Newest Treatments in Pediatrics Using Non-Invasive Spinal and Functional Electrical Stimulation 

NISE-Stim Certification Part1

by Gerti Motavalli

For PTs, PTAs, OTs

“This course content is not intended for use by any participants outside the scope of their license or regulation.”

Presented by: Gerti Motavalli, MPT
Date: Saturday June 7, 2025
Time: 10 a.m.- 2.15 p.m. EST (4 contact hours)

Course Location: Live online hands on course

Equipment Needed: E-stim unit and electrodes for hands on portion

(Chattanooga Continuum, Empi, Cerfar Rehab X2, TwinStim IV, Beurer EM49)

Course Cost: $US 250

Course Description:

This specialized course is designed for physical therapists and clinicians seeking the most advanced applications of Non-Invasive Spinal Electrical Stimulation (NISE-Stim) to enhance clinical outcomes in children with:

Spina bifida
Spinal muscular atrophy (SMA)
Spinal cord injuries
Brachial plexus paralysis
Cerebral palsy (CP)
Other neuromotor impairments

Course Highlights:
✔ Muscle Activation & Neuromodulation – Learn how NISE-Stim can be used to activate muscles and, with different parameters, dampen spasticity and dystonia.
✔ Functional Electrical Stimulation (FES) – Discover effective treatment strategies for improving trunk, upper, and lower extremity control.
✔ Muscle & Nerve Testing – Gain expertise in assessing muscle-nerve function and optimizing stimulation parameters.
✔ Hands-On Training & Clinical Videos – Participate in practical sessions and review real case studies to enhance your skills.

This course will provide step-by-step guidance on selecting optimal stimulation settings, refining treatment plans, and advancing therapy techniques for better patient outcomes.

Biography:Gerti Motavalli, PT, MPT
With 40 years of experience as a pediatric physical therapist, Gerti Motavalli, MPT, has worked in Germany, India, and the USA, specializing in neurological rehabilitation. In collaboration with Dr. Gad Alon, PhD, PT, she developed the first surface spinal electrical stimulation protocol in 2017 for children with Spina Bifida, published 2019 in Child Neurology Open.

Gerti has presented at the Spina Bifida World Conference (2023, Tucson, AZ) and international conferences in the UK and Germany. She trains therapists worldwide in NISE-Stim, expanding its use for children with Spina Bifida, cerebral palsy, SMA, and other motor impairments. Through in-person and online treatment, she continues to make spinal stimulation more accessible globally.

For more information, visit spinalstim.net.

Program Objectives:
1, Define Stimulation Parameters – Explain frequency, intensity, pulse duration, waveform, and pediatric-specific protocols.
2, Evaluate Electrical Stimulation in Pediatrics – Discuss benefits, limitations, contraindications, and clinical indications.
3, Explore Mechanisms of FES and Spinal Stimulation – Describe effects on the neuromuscular system, vascular function, skeletal development, and central nervous system.
4, Outline Nerve Conduction Testing – Provide steps for preparation, electrode placement, and result interpretation.
5, Detail NISE-Stim Protocols and Lower Spinal Stimulation – Explain electrode placement, settings, session duration, and progression for motor and sensory improvements.
6, Use NISE-Stim for Spasticity and Dystonia – Demonstrate protocols to reduce muscle tone and improve movement.
7, Guide Caregivers on Home Use – Provide clear instructions for safe and effective application.                                                  

 

 

Class Schedule (subject to change)

• 60 min – Electrical Stimulation Technology (electrical parameters, electrodes) and nerve-muscle testing
• 30 min – Hands-On Laboratory I: Sensory vs. muscle activation, twitch vs. sustained contraction, nerve excitability testing
• 30 min – Research
• 15 min – Break
• 60 min – Introducing NISE-Stim
• 30 min – Hands-On Laboratory II: Various placements and settings for surface non-invasive spinal cord stimulation
• 30 min – Functional Electrical Stimulation (FES)
  
  

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.

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.