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 14-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
📅 Date: Monday, April 13, 2026
🕗 Time: 8:00 a.m. – 5:00 p.m.

📅 Date: Tuesday, April 14, 2026
🕗 Time: 8:00 a.m. – 2.45 p.m.

📍 Location: SMILE Therapy for Kids Vancouver
🏠 Address: 507, 233 Nelson’s Crescent, BC V3L 0E4, Canada

Sponsor: EZ Steps Physiotherapy Inc. (DBA: SMILE Therapy For Kids Vancouver)

Course Coordinator:
Chelsea Ezzy – Owner, Physiotherapist
📧 Email: info@smiletherapyforkidsvancouver.com
📞 Phone: +1 (604) 351-2720

Course Length: 14 hours, in-person

💰 Tuition
Early Bird: US $660
Regular: US $690
If you attended the Vancouver NISE-Stim 1 Course: US $500

🔗 More Information
🌐 Website: spinalstim.net
📸 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-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.

Holsheimer, J. (1995). Effectiveness of spinal cord stimulation parameters and configurations. Pain, 64(2), 211–219.
Demonstrated that optimized electrode configurations reduce unintended nerve activation and minimize discomfort, supporting safe parameter selection in SCS.

Isagulyan, E. (2020). Spinal cord stimulation in chronic pain: technical advances. The Korean Journal of Pain, 33(2), 99–111.
Reviewed advances in SCS technology and programming, concluding that adverse effects are rare when proper protocols are followed.

North, R.B., Kidd, D.H., Zahurak, M., James, C.S., & Long, D.M. (1993). Spinal cord stimulation for chronic, intractable pain. Neurosurgery, 32(3), 384–394.
Reported transient sensory side effects in early SCS systems but no long-term neurological harm with appropriate calibration and placement.

Oakley, J.C. (2002). Spinal cord stimulation: mechanisms of action. Pain Research & Management, 7(3), 137–149.
Outlined neuromodulatory mechanisms of SCS and reaffirmed its neurological safety within therapeutic parameters.

Pluijms, W.A., Slangen, R., van Kleef, M., Joosten, E.A., & Reulen, J.P. (2015). Evoked potential latency improvements with SCS for diabetic neuropathy. Neuromodulation, 18(2), 126–132.
Demonstrated improved neural conduction alongside pain relief, supporting both functional benefit and safety.

Prager, J.P. (2010). Mechanisms of action of spinal cord stimulation. Pain Medicine, 11(8), 1278–1285.
Confirmed that most SCS side effects are mild and transient, with no evidence of spinal cord damage under standard protocols.

Pediatric Applications
Bakr, S.M., Knight, J.A., Shlobin, N.A., et al. (2022). Spinal cord stimulation for adolescent chronic neuropathic pain: a systematic review. Neurosurgical Focus, 53(4), E13.
Found SCS to be generally well tolerated in adolescents, with complication rates comparable to adults.

Barišić, N., Nemir, J., Perković, R., et al. (2025). Neuromodulation outcomes of SCS in pediatric chronic pain. European Journal of Paediatric Neurology, 54, 186–192.
Reported significant pain reduction and functional improvements with no serious adverse events in pediatric patients.

Keller, A., Singh, G., Sommerfeld, J.H., & King, M. (2021). Noninvasive spinal stimulation enables upright posture in pediatric SCI. Nature Communications, 12, 5887.
Demonstrated safe use of transcutaneous spinal stimulation to improve posture and motor control in children with spinal cord injury.

Novikov, A., Maldova, M., Shandybina, N., & Shalmiev, I. (2023). First use of non-invasive SCS in children with SMA. Life, 13(2), 449.
Showed improved motor outcomes without reported side effects, supporting early neuromodulatory intervention in SMA.

Tyagi, P., Tsai, E., & Hankinson, T.C. (2015). Spinal cord stimulation for recurrent tethered cord syndrome in a pediatric patient. Journal of Neurosurgery: Pediatrics, 18, 105–108.
Case report demonstrating effective pain relief through carefully individualized SCS application.

Psychological & Quality-of-Life Effects
Cebalo, N., Cebalo, J., Budak, L., et al. (2025). TENS reduces anxiety in pediatric dental procedures. Dental and Medical Problems, 62(3), 419–426.
Demonstrated that non-invasive electrical stimulation can significantly reduce anxiety in pediatric populations.

Cheng, Y.C., Lee, J.H., Hsu, H.J., et al. (2022). Neuromodulation improves anxiety and sleep: a meta-analysis. Psychological Medicine, 52(2), 234–247.
Reported improvements in anxiety and sleep outcomes following non-invasive neuromodulation techniques.

Rajapakse, T., & Kirton, A. (2013). Non-invasive brain stimulation in children: emerging evidence. Developmental Medicine & Child Neurology, 55(8), 648–655.
Identified favorable safety profiles and improvements in mood and executive functioning in pediatric populations.

Selected Research on Pediatric SCS and Motor Function
Barišić, N., Nemir, J., Perković, R., & Frančić, M. (2025). Spinal cord stimulation–induced favorable neuromodulative outcomes in children. European Journal of Paediatric Neurology, 54, 186–192.
Reported significant motor recovery and pain relief with no adverse events in children with complex neuromotor conditions.

Ikoeva, G.A., Nikityuk, I.E., & Kivoenko, O.I. (2016). Motor rehabilitation in children with cerebral palsy using transcutaneous spinal stimulation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 4(4), 47–55.
Showed superior motor and postural improvements when spinal stimulation was combined with mechanotherapy.

Johnston, T.E., Smith, B.T., Oladeji, O., & Betz, R.R. (2008). Home cycling with functional electrical stimulation in pediatric SCI. Journal of Spinal Cord Medicine, 31(2), 215–222.
Supported home-based neuromodulation as a safe and effective adjunct to pediatric rehabilitation.

Karabay, İ., Doğan, A., Arslan, M.D., & Dost, G. (2012). Effects of FES on trunk control in diplegic cerebral palsy. Disability and Rehabilitation, 34(12), 1–7.
Demonstrated significant improvements in trunk stability and sitting balance.

Keller, A., Singh, G., Lucas, K., Borders, C., & Stout, D. (2024). Safety and feasibility of transcutaneous spinal stimulation in pediatric SCI. Journal of Pediatric Rehabilitation Medicine (In Press).
Reported improved hand function and motor control with no adverse events.

Mulcahey, M.J., & Betz, R.R. (1997). Functional electrical stimulation in pediatric spinal injury. Pediatric Physical Therapy, 9(3), 119–126.
Summarized a decade of research showing improved voluntary control and functional participation.

Triolo, R.J., Betz, R.R., Mulcahey, M.J., & Gardner, E.R. (1994). Functional neuromuscular stimulation in pediatric SCI. Spinal Cord, 32(10), 679–688.
Provided early framework for patient selection and safe application of neuromuscular stimulation.

Vissarionov, S.V., & Solokhina, I.Y. (2017). Non-invasive spinal stimulation in pediatric motor rehabilitation. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 5(4), 48–52.
Reported sustained improvements in motor coordination and voluntary control following non-invasive spinal stimulation.

 

 

Please note:
The course will be confirmed once the minimum number of participants is reached, four weeks before the start date. Please avoid making any travel arrangements before that time.

In the event of unforeseen circumstances—such as sudden severe illness or canceled flights—that prevent me from attending the course, the course fee will be fully refunded. However, I cannot be held responsible for any additional costs participants may incur, including travel or accommodation expenses.