Chronic Spinal Cord Injury. Neuromodulation 4/2023, https://doi.org/10.1016/j.neurom.2023.04.475

Kristin Girshin 1,2, Rahul Sachdeva, et al. Spinal Cord Neuromodulation to treat Cerebral Palsy in Pediatrics: POUNCE Multiside Randomized Clinical Trial 6/2023 Frontiers in Neuroscience, 10.3389/fnins.2023.1221809

James J. Laskin, Zeina Waheed,et al. Spinal Cord Stimulation Research in the Restoration of Motor, Sensory, and Autonomic Function for Individuals Living With Spinal Cord Injuries: A Scoping Review, Archives of Physical Medicine and Rehabilitation 2022;103: 1387-97, http://www.archives-pmr.org/

Parag N. Gad, Evgeniy Kreydin, Non-invasive Neuromodulation of Spinal Cord Restores Lower Urinary Tract Function After Paralysis, Frontiers in Neuroscience, doi: 10.3389/fnins.2018.00432

Samejima, S. Caskey, C. D. Inanici, F. Multisite Transcutaneous Spinal Stimulation for Walking and        Autonomic Recovery in Motor-Incomplete Tetraplegia: A Single-Subject Design. Phys Ther 2022;102: DOI10.1093/ptj/pzab228.

Anastasia Keller1,2, Goutam Singh 1,2, et al. Noninvasive spinal stimulation safely enables upright posture in children with spinal cord injury NATURE COMMUNICATIONS https://doi.org/10.1038/s41467-021-26026-z

Solopova IA, Sukhotina IA, Zhvansky DS, et al. Effects of spinal cord stimulation on motor functions in children with cerebral palsy. Neurosci Lett. 2017;639:192-198.

Krucoff MO, Rahimpour S, Slutzky MW, Edgerton VR, Turner DA. Enhancing Nervous System Recovery through Neurobiologics, Neural Interface Training, and Neurorehabilitation. Front Neurosci. 2016;10:584.

Gerasimenko Y, Gad P, Sayenko D, et al. Integration of sensory, spinal, and volitional descending inputs in regulation of human locomotion. J Neurophysiol. 2016;116(1):98-105.

Lee NG, Andrews E, Rosoklija I, et al. The effect of spinal cord level on sexual function in the spina bifida population. J Pediatr Urol. 2015;11(3):142 e141-146.

Sayenko DG, Atkinson DA, Floyd TC, et al. Effects of paired transcutaneous electrical stimulation delivered at single and dual sites over lumbosacral spinal cord. Neurosci Lett.2015;609:229-234.

Shideler, B.L., et al., Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension. J Neuroeng Rehabil, 2020.